Detection of Nanobacteria Infection in Type III Prostatitis

Zhou, Zhansong; Li, Hong; Shen, Xiaoxu; Rao, Xiancai; Jin, Xin; Lu, Gensheng; Li, Longkun; Xiong, Enqing; Li, Weibing; Zhang, Jiahua; Chen, Zhiwen; Pan, Jinhong; Song, Bo

doi:10.1016/j.urology.2008.02.041

Cited by 71 publications

(62 citation statements)

References 19 publications

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“…Low patient numbers may also have contributed to the lack of significance. More promising results were observed in a comparison of tetracycline hydrochloride vs placebo, with significant differences in NIH-CPSI scores and bacterial eradication rates; however, patient numbers were small (n = 48) [72]. Recent direct meta-analyses of these trials showed that antibiotics provide symptom improvement, but not at a significant level [63,64] Evidence from small (n = 20-105), randomised, comparative trials provides mixed support for using antibiotics in CP/CPPS, with significant differences from baseline in symptoms observed using levofloxacin [73], but not ciprofloxacin [74]; however, the ciprofloxacin study imposed a stringent significance threshold (P < 0.001)…”

Section: A-adrenergic Antagonistsmentioning

confidence: 98%

“…The quinolones, such as ciprofloxacin and levofloxacin, are considered the antibiotics of choice because of their favourable pharmacokinetic properties [9]. Another antibiotic agent, fosfomycin, achieves reasonable intraprostatic tissue levels and is active against extended-spectrum b-lactamase producing organisms; it can be considered in patients with multiresistant Gram-negative infections, based on susceptibility results and discussion with local microbiologists CP/CPPS Only three small-to-medium sized (n = 48-196), adequately designed RCTs, which assessed ciprofloxacin [53], levofloxacin [48], and tetracycline hydrochloride [72] vs placebo in patients with CP/CPPS, were identified. Although symptom improvement was observed, the ciprofloxacin study failed to show a statistical difference in NIH-CPSI total score from baseline to 6 weeks in a CP/CPPS population [53].…”

Section: A-adrenergic Antagonistsmentioning

confidence: 99%

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Diagnosis and treatment of chronic bacterial prostatitis and chronic prostatitis/chronic pelvic pain syndrome: a consensus guideline

Rees

Abrahams

Doble³

et al. 2015

BJU International

241

193

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ObjectivesTo improve awareness and recognition of chronic bacterial prostatitis (CBP) and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) among non-specialists and patients. To provide guidance to healthcare professionals treating patients with CBP and CP/CPPS, in both non-specialist and specialist settings. To promote efficient referral of care between nonspecialists and specialists and the involvement of the multidisciplinary team (MDT). Patients and MethodsThe guideline population were men with CBP or CP/CPPS (persistent or recurrent symptoms and no other urogenital pathology for ≥3 of the previous 6 months). Consensus recommendations for the guidelines were based on a search to identify literature on the diagnosis and management of CBP and CP/CPPS (published between 1999 and February 2014). A Delphi panel process was used where high-quality, published evidence was lacking. ResultsCBP and CP/CPPS can present with a wide range of clinical manifestations. The four main symptom domains are urogenital pain, lower urinary tract symptoms (LUTSvoiding or storage symptoms), psychological issues and sexual dysfunction. Patients should be managed according to their individual symptom pattern. Options for first-line treatment include antibiotics, a-adrenergic antagonists (if voiding LUTS are present) and simple analgesics. Repeated use of antibiotics, such as quinolones, should be avoided if there is no obvious symptomatic benefit from infection control or cultures do not support an infectious cause. Early use of treatments targeting neuropathic pain and/or referral to specialist services should be considered for patients who do not respond to initial measures. An MDT approach (urologists, pain specialists, nurse specialists, specialist physiotherapists, general practitioners, cognitive behavioural therapists/psychologists, and sexual health specialists) is recommended. Patients should be fully informed about the possible underlying causes and treatment options, including an explanation of the chronic pain cycle. ConclusionChronic prostatitis can present with a wide variety of signs and symptoms. Identification of individual symptom patterns and a symptom-based treatment approach are recommended. Further research is required to evaluate management options for CBP and CP/CPPS.

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Section: A-adrenergic Antagonistsmentioning

confidence: 98%

Section: A-adrenergic Antagonistsmentioning

confidence: 99%

Diagnosis and treatment of chronic bacterial prostatitis and chronic prostatitis/chronic pelvic pain syndrome: a consensus guideline

Rees

Abrahams

Doble³

et al. 2015

BJU International

241

193

View full text Add to dashboard Cite

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“…Of all chronic prostatitis of different types, chronic nonbacterial prostatitis (IIIa) or chronic prostatitis/chronic pelvic pain syndrome (IIIb) is the most common and accounts for about 95% of chronic prostatitis (18,19). Generally, chronic prostatitis is characterized by refractory pelvic or perineal pain without evidence of urinary tract infection, which is usually accompanied by bladder and urethra dysfunction.…”

Section: Discussionmentioning

confidence: 99%

P2X7 receptor mediates activation of microglial cells in prostate of chemically irritated rats

Zhang

Liu

et al. 2013

Int. braz j urol.

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Purpose: Evidence shows that adenosine triphosphate (ATP) is involved in the transmission of multiple chronic pain via P 2 X 7 receptor. This study was to investigate the P 2 X 7 and microglial cells in the chronic prostatitis pain. Materials and Methods: Rats were divided into control group and chronic prostatitis group (n = 24 per group). A chronic prostatitis animal model was established by injecting complete Freund's adjuvant (CFA) to the prostate of rats, and the thermal withdrawal latency (TWL) was detected on days 0, 4, 12 and 24 (n = 6 at each time point in each group). Animals were sacrificed and the pathological examination of the prostate, detection of mRNA expression of P 2 X 7 and ionized calcium binding adaptor molecule 1 (IBA-1) and measurement of content of tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) in the dorsal horn of L 5 -S 2 spinal cord were performed on days 0, 4, 12 and 24. In addition, the content of TNF-α and IL-1β in the dorsal horn of L 5 -S 2 spinal cord was measured after intrathecal injection of inhibitors of microglial cells and/or P 2 X 7 for 5 days. Results: The chronic prostatitis was confirmed by pathological examination. The expression of P 2 X 7 and IBA-1 and the content of TNF-α and IL-1β in rats with chronic prostatitis were significantly higher than those in the control group. On day 4, the expressions of pro-inflammatory cytokines became to increase, reaching a maximal level on day 12 and started to reduce on day 24, but remained higher than that in the control group. Following suppression of microglial cells and P 2 X 7 receptor, the secretion of TNF-α and IL-1β was markedly reduced. Conclusion: In chronic prostatitis pain, the microglial cells and P 2 X 7 receptor are activated resulting in the increased expression of TNF-α and IL-1β in the L 5 -S 2 spinal cord, which might attribute to the maintenance and intensification of pain in chronic prostatitis. INTRODUCTIONChronic prostatitis, a common urological condition in young and middle-age men, is caused by multiple etiological factors. Pain is a major presentation of chronic prostatitis (1). Previous studies focused on the pathological changes in the prostate, while the pathways related to neurotransmission and the regulatory mechanisms of chronic prostatitis pain have not been studied. Recent studies have identified the chronic prostatitis pain as a visceral referred pain, which is usually accompanied by the dysfunction of pelvic floor muscles. The prostate is innervated largely by the pelvic nerves arising from the L 5 -S 2 spinal cord (2,3). P2X7 receptor mediates activation of microglial cells in prostate of chemically irritated rats _______________________________________________ 277It has also been shown that the transmission and regulation of pain are associated with not only the neurons but the microglia and astrocytes (4,5). Studies also demonstrated that astrocytes and microglias may secrete pro-inflammatory cytokines such as tumor necrosis factors (TNF), interleukin-1 (IL-1), nerve growth fac...

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“…In tetracycline research, symptom improvement was represented when comparing with the control group by using such an agent for 12 weeks. However, a survey on quality of life was not sufficient [19]. In a randomized controlled research, levofloxacin was used for 6 weeks and it was compared with placebo [20].…”

Section: Monotherapymentioning

confidence: 99%

Recent trend of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) management

Lee

2017

Hanyang Med Rev

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Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common condition. However, many of the traditional therapies like monotherapy used in clinical practice fail to show efficacy. There is no one particular treatment to be recommended as monotherapy for CP/CPPS. The new concept of treatment which is 'UPOINT' is introduced. The major barrier in treating men with CP/CPPS is the heterogenous nature of this syndrome. In order to treat appropriately, the patient should be evaluated individually to assess the nature of symptoms. To evaluate patients with chronic urologic pelvic pain, a six-point clinical phenotyping system has been developed. The clinical domains are urinary symptoms, psychosocial dysfunction, organ specific findings, infection, neurologic/systemic, and tenderness of muscles, which produces the acronym 'UPOINT' . This clinical phenotyping system may provide a useful and clinically relevant framework for multimodal therapy for the treatment of CP/CPPS. However, the concept of UPOINT needs randomization, placebo or sham control studies to show verified treatment.

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Detection of Nanobacteria Infection in Type III Prostatitis

Cited by 71 publications

References 19 publications

Diagnosis and treatment of chronic bacterial prostatitis and chronic prostatitis/chronic pelvic pain syndrome: a consensus guideline

Diagnosis and treatment of chronic bacterial prostatitis and chronic prostatitis/chronic pelvic pain syndrome: a consensus guideline

P2X7 receptor mediates activation of microglial cells in prostate of chemically irritated rats

Recent trend of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) management

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