Evidence for Overlap Between Urological and Nonurological Unexplained Clinical Conditions

Rodriguez, Marisela; Afari, Niloofar; Buchwald, Dedra

doi:10.1016/j.juro.2012.11.019

Cited by 101 publications

(68 citation statements)

References 49 publications

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“…Second, the behavioral and molecular changes resulting from NMS are largely due to dysregulation of the HPA axis [15][16][17][18] , suggesting that the effect is centrally-mediated and could have comorbid results, including changes in anxiety-and/or depression-like behaviors and increased sensitivity in other pelvic organs or more distant locations. This comorbid phenotype is indicative of what is commonly seen clinically and may be more representative of CP/CPPS patients as a whole 5,[28][29][30][31]42 . Third, based on these changes occurring as a result of HPA axis dysregulation, the impact of stress should be of utmost concern during both the NMS procedure and later behavioral testing and in vitro analysis.…”

Section: Discussionmentioning

confidence: 91%

“…Patients with CP/CPPS report pain in the perineum, rectum, prostate, penis, testicles, and/or abdomen 28 , experience a higher degree of psychological stress than control patients 29 , and commonly present with symptoms of or are diagnosed with comorbid chronic pelvic pain or mood disorders 5,[29][30][31] . Recurrent infection, leaky epithelium, neurogenic inflammation, and autoimmunity have all been surmised as potential underlying causes of CP/CPPS 2,32,33 , as well as mast cell activation and degranulation 34 .…”

Section: Introductionmentioning

confidence: 99%

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Assessment of Perigenital Sensitivity and Prostatic Mast Cell Activation in a Mouse Model of Neonatal Maternal Separation

Fuentes

Pierce

O’Neil

et al. 2015

JoVE

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Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) has a lifetime prevalence of 14% and is the most common urological diagnosis for men under the age of 50, yet it is the least understood and studied chronic pelvic pain disorder. A significant subset of patients with chronic pelvic pain report having experienced early life stress or abuse, which can markedly affect the functioning and regulation of the hypothalamicpituitary-adrenal (HPA) axis. Mast cell activation, which has been shown to be increased in both urine and expressed prostatic secretions of CP/ CPPS patients, is partially regulated by downstream activation of the HPA axis. Neonatal maternal separation (NMS) has been used for over two decades to study the outcomes of early life stress in rodent models, including changes in the HPA axis and visceral sensitivity. Here we provide a detailed protocol for using NMS as a preclinical model of CP/CPPS in male C57BL/6 mice. We describe the methodology for performing NMS, assessing perigenital mechanical allodynia, and histological evidence of mast cell activation. We also provide evidence that early psychological stress can have long-lasting effects on the male urogenital system in mice. Video LinkThe video component of this article can be found at

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Section: Discussionmentioning

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Assessment of Perigenital Sensitivity and Prostatic Mast Cell Activation in a Mouse Model of Neonatal Maternal Separation

Fuentes

Pierce

O’Neil

et al. 2015

JoVE

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“…Patients with CP/CPPS and “central pain” syndromes, such as fibromyalgia or chronic fatigue syndrome, often present with similar or overlapping symptoms. Therefore, it has been suggested to view and treat CP/CPPS as another “central pain” syndrome instead of a prostatic disease (3, 31). Interestingly, data from intervention trials and meta-analyses suggest that exercise may reduce severity of symptoms associated with several “central pain” related syndromes and exercise is often included in the management of fibromyalgia or chronic fatigue syndrome (4, 14, 36, 38).…”

Section: Discussionmentioning

confidence: 99%

Physical Activity and Chronic Prostatitis/Chronic Pelvic Pain Syndrome

Zhang

Chomistek²,

Dimitrakoff

et al. 2015

Medicine &Amp; Science in Sports &Amp; Exercise

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Purpose Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a prevalent urologic disorder among men, but its etiology is still poorly understood. Our objective was to examine the relationship between physical activity and incidence of CP/CPPS in a large cohort of male health professionals. Methods We conducted a prospective cohort study among men in the Health Professionals Follow-up Study followed from 1986 to 2008. The study population included 20,918 men who completed all CP/CPPS questions on the 2008 questionnaire. Leisure-time physical activity, including type and intensity of activity, was measured by questionnaire in 1986. A National Institute of Health Chronic Prostatitis Symptom Index pain score was calculated based on the responses on the 2008 questionnaire. Participants with pain scores ≥ 8 were considered CP/CPPS cases (n=689). Results Higher leisure-time physical activity was associated with lower risk of CP/CPPS. The multivariable-adjusted odds ratio (OR) comparing >35.0 to ≤3.5 MET-h/wk of physical activity was 0.72 (95% confidence interval (CI): 0.56, 0.92, p for trend <0.001). Observed inverse associations between physical activity and CP/CPPS were similar for both moderate- and vigorous-intensity activities. Sedentary behavior, measured as time spent watching television, was not associated with risk of CP/CPPS (p for trend 0.64). Conclusions Findings from this study, the first large scale and most comprehensive study to date on this association, suggest that higher levels of leisure-time physical activity may lower risk of CP/CPPS in middle-aged and older men.

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“…Indeed, the overlap observed between OAB and IBS might reflect the existence of a common pathophysiology 83,94 , although the nature of the underlying mechanisms has not been examined. Various reports in the literature suggest the existence of overlap between OAB and some of the more commonly recognized central sensitization syndromes 36,41 , including IBS 77,92,94,120,121 , fibromyalgia 122–126 , and idiopathic back pain 127 . According to population data, over one-third of Japanese women with OAB have concomitant IBS, as defined by Rome criteria 128 , whereas American women are more likely to report a diagnosis of IBS if they have more severe storage-type lower urinary tract symptoms 120 .…”

Section: Current Evidencementioning

confidence: 99%

Does central sensitization help explain idiopathic overactive bladder?

et al. 2016

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The pathophysiological mechanisms underlying overactive bladder syndrome (OAB) can include dysfunction of sensory pathways of the peripheral and central nervous systems, resulting in bladder hypersensitivity. Central sensitization describes an induced state of spinal hypersensitivity that is associated with a variety of chronic pain disorders that share many attributes with OAB, albeit without the presence of pain. As such, the concept of central sensitization might be relevant to understanding the mechanisms and clinical manifestations of OAB syndrome. An understanding of the pathophysiology and clinical manifestations of central sensitization, and the evidence that supports a role of central sensitization in OAB, including the potential implications of mechanisms of central sensitization for the treatment of patients with OAB could provide a novel approach to the treatment of patients with this disease. Such an approach would be especially relevant to those patients with central sensitization-related comorbidities, and has the potential to improve the outcomes of these patients in particular.

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Evidence for Overlap Between Urological and Nonurological Unexplained Clinical Conditions

Cited by 101 publications

References 49 publications

Assessment of Perigenital Sensitivity and Prostatic Mast Cell Activation in a Mouse Model of Neonatal Maternal Separation

Assessment of Perigenital Sensitivity and Prostatic Mast Cell Activation in a Mouse Model of Neonatal Maternal Separation

Physical Activity and Chronic Prostatitis/Chronic Pelvic Pain Syndrome

Does central sensitization help explain idiopathic overactive bladder?

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