Leukocytes And Bacteria In Men With Chronic Prostatitis/Chronic Pelvic Pain Syndrome Compared To Asymptomatic Controls

Nickel, J. Curtis; Alexander, Richard B.; Schaeffer, Anthony J.; Landis, J. Richard; Knauss, Jill; Propert, Kathleen J.

doi:10.1097/01.ju.0000082252.49374.e9

Cited by 187 publications

(107 citation statements)

References 6 publications

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“…However, recent studies have demonstrated that the presence of bacteria in prostate has no relationship with symptoms 40 and that the presence of bacteria in prostatic secretions is identical in men with CP/CPPS and age-matched asymptomatic men. 41 The current body of medical literature is almost devoid of information pertaining to orgasmic dysfunction and orgasm-associated pain in men. The neurophysiology of the male orgasm is even less well understood than that of erection.…”

mentioning

confidence: 99%

Safety and efficacy of tamsulosin in the treatment of painful ejaculation: a randomized, double-blind, placebo-controlled study

Safarinejad¹

2006

Int J Impot Res

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mentioning

confidence: 99%

Safety and efficacy of tamsulosin in the treatment of painful ejaculation: a randomized, double-blind, placebo-controlled study

Safarinejad¹

2006

Int J Impot Res

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“…Confounding the diagnosis is the fact that up to 8% of men with presumed CP/CPPS and no history of positive urinary tract infections have positive prostate localization cultures. However, a similar number of asymptomatic men will have positive localization cultures as well [21].…”

Section: Diagnosismentioning

confidence: 99%

Pharmacotherapy strategies in chronic prostatitis/chronic pelvic pain syndrome management

Nadler

2010

Expert Opinion on Pharmacotherapy

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“…Therefore, infection has been commonly assumed by patients and clinicians alike to be the cause of the symptoms, both historically and to this day. In the Chronic Prostatitis Collaborative Research Network (CPCRN) study, using the 4-glass urine test for localization, men with CP/CPPS and asymptomatic controls showed almost identical numbers of bacteria isolated from urine, prostatic fluid, and post-prostate massage urine [5]. Eight percent of men had uropathogenic bacteria and roughly 70% had some form of bacteria in each group.…”

Section: Infectionmentioning

confidence: 99%

Proposed New Pathophysiology of Chronic Prostatitis/Chronic Pelvic Pain Syndrome

Cho

Min

2015

Urogenit Tract Infect

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The most common type of prostatitis is category III, also known as chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). The current National Institutes of Health definition of CP/CPPS includes genitourinary pain with or without voiding symptoms in the absence of uropathogenic bacteria, as detected by standard microbiological methods, or other identifiable causes such as malignancy. Many different etiologies and mechanisms of pathogenesis of CP/CPPS have been proposed with a suggested role for immunological, neurological, endocrine, and psychological factors. We examined the data supporting the role of each of these areas and also examined the possible interrelationship of these factors in producing the symptoms of CP/CPPS. Prostatitis types IIIa and IIIb are classified according to the presence of pain without concurrent presence of bacteria; however, it is becoming more evident that, although levels of bacteria are not directly associated with levels of pain, the presence of bacteria might act as the initiating factor that drives primary activation of mast-cell-mediated inflammation in the prostate. The gate control theory provides a neurologic basis for the influence of both somatic and psychological factors on pain. Acceptance of chronic pain as a diagnosis may be difficult for the clinician and patient, however it is an important concept in the care of CP/CPPS, which enables the use of pain-directed therapies. Management of CP/CPPS will remain challenging; however, this review provides a better understanding of the condition and improved management strategies based on the newest evidence and concepts available. Keywords: Prostatitis; Chronic pain; Physiopathology INTRODUCTIONChronic prostatitis/chronic pelvic pain syndrome (CP/ CPPS) is a condition of chronic pelvic pain in men [1]. It has been estimated that between 2% and 14% of men worldwide may have symptoms of CP/CPPS [2,3]. The diagnosis is made on the basis of symptoms of pain with or without voiding symptoms in the absence of other identifiable causes [4]. The etiology of symptoms in a given patient can be from many causes. Whether there are identifiable, repeatable patterns of causes of symptoms, or just individual patients with distinct individual phenotypes are unknown. Because CP/CPPS is a common condition associated with significant physical, mental, and social burden, the medical community has made tremendous efforts to understand the condition and improve management strategies. Despite these efforts, answers remain elusive. Robust tools to measure symptom severity Our improved understanding of the etiology and clinical phenotypes associated with CP/CPPS has made the condition less of a clinical enigma. Acceptance of clinical definitions (and classification system) and validated, reliable outcome questionnaire (the CP symptom index) has led to high-quality treatment evidenced from randomized placebo-controlled trials. This article is a very timely review of the topic and provides the clinician with an improved understanding of CP/CPPS a...

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Leukocytes And Bacteria In Men With Chronic Prostatitis/Chronic Pelvic Pain Syndrome Compared To Asymptomatic Controls

Cited by 187 publications

References 6 publications

Safety and efficacy of tamsulosin in the treatment of painful ejaculation: a randomized, double-blind, placebo-controlled study

Safety and efficacy of tamsulosin in the treatment of painful ejaculation: a randomized, double-blind, placebo-controlled study

Pharmacotherapy strategies in chronic prostatitis/chronic pelvic pain syndrome management

Proposed New Pathophysiology of Chronic Prostatitis/Chronic Pelvic Pain Syndrome

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