Management of Chronic Prostatitis/ Chronic Pelvic Pain Syndrome

Anothaisintawee, Thunyarat; Attia, John; Nickel, J. Curtis; Thammakraisorn, Sangsuree; Numthavaj, Pawin; McEvoy, Mark; Thakkinstian, Ammarin

doi:10.1001/jama.2010.1913

Cited by 238 publications

(172 citation statements)

References 59 publications

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“…previous exposure to a-blockers) and trial duration (1.5-6 months). A recent systematic review and network meta-analysis of a-blocker RCTs found significant differences vs placebo in total, pain, voiding and QoL NIH-CPSI scores [63]. However, another recent systematic review questioned the clinical significance of these reductions [64].…”

Section: A-adrenergic Antagonistsmentioning

confidence: 99%

“…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: 99%

See 1 more Smart Citation

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: 99%

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

show abstract

“…In total score of the NIH-CPSI, improved score between two groups was represented but its difference was not shown. In NIDDK-sponsored research, it was announced that ciprofloxacin was not superior to placebo [21]. In Meta-analysis for use of antibiotics [22], there was a research study that presented results that it may be clearly, individually effective, but not statistically and clinically.…”

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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“…(Package insert Flomax 2007; Package insert Rapaflo 2008). Alfuzosin's improved tolerability is largely attributable to its extended-release formulation, which prevents peaks in serum concentrations (Roehrborn et al, 2000) Aside from the robust data demonstrating benefit in men with BPH, these agents have an emerging role in other areas of urology including facilitating the passage of urinary caliculi, as an adjunctive treatment for chronic prostatitis, following ureteral stent placement, and also improving symptoms of overactive bladder in select patients (Anothaisintawee et al, 2011;Kaplan et al, 2006;Navanimitkul & Lojanapiwat, 2010;Singh et al, 2007). Use of 1 AR is limited outside the urological arena; however, some patients are undoubtedly still taking them for treatment refractory hypertension.…”

Section: Introductionmentioning

confidence: 99%

Pathophysiology and Pre-Operative Evaluation of Patients at Risk for Intraoperative Floppy Iris Syndrome (IFIS)

Cantrell¹,

Bream-Rouwenhorst²,

Oetting³

2013

Cataract Surgery

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Management of Chronic Prostatitis/ Chronic Pelvic Pain Syndrome

Cited by 238 publications

References 59 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

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

Pathophysiology and Pre-Operative Evaluation of Patients at Risk for Intraoperative Floppy Iris Syndrome (IFIS)

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