Prostatitis and Male Pelvic Pain Syndrome

Wagenlehner, Florian M. E.; Naber, Kurt G.; Bschleipfer, Thomas; Brähler, Elmar; Weidner, W.

doi:10.3238/arztebl.2009.0175

Cited by 34 publications

(44 citation statements)

References 40 publications

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“…A recent review article summarizing the results of six chronic bacterial prostatitis studies showed that ciprofloxacin, administered as a single agent at a dose of 1 g day 21 for 4 weeks, results in eradication rates ranging between 63% and 77%. 42 The present study shows that in chronic bacterial prostatitis, the daily dosage of the fluoroquinolone is more crucial than the duration of therapy, as administration of the cumulative dose of 21 g of ciprofloxacin at the rate of 750 mg day 21 for 4 weeks, rather than 500 mg day 21 for 6 weeks, increased eradication rates from 62.35% to 77.32% and the total bacteriological success from 71.76% to 85.57%. In particular, increased eradication of Enterococci was observed in the Cipro-750 cohort.…”

Section: Discussionmentioning

confidence: 59%

Fluoroquinolone–macrolide combination therapy for chronic bacterial prostatitis: retrospective analysis of pathogen eradication rates, inflammatory findings and sexual dysfunction

Magri¹,

Montanari²,

Škerk³

et al. 2011

Asian J Androl

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We previously demonstrated the safety and efficacy of fluoroquinolone-macrolide combination therapy in category II chronic bacterial prostatitis (CBP). The aim of this study is to retrospectively compare the microbiological and clinical findings of two treatment schemes for CBP based on the combination of azithromycin (500 mg, thrice-weekly) with a once-daily 500-or 750-mg dose of ciprofloxacin (Cipro-500 or Cipro-750 cohort, respectively). Combined administration of azithromycin (1500 mg week 21 ) with ciprofloxacin at the rate of 750 mg day 21 for 4 weeks rather than at 500 mg day 21 for 6 weeks increased the eradication rates from 62.35% to 77.32% and the total bacteriological success from 71.76% to 85.57%. A significant decrease in pain and voiding signs/symptoms and a significant reduction in inflammatory leukocyte counts and serum prostate-specific antigen (PSA) were sustained throughout an 18-month follow-up period in both groups. Ejaculatory pain, haemospermia and premature ejaculation were significantly attenuated on microbiological eradication in both groups, but the latter subsided more promptly in the Cipro-750 cohort. In total, 59 Cipro-750 patients showed mild-to-severe erectile dysfunction (ED) at baseline, while 22 patients had no ED on microbiological eradication and throughout the follow-up period. In conclusion fluoroquinolone-macrolide therapy resulted in pathogen eradication and CBP symptom attenuation, including pain, voiding disturbances and sexual dysfunction. A once-daily 750-mg dose of ciprofloxacin for 4 weeks showed enhanced eradication rates and lower inflammatory white blood cell counts compared to the 500-mg dose for 6 weeks. Our results are open to further prospective validation.

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Section: Discussionmentioning

confidence: 59%

Fluoroquinolone–macrolide combination therapy for chronic bacterial prostatitis: retrospective analysis of pathogen eradication rates, inflammatory findings and sexual dysfunction

Magri¹,

Montanari²,

Škerk³

et al. 2011

Asian J Androl

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“…Finalmente, la muestra Nº 4 corresponde a los primeros 10 ml de volumen evacuado posterior al masaje. Este especimen probablemente incluye la secreción prostática que permanece en la uretra después del masaje (7,8) .…”

Section: Discussionunclassified

Masculino 49 años con tuberculosis prostática

Madrigal¹,

Zúñiga²

2013

RC_UCR-HSJD

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“…Chronic prostatitis/chronic pelvic pain syndrome (CP/ CPPS, NIH category III), is the most prevalent form of prostatitis, which is characterized by chronic pelvic pain without an infection of the urinary tract [1][2][3][4][5]. To date, the pathogenesis of CP/CPPS is also unclear.…”

Section: Introductionmentioning

confidence: 99%

“…To date, the pathogenesis of CP/CPPS is also unclear. Five different causes, including infection, detrusor-sphincter dysfunction, immunological dysfunction, interstitial cystitis and neuropathic pain, have been discussed [3,4]. According to the presence or absence of inflammatory cells in the expressed prostatic secretions (ePS), CP/CPPS is split into inflammatory CP/CPPS (category IIIa) and non-inflammatory CP/CPPS (IIIb).…”

Section: Introductionmentioning

confidence: 99%

A novel and simple approach to distinguish chronic prostatitis/ chronic pelvic pain syndrome IIIb from IIIa using virtual touch tissue quantification

Zheng

Mao

et al. 2011

Bosn J of Basic Med Sci

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Virtual touch tissue quantification (VTTQ) is a new, promising technique for detecting the stiffness of tissues. To evaluate the performance of VTTQ in discrimination between chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS) IIIa and IIIb, VTTQ was performed in 147 patients with clinical definite CP/CPPS. The shear wave velocity (SWV) at inner gland and outer gland was quantified by implementing an acoustic radiation force impulse. The performance of different ratios of SWV at outer gland and inner gland in discrimination between CP/ CPPS IIIa and IIIb was compared. CP/CPPS IIIb and IIIa was detected in 69 and 78 patients, respectively. The SWV values of outer gland in the patients with CP/CPPS IIIa were significantly greater than that of inner gland, while there were no significant difference between outer gland and inner gland in the patients with CP/CPPS IIIb. The area under the receiver operating characteristic curve for the ratio one (<1.5) of SWV at outer gland and inner gland to distinguish CP/CPPS IIIb from IIIa was 0.72, while it was 0.88 for the ratio two (<1.1). The diagnostic sensitivity, specificity and accuracy for CP/CPPS IIIb were 100%, 69.2%, 83.7%, respectively for the ratio one and 100%, 84.6%, 91.8%, respectively for the ratio two. These data suggested that CP/CPPS IIIa and IIIb have different SWV values in inner gland and outer gland, and VTTQ can effectively distinguish CP/CPPS IIIb from CP/CPPS IIIa using the ratio of SWV at outer gland and inner gland.

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Prostatitis and Male Pelvic Pain Syndrome

Abstract: The prostatitis syndrome is a complex condition with a tendency toward chronification. It is important, therefore, that the patient be fully informed about the diagnostic uncertainties and the possibility that treatment may meet with less than complete success.

Cited by 34 publications

References 40 publications

Fluoroquinolone–macrolide combination therapy for chronic bacterial prostatitis: retrospective analysis of pathogen eradication rates, inflammatory findings and sexual dysfunction

Fluoroquinolone–macrolide combination therapy for chronic bacterial prostatitis: retrospective analysis of pathogen eradication rates, inflammatory findings and sexual dysfunction

Masculino 49 años con tuberculosis prostática

A novel and simple approach to distinguish chronic prostatitis/ chronic pelvic pain syndrome IIIb from IIIa using virtual touch tissue quantification

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