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Prim Care 2010 Sep;37(3):547-63, viii-ix

Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA.

Prostatitis, one of the most common urological infections afflicting adult men, has recently been divided into 4 different categories based on the National Institutes of Health consensus classification: acute bacterial prostatitis, chronic bacterial prostatitis, chronic nonbacterial prostatitis and pelvic pain syndrome, and asymptomatic inflammatory prostatitis. Most patients with prostatitis are found to have either nonbacterial prostatitis or prostatodynia. Prostatitis poses an international health problem, with epidemiologic studies suggesting a worldwide prevalence of more than 10%. Read More

Prim Care 2010 Sep;37(3):527-46, viii

Duke Family Medicine Residency Program, Division of Family Medicine, Department of Community and Family Medicine, Duke University, DUMC 3886, Durham, NC 27710, USA.

Painful bladder syndrome or urologic chronic pelvic pain syndrome is a chronic condition that presents with lower urinary tract symptoms that include dysuria, urgency, frequent urination, and chronic pelvic pain. Diagnoses included in the painful bladder syndrome are interstitial cystitis and prostatodynia. The history, physical examination, and laboratory evaluation of patients with lower urinary tract symptoms are important in ruling out other diagnoses. Read More

Curr Urol Rep 2005 Jul;6(4):282-9

University of Tennessee, Memphis, Department of Obstetrics & Gynecology, 853 Jefferson Avenue, Memphis, TN 38103, USA.

Approximately 8 million prostatitis-related outpatient visits per year have been reported worldwide. Only a small percentage presents with bacterial prostatitis. Chronic pelvic pain syndrome/prostatodynia is a frustrating disease for patients and caregivers. Read More

J Endourol 2004 Apr;18(3):227-31

Department of Urology, Long Island Jewish Medical Center, New Hyde Park, New York 11040-1496, USA.

The clinical syndrome of chronic prostatitis ranges from well-defined chronic bacterial infections to poorly defined chronic pelvic pain syndrome (CPPS), previously referred to as "prostatodynia" or "abacterial prostatitis." Faced with the obscure nature of the disease, its protracted course, and the poor response to oral medication, urologists have considered alternative routes of drug administration. We review the indications and outcomes of local drug infiltration (intraprostatic antibiotic and zinc, intrasphincteric botulinum toxin A, pudendal nerve blocks) and discuss their potential use and benefit in the treatment of chronic prostatitis syndromes. Read More

Schmerz 2004 Apr;18(2):98-103

Medizinische Klinik I, Klinikum Saarbrücken gGmbH.

A significant number of pain syndromes to be found in all medical specialties, including pain therapy, can be ascribed to a group that according to the classification of the International Association for the Study of Pain (IASP) is referred to as "pain syndromes with dysfunctional etiology," or according to internal medical terminology as "functional somatic syndromes" (functional disorders), or based on psychiatric nomenclature as "somatoform disorders." Frequent syndromes exhibiting pain as the major symptom include fibromyalgia syndrome (FMS), irritable bowel syndrome (IBS), chronic pelvic pain (CPP), tension headache, chronic myoarthropathies of the masticatory system (MAP), and prostatodynia. It is important for practitioners of both somatic and psychosocial medicine to be aware of the terminology used in other fields and the frequency of comorbidities of the individual syndromes. Read More

Eur Urol 2003 Nov;44(5):546-8

Clinic of Urology, University Hospital of Zurich, Zurich, Switzerland.

Objectives: Prostatitis NIH IIIB is defined by chronic pelvic pain without evidence of inflammation in prostate secretions or ejaculate. The relations between chronic prostatitis and fertility are discussed controversially. In this context, we analysed fertility data of a well defined collective of patients with prostatitis NIH IIIB. Read More

Curr Urol Rep 2002 Aug;3(4):301-6

Department of Urology, University of Washington School of Medicine, Box 356510, Seattle, WA 98109, USA.

The new National Institutes of Health (NIH) consensus classification identifies chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) based on the presence or absence of leukocytes in expressed prostatic secretions (EPS), postprostatic massage urine (VB3), or seminal fluid analysis. The purpose of this review is to determine the effect of the new classification on the proportion of symptomatic patients diagnosed with inflammation. We compare and contrast the new consensus classification with the traditional classification of prostatitis syndromes, then review how these changes effect patient classification in our clinical practice. Read More

J Urol 2002 Apr;167(4):1768-73

Department of Psychiatry, University of Washington School of Medicine, Center for Health Studies, Seattle, Washington, USA.

Purpose: We assessed symptoms and health related quality of life in men who received prostatitis-prostatodynia diagnoses at primary care and urology visits, and compared those in whom pain-discomfort had versus had not resolved approximately 1 month later.

Materials And Methods: Telephone interviews were done with 357 men an average of 1 month after a prostatitis-prostatodynia diagnosis was made at a health maintenance organization visit. The interview included the National Institutes of Health Chronic Prostatitis Symptom Index, and pain and health related quality of life measures. Read More

World J Urol 2001 Jun;19(3):180-5

Department of Neurology, The Johns Hopkins University School of Medicine, Blaustein Pain Treatment Center, Baltimore, MD 21287, USA.

Chronic pelvic pain is a puzzling disease entity. The pathophysiological mechanisms of chronic pelvic pain are not clear and current treatment strategies are often not successful, leaving patients as well as health care providers frustrated. In a subgroup of patients with chronic pelvic pain (e. Read More

Minerva Urol Nefrol 2001 Mar;53(1):13-7

Andros Italia, Ferrara, Italy.

Background: The aim of this paper is to compare the activity of mepartricin vs placebo in male pain pelvic syndrome secondary to chronic nonbacterial prostatitis/prostatodynia.

Methods: Forty-two patients have been tested (mean age: 35 years; range 29-44), these proved affected by male pain pelvic syndrome secondary to chronic nonbacterial prostatitis/prostatodynia, and were randomized into 2 groups: the 1st treated with mepartricin 40 mg/die for 60 days, the 2nd with placebo (C vitamin 500 mg/die) for 60 days. The following patterns were examined: spontaneous and rectal examination pain, diurnal and nocturnal urinary frequency and prostatic volume. Read More

Curr Pain Headache Rep 2001 Feb;5(1):27-34

University of Alabama at Birmingham, 937 Zeigler Research Building, 619 19th Street South, Birmingham, AL 35233, USA.

Chronic pains typically evaluated by a urologist are discussed from the perspective of a non-urologist pain clinician. The pathophysiology of some pains is understood and so we believe the patient's symptoms: examples are cancer-related pain and recurrent urolithiasis. We treat these pains with traditional analgesics. Read More

Urologe A 2001 Jan;40(1):4-8

Urologische Universitätsklinik, Anna-Seiler-Haus, Inselspital, CH-3010 Bern.

The first step in adopting a practical approach to the management of patients with prostatitis lies in the realization that the etiology of the symptoms often remains unclear and the traditional etiologically based classification system is part of the problem and not the solution. This problem was recognized in 1995 by the National Institutes of Health Consensus Conference on prostatitis. It was suggested that the classification of this disease be changed. Read More

Sex Transm Infect 2000 Oct;76(5):398-9

Department of Genito-Urinary Medicine, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, UK.

Objective: To report on a small group of patients with chronic abacterial prostatitis/chronic pelvic pain syndrome treated with oral corticosteroids in order to suggest a hypothesis for a future randomised controlled trial.

Design: A retrospective, observational report.

Results: Three out of the four patients reported improvement in symptoms following steroid treatment. Read More

J Urol 2000 Nov;164(5):1554-8

Department of Urology, University of Washington School of Medicine, Seattle, Washington, USA.

Purpose: The new consensus classification considers the chronic prostatitis/pelvic pain syndrome (CPPS) based on presence or absence of leukocytes in the expressed prostatic secretions, post-massage urine or seminal fluid analysis. We compared classification based on evaluation of these 3 specimens to the traditional classification based on expressed prostatic secretion examination alone.

Materials And Methods: A prospective clinical and laboratory protocol was used to evaluate symptomatic patients who had no evidence of urethritis, acute bacterial prostatitis or chronic bacterial prostatitis. Read More

J Androl 2000 Sep-Oct;21(5):669-75

Division of Urology, Harbor-UCLA Medical Center, Torrance, California, USA.

The etiology of chronic pelvic pain syndrome (CPPS)/chronic prostatitis category III remains unknown. Whereas a subset of men respond to antimicrobial therapy, gram positive bacteria isolated from expressed prostatic secretions (EPS) are often considered to be commensal rather than pathogenic. We wished to study oxidative stress as a marker of tissue injury and response in EPS of men with CPPS to determine whether infection with gram positive bacteria is associated with increased oxidative stress. Read More

Tech Urol 2000 Sep;6(3):240-2

Division of Urology, Harbor-UCLA Medical Center, Torrance, California 90509, USA.

Purpose: Some men with chronic pelvic pain syndrome (CPPS) have evidence of bacteria in their prostatic fluid (expressed prostatic secretions [EPS]) detected by 16S rRNA techniques. In this study, we correlate presence of bacterial signal with response to therapy.

Materials And Methods: EPS and first voided urine (VB1) from 47 men with CPPS were analyzed by polymerase chain reaction (PCR) for bacterial signal using universal primers specific for bacterial 16S rRNA. Read More

Urology 1999 Dec;54(6):960-3

Institute for Male Urology, Encino, California, USA.

Objectives: The National Institutes of Health (NIH) category III chronic prostatitis syndromes (nonbacterial chronic prostatitis and prostatodynia) are common disorders with few effective therapies. Bioflavonoids have recently been shown in an open-label study to improve the symptoms of these disorders in a significant proportion of men. The aim of this study was to confirm these findings in a prospective randomized, double-blind, placebo-controlled trial. Read More

J Urol 2000 Jan;163(1):127-30

Department of Urology, Northwestern University Medical School, Chicago, Illinois, USA.

Purpose: The role of bacteria in the chronic pelvic pain syndrome (nonbacterial prostatitis and prostatodynia) is controversial and difficult to assess because the bacterial flora of the prostate is not well defined. Polymerase chain reaction (PCR) is a highly sensitive molecular method of bacterial detection. It confirms the sterility of tissue with a high level of confidence and detects small numbers of microbial agents that may represent pathogens. Read More

Int Surg 1998 Oct-Dec;83(4):347-9

Department of Surgery, Wausau Hospital, Wisconsin, USA.

There is almost a complete failure of the urological profession to study chronic prostate gland pain, which is its most common and difficult condition to manage. Variations in nomenclature for the disease include pelvic floor myalgia syndrome, chronic anxiety syndrome, prostatodynia, interstitial cystitis and abacterial prostatitis, so comparison of treatment populations is difficult. Over 50% of negative prostate biopsies being performed for PSA elevation show prostatitis lesions. Read More

Hinyokika Kiyo 1994 Jul;40(7):587-91

Department of Urology, Fujigaoka Hospital, School of Medicine, Showa University.

Seventeen patients with prostatodynia (chronic prostatitis-like syndrome) refractory to conventional medical treatment were treated with electric acupuncture at a low-wave frequency. All of them had had a complicated clinical course and pelvic hypertonicity. This therapy was administered to mitigate the congestion of pelvic circulation, especially around the prostate. Read More