Michel Pontari1, Laura Giusto. 1. Temple University Hospital, Department of Urology, Philadelphia, Pennsylvania, USA.
Abstract
PURPOSE OF REVIEW: To describe new developments in the diagnosis and treatment of chronic prostatitis/chronic pelvic pain syndrome (CPPS). RECENT FINDINGS: Symptoms in men with chronic prostatitis/CPPS appear to cluster into a group with primarily pelvic or localized disease, and a group with more systemic symptoms. Several other chronic pain conditions can be associated with chronic prostatitis/CPPS, including irritable bowel syndrome, fibromyalgia, and chronic fatigue syndrome. Markers of neurologic inflammation and autoimmune disease parallel changes in symptoms after treatment. Treatment options include new alpha-blockers, psychological intervention, and prostate-directed therapy. The areas of acupuncture and pelvic floor physical therapy/myofascial release have received increased recent attention and appear to be good options in these patients. Future therapy may include antibodies to mediators of neurogenic inflammation and even treatment of bacteria in the bowel. SUMMARY: The diagnosis of chronic prostatitis/CPPS must include conditions traditionally outside the scope of urologic practice but important for the care of men with chronic pelvic pain. The treatment is best done using multiple simultaneous therapies aimed at the different aspects of the condition.
PURPOSE OF REVIEW: To describe new developments in the diagnosis and treatment of chronic prostatitis/chronic pelvic pain syndrome (CPPS). RECENT FINDINGS: Symptoms in men with chronic prostatitis/CPPS appear to cluster into a group with primarily pelvic or localized disease, and a group with more systemic symptoms. Several other chronic pain conditions can be associated with chronic prostatitis/CPPS, including irritable bowel syndrome, fibromyalgia, and chronic fatigue syndrome. Markers of neurologic inflammation and autoimmune disease parallel changes in symptoms after treatment. Treatment options include new alpha-blockers, psychological intervention, and prostate-directed therapy. The areas of acupuncture and pelvic floor physical therapy/myofascial release have received increased recent attention and appear to be good options in these patients. Future therapy may include antibodies to mediators of neurogenic inflammation and even treatment of bacteria in the bowel. SUMMARY: The diagnosis of chronic prostatitis/CPPS must include conditions traditionally outside the scope of urologic practice but important for the care of men with chronic pelvic pain. The treatment is best done using multiple simultaneous therapies aimed at the different aspects of the condition.
Authors: James W Griffith; Alisa J Stephens-Shields; Xiaoling Hou; Bruce D Naliboff; Michel Pontari; Todd C Edwards; David A Williams; J Quentin Clemens; Niloofar Afari; Frank Tu; R Brett Lloyd; Donald L Patrick; Chris Mullins; John W Kusek; Siobhan Sutcliffe; Barry A Hong; H Henry Lai; John N Krieger; Catherine S Bradley; Jayoung Kim; J Richard Landis Journal: J Urol Date: 2015-11-14 Impact factor: 7.450
Authors: Stephen F Murphy; Anthony J Schaeffer; Joseph Done; Larry Wong; Ashlee Bell-Cohn; Kenny Roman; John Cashy; Michelle Ohlhausen; Praveen Thumbikat Journal: PLoS One Date: 2015-05-01 Impact factor: 3.240
Authors: Onita Bhattasali; Leonard N Chen; Jennifer Woo; Jee-Won Park; Joy S Kim; Rudy Moures; Thomas Yung; Siyuan Lei; Brian T Collins; Keith Kowalczyk; Simeng Suy; Anatoly Dritschilo; John H Lynch; Sean P Collins Journal: Radiat Oncol Date: 2014-02-11 Impact factor: 3.481