Critical issues in chronic prostatitis (original) (raw)
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Current urology reports, 2002
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. Thorough clinical and microbiologic examination of 140 patients attending the University of Washington Prostatitis Clinic included evaluation of first void urine, mid-stream urine, EPS, VB3, and semen specimens. Inflammation was documented in 111 (26%) of 420 samples including 39 EPS samples, 32 VB3 samples, and 40 SFA specimens. Of the 140 patients,...
Management of chronic nonbacterial prostatitis/chronic pelvic pain syndrome
Bosnian journal of basic medical sciences / Udruženje basičnih mediciniskih znanosti = Association of Basic Medical Sciences, 2007
Chronic nonbacterial prostatitis/chronic pelvic pain syndrome is unsatisfactorily defined and insufficiently studied illness. Also, the treatment success is questionable and therefore, this illness is a therapeutical problem for urologists--which medications are the best choice in treating this uncomfortable condition? This paper presents results of prospective, open, analytical, comparative study that was performed on 90 patients with diagnosed chronic nonbacterial prostatitis/chronic pelvic pain syndrome. Patients were divided into three groups and were treated with two medications ciprofloxacin (C), doxazosin (D) and combination of ciprofloxacin + doxazosin (C+D). The effects were measured using symptom questionnaire for prostate illnesses of the National Institute for Health - USA (NIH-CPSI). During the basic evaluation, sum ranging from 0 to 43 was calculated for each patient. This number is called total sum NIH-CPSI (National Institutes of Health Chronic Prostatitis Symptom In...
Prostatitis and Male Pelvic Pain Syndrome – Diagnosis and Treatment
Background: The prostatitis syndrome is a multifactorial condition of largely unknown etiology. The new NIH classification divides the prostatitis syndrome into a number of subtypes: acute bacterial prostatitis, chronic bacterial prostatitis, inflammatory and noninflammatory chronic pelvic pain syndrome, and asymptomatic prostatitis. Methods: This article is based on a selective review of the literature regarding the assessment and management of the prostatitis syndrome and on a recently published consensus statement of the International Prostatitis Collaboration Network. Results: Pathogenic organisms can be cultured only in acute and chronic bacterial prostatitis. These conditions should be treated with antibiotics, usually fluoroquinolones, for an adequate period of time. 90% of patients with prostatitis syndrome, however, suffer not from bacterial prostatitis but from chronic (abacterial) prostatitis / chronic pelvic pain syndrome (CP/CPPS). It remains unclear whether CP/CPPS is of infectious origin, and therefore the utility of a trial of antimicrobial treatment is debatable. Treatment with alpha receptor blockers is recommended if functional subvesical obstruction is documented or suspected. Symptomatic therapy for pelvic pain should be given as well. Conclusions: The prostatitis syndrome is a complex conditi- on 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.
A Prospective Interventional Study in Chronic Prostatitis with Emphasis to Clinical Features
Purpose: Chronic bacterial prostatitis displays a variety of symptoms (mainly local pain exhibiting variability in origin and intensity). These symptoms often persist despite bacterial eradication. The purpose of this article is to exam the role of phytotherapeutic agents as complementary treatment in patients with bacterial prostatitis. Materials and Methods: The material consisted of individuals with reported pelvic discomfort and genital pain with or without lower urinary tract symptoms (LUTS) and sexual dysfunction visiting our department from March 2009 to March 2011. Patients underwent Stamey-Meares test (several cases underwent the two glass test). Depending on history and specific symptoms urethral smear and semen cultures were additionally obtained from several patients. All patients were randomized into two groups. Subjects in the first group (72 patients) received appropriate antibiotic (according to the sensitivity test) for 15 days, while subjects in the second group (72 patients) received phytotherapeutic agents for 30 days, additionally the conventional 15 days antibiotic treatment. The response was tested using laboratory and clinical criteria. Results: We found no statistically significant differences between the two groups regarding bacterial and symptom persistence rate, however, symptoms burden was lower in patients receiving combinational treatment. Conclusion: Phytotherapeutic agents may improve pain and prostatitis related difficulty in urination. Further randomized, placebo-controlled studies are needed to substantiate safer conclusions.