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Lin W, Wang Y, Chen Y. Efficacy Analysis of Physical Therapy in Treating Chronic Prostatitis: Unblocking Obstructed Glandular Ducts Could Be a Novel Treatment Strategy. Res Rep Urol 2023; 15:553-561. [PMID: 38145159 PMCID: PMC10742744 DOI: 10.2147/rru.s442844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 11/28/2023] [Indexed: 12/26/2023] Open
Abstract
Objective This study investigates the efficacy of physical therapy in treating chronic prostatitis grounded on the glandular duct blockage theory. Methods The study includes patients who were diagnosed and treated for chronic prostatitis between November 2022 and July 2023 at Renhui clinic in Jiangmen, Guangdong and Renhui frontline clinic in Shenzhen Guangdong. The recorded data includes the frequency of physical therapies including prostate massages, rectal probe high-frequency vibration treatment, and low-intensity extracorporeal shockwave therapy (Li-ESWT). Post-treatment urine sediment was collected for microscopic examination, and the scores of each patient on the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) and the Premature Ejaculation Diagnostic Tool (PEDT) were recorded pre- and post-treatment in order to calculate the effectiveness rate. Results The study involved a total of 48 patients, of which 26 were diagnosed with premature ejaculation. On average, each patient received 2.1 prostate massages, underwent 4.1 rectal probe high-frequency vibration treatments, and 8.3 Li-ESWT sessions. Following treatment, the initial microscopic examination of the urine sediment revealed aged white blood cell clusters, prostate calculi clusters, and inactive sperm clusters, all appearing in the shape of glandular tubes. The mean NIH-CPSI scores pre- and post-treatment were 27.2±6.9 and 18.0±6.6, respectively, indicating an effectiveness rate of 81.3%. The average PEDT scores pre- and post-treatment were 14.5±3.5 and 10.5±4.2, respectively, with an effectiveness rate of 53.8%. Conclusion Unblocking obstructed glandular ducts might provide a novel therapeutic strategy for treating chronic prostatitis.
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Affiliation(s)
- Weiguang Lin
- Department of Urology, Renhui Clinic, Jiangmen, 529099, People’s Republic of China
- Department of Urology, Renhui Frontline Clinic, Shenzhen, 518038, People’s Republic of China
| | - Yunlong Wang
- Department of Urology, Renhui Clinic, Jiangmen, 529099, People’s Republic of China
- Department of Urology, Renhui Frontline Clinic, Shenzhen, 518038, People’s Republic of China
| | - Yanxiong Chen
- Department of Urology, Renhui Clinic, Jiangmen, 529099, People’s Republic of China
- Department of Urology, Renhui Frontline Clinic, Shenzhen, 518038, People’s Republic of China
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Yuan P, Sun T, Han Z, Chen Y, Meng Q. Uncovering the genetic links of diabetic erectile dysfunction and chronic prostatitis/chronic pelvic pain syndrome. Front Physiol 2023; 14:1096677. [PMID: 36846330 PMCID: PMC9946966 DOI: 10.3389/fphys.2023.1096677] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 01/31/2023] [Indexed: 02/11/2023] Open
Abstract
Background: Clinical associations between erectile dysfunction and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) have been noticed, but the common pathogenic mechanisms between them remain elusive. The aim of the study was to mine shared genetic alterations between ED and chronic prostatitis/chronic pelvic pain syndrome. Method: Transcriptome data of ED and chronic prostatitis/chronic pelvic pain syndrome-related genes (CPRGs) were retrieved from relevant databases and differentially expressed analysis was used to obtain significant CPRGs. Then function enrichment and interaction analyses were performed to show shared transcriptional signature, including gene ontology and pathway enrichment, the construction of protein-protein interaction (PPI) network, cluster analysis, and co-expression analysis. Hub CPRGs and key cross-link were selected by validating these genes in clinical samples, chronic prostatitis/chronic pelvic pain syndrome and ED-related datasets. Then the miRNA-OSRGs co-regulatory network was predicted and validated. Subpopulation distribution and disease association of hub CPRGs were further identified. Result: Differentially expressed analysis revealed 363 significant CPRGs between ED and chronic prostatitis/chronic pelvic pain syndrome, functioning in inflammatory reaction, oxidative stress, apoptosis, smooth muscle cell proliferation, and extracellular matrix organization. A PPI network containing 245 nodes and 504 interactions was constructed. Module analysis depicted that multicellular organismal process and immune metabolic process were enriched. 17 genes were screened in PPI via topological algorithms, and reactive oxygen species as well as interleukin-1 metabolism were regarded as the bridging interactive mechanism. After screening and validation, a hub-CPRG signature consisting of COL1A1, MAPK6, LPL, NFE2L2 and NQO1 were identified and associated miRNA were verified. These miRNAs played an important role in immune and inflammatory response likewise. Finally, NQO1 was identified as a key genetic link between ED and chronic prostatitis/chronic pelvic pain syndrome. It was predominately enriched in corpus cavernosum endothelial cell, and correlated with other male urogenital and immune system diseases tightly. Conclusion: We identified the genetic profiles as well as corresponding regulatory network underlying interaction between ED and chronic prostatitis/chronic pelvic pain syndrome via multi-omics analysis. These findings expanded a new understanding for the molecular mechanism of ED with chronic prostatitis/chronic pelvic pain syndrome.
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Affiliation(s)
- Penghui Yuan
- Department of Urology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China,*Correspondence: Penghui Yuan, ; Yinwei Chen, ; Qingjun Meng,
| | - Taotao Sun
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Zhengyang Han
- Department of Ultrasound, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Yinwei Chen
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China,*Correspondence: Penghui Yuan, ; Yinwei Chen, ; Qingjun Meng,
| | - Qingjun Meng
- Department of Urology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China,*Correspondence: Penghui Yuan, ; Yinwei Chen, ; Qingjun Meng,
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Improvement of chronic non-bacterial prostatitis by Jiedu Huoxue decoction through inhibiting TGF-β/SMAD signaling pathway. Biomed Pharmacother 2022; 152:113193. [PMID: 35665666 DOI: 10.1016/j.biopha.2022.113193] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 05/19/2022] [Accepted: 05/23/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Chronic non-bacterial prostatitis (CNBP) accounts for more than 90 % of clinical prostatitis cases, and there is no specific and effective treatment for CNBP. The regulatory role of Jiedu Huoxue decoction (JDHXD)in CNBP remains unclear. We investigated if JDHXD could improve CNBP METHODS: The animal model of CNBP was established by carrageenan injection with 1 % carrageenan (50 μL). The prostate index, epithelial thickness, lumen area, and pain response time were investigated. The apoptosis levels were measured with TUNEL staining and flow cytometry, respectively. Inflammatory factors in the serum were measured with ELISA method. RESULTS Treatment with JDHXD significantly improve prostate tissues injury in CNBP rats. Some parameters, such as prostate index, and pain response time, reflecting the prostate function were improved by JDHXD. Inhibition of apoptosis, reactive oxygen species (ROS), and inflammatory response were achieved by JDHXD in vivo. JDHXD markedly suppressed the TGF-β/SMAD signaling pathway, and activation of TGF-β/SMAD signaling pathway could reverse the improvement of CNBP injury by JDHXD. The anti-inflammatory, anti-oxidative and anti-apoptotic effects of JDHXD were proved. CONCLUSION JDHXD might improve CNBP injury through suppressing inflammation response, ROS, and apoptosis by targeting TGF-β/SMAD signaling pathway. This research might provide a new thought for the prevention and treatment of CNBP through inhibiting TGF-β/SMAD signaling pathway.
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Puerta Suárez J, Cardona Maya WD. Prostatitis‐like symptoms in Antioquia, Colombia using the National Institute of Health‐Chronic Prostatitis Symptom Index. INTERNATIONAL JOURNAL OF UROLOGICAL NURSING 2022. [DOI: 10.1111/ijun.12330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Jenniffer Puerta Suárez
- Reproduction Group, Department of Microbiology and Parasitology, School of Medicine University of Antioquia – UdeA Antioquia Colombia
| | - Walter Darío Cardona Maya
- Reproduction Group, Department of Microbiology and Parasitology, School of Medicine University of Antioquia – UdeA Antioquia Colombia
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Tawfik AM, Radwan MH, Abdulmonem M, Abo-Elenen M, Elgamal SA, Aboufarha MO. Tadalafil monotherapy in management of chronic prostatitis/chronic pelvic pain syndrome: a randomized double-blind placebo controlled clinical trial. World J Urol 2022; 40:2505-2511. [PMID: 35802142 PMCID: PMC9512753 DOI: 10.1007/s00345-022-04074-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 06/07/2022] [Indexed: 11/29/2022] Open
Abstract
Purpose In this placebo-controlled trial, we aimed to evaluate the clinical results of using PDE-5 inhibitor, tadalafil 5 mg OD, for management of CP/CPPS. Patients and methods 140 patients ≤ 45 years old with moderate/severe CP/CPPS associated with ED (IIEF-5 < 22) were randomly divided and received either tadalafil 5 mg OD (tadalafil-group) or placebo (control-group) for 6 weeks. Post-treatment CPSI scores were compared to baseline and to placebo. Clinically significant responders (≥ 25% reduction from baseline score) were calculated. Tadalafil-induced changes in IIE-5 were evaluated in correlation to that of CPSI scores. Results By the 6th week, 59 and 56 patients were available in both groups respectively. Compared to baseline, tadalafil-group patients showed significant improvement in total, pain, urinary and Qol domains of CPSI (19.1 ± 5.26, 10.42 ± 3.55, 4.2 ± 1.72 and 4.47 ± 1.64 vs. 24.21 ± 5.05, 12.14 ± 3.57, 6.08 ± 1.53 and 6.22 ± 1.76), p < 0.5. When compared to placebo, all 6th week CPSI domains scores, except for pain, were significantly better in tadalafil-group (p < 0.05). Post-treatment pain score didn't significantly differ between both groups (10.42 ± 3.55, vs. 11.71 ± 3.9, p > 0.05). Clinically significant responders were 30 patients (50.8%) in tadalafil-group vs. 3 patients (5.4%) in control. Tadalafil-induced changes in IIEF-5 score had weak but significant correlation to Qol domain (r = − 0.28, p < 0.05). Conclusion Tadalafil 5 mg OD can significantly improve all CPSI domains as compared to baseline. Post-treatment CPSI scores, except for pain, were better than placebo. About 50.8% of patients can develop ≥ 25% reduction in their total CPSI scores after treatment. Apart from Qol domain, these changes are not significantly correlated to tadalafil-induced IIEF-5 scores changes.
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Affiliation(s)
- Ahmed M Tawfik
- Urology Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
| | - Mohammed H Radwan
- Urology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | | | | | - Samir A Elgamal
- Urology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
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Treatment with the soluble guanylate cyclase activator BAY 60–2770 normalizes bladder function in an in vivo rat model of chronic prostatitis. Eur J Pharmacol 2022; 927:175052. [DOI: 10.1016/j.ejphar.2022.175052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 05/17/2022] [Accepted: 05/19/2022] [Indexed: 12/30/2022]
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Matsukawa Y, Funahashi Y, Ishida S, Naito Y, Yuba T, Matsuo K, Gotoh M. Clinical features and urodynamic findings in elderly men with chronic prostatitis. Int J Urol 2022; 29:441-445. [PMID: 35146792 DOI: 10.1111/iju.14805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 12/24/2021] [Accepted: 01/11/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To investigate the complication rate of chronic prostatitis/chronic pelvic pain syndrome in men with lower urinary tract symptoms, and to clarify their clinical features and urodynamic findings. METHODS We retrospectively reviewed the clinical data of treatment-naïve men with lower urinary tract symptoms. Patients were divided into two groups (chronic prostatitis/chronic pelvic pain syndrome + lower urinary tract symptoms and lower urinary tract symptoms only) according to the presence or absence of chronic prostatitis/chronic pelvic pain syndrome, and the patient characteristics as well as the parameters of lower urinary tract symptoms and lower urinary tract function assessed by urodynamics were compared. The diagnostic criteria for chronic prostatitis/chronic pelvic pain syndrome included a complaint of pelvic pain for ≥3 months, National Institutes of Health Chronic Prostatitis Symptom Index pain subscore ≥4, and negative culture of a urine specimen collected after prostate massage. RESULTS Out of 386 men, 123 (31.9%) had chronic prostatitis/chronic pelvic pain syndrome. Parameters of lower urinary tract symptoms and National Institutes of Health Chronic Prostatitis Symptom Index scores were significantly higher in the chronic prostatitis/chronic pelvic pain syndrome + lower urinary tract symptoms group. Although there were no significant intergroup differences in voiding parameters such as maximum flow rate and bladder outlet obstruction index, storage functions such as the incidence of detrusor overactivity and bladder compliance were significantly reduced in the chronic prostatitis/chronic pelvic pain syndrome + lower urinary tract symptoms group. The multivariable regression analysis revealed that a low serum total testosterone level (<3.5 ng/mL), complications of hyperlipidemia, and presence of overactive bladder and detrusor overactivity were significantly associated with the development of chronic prostatitis/chronic pelvic pain syndrome. CONCLUSIONS Chronic prostatitis causes a significant decrease in storage function, such as an increase in detrusor overactivity. Additionally, low serum testosterone levels and hyperlipidemia were found to be significantly associated with the development of chronic prostatitis/chronic pelvic pain syndrome in men with lower urinary tract symptoms.
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Affiliation(s)
- Yoshihisa Matsukawa
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yasuhito Funahashi
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shohei Ishida
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yushi Naito
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Takuma Yuba
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kazuna Matsuo
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Momokazu Gotoh
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Japan Community Health Care Organization Chukyo Hospital, Nagoya, Japan
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Puerta Suárez J, Velázquez Rivera V, Morales M, Alvarez AM, Carvajal A, Cardona Maya WD. Chronic Prostatitis: Impact of Lifestyle, Infection, and Inflammation on Semen Parameters. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Chronic prostatitis is a widespread disease of the prostate affecting men’s sexual and reproductive health worldwide. Its leading causes are urogenital tract infections by microorganisms with a prostate tropism. This study aimed to evaluate semen parameters and the factors associated (lifestyle, urogenital infections, and inflammation) with the onset of chronic prostatitis symptoms. This case-control study included seventy-six donors: 30 volunteers with chronic prostatitis and 46 asymptomatic volunteers for urogenital infections as a control group. Sociodemographic, urinary symptoms, pain location, sexual and reproductive health and lifestyle-related variables were collected in a survey. Seminal quality, cytokine levels in semen and serum, and the presence of nineteen microorganisms in the urogenital tract were evaluated. Prostatitis was also associated with poor sperm morphology, more lipoperoxidation of the sperm membrane, and lower serum nitric oxide concentration. In addition, N. gonorrhoeae infection was detected more frequently in semen samples from volunteers with chronic prostatitis. Volunteers with chronic prostatitis report more frequently erectile dysfunction and premature ejaculation, anxiety, depression, and stress compared to the control group. Chronic prostate infections alter the microbiota from the genitourinary tract causing prostatitis, a disease that affects all life areas, including the familiar environment of patients. Chronic prostatitis affects seminal parameters, with a great impact on life quality and sexual and reproductive health. Despite being a relatively unexplored disease, much remains to be clarified regarding its diagnosis and treatment. Alterations in the genitourinary microbiota can favor sexually transmitted infections that produce chronic and systemic inflammation.
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Song X, Chen G, Li C, Yang C, Deng Y. Tadalafil Alleviates LPS-Induced Inflammation and Oxidative Stress of RWPE-1 Cell by Regulating the Akt/Nrf2 Signaling Pathway. Inflammation 2021; 44:890-898. [PMID: 33398543 DOI: 10.1007/s10753-020-01384-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 10/29/2020] [Accepted: 11/09/2020] [Indexed: 10/22/2022]
Abstract
Tadalafil (TAD) is primarily a treatment drug for erectile dysfunction. Studies have shown that TAD has a therapeutic effect on prostatitis, but the specific mechanism has not been reported. LPS induced RWPE-1 cells to form a model of chronic nonbacterial prostatitis (CNP). Cell activity was measured by MTT assay. Apoptosis was detected by TUNEL assay. Western blot was used to detect the expression of apoptosis-related proteins Bcl-2, Bax, Caspase-3, and cleaved caspase3. ELISA was used to detect the expression of inflammatory cytokines TNF-α, IL-6, and IL-8. GSH, catalase (CAT), and malondialdehyde (MDA) kits were used to detect the expression of oxidative stress-related indicators GSH, CAT, and MDA. Western blot was used to detect the expression of proteins related to Akt/Nrf2 signaling pathway. After different concentrations of TAD were given, the survival rate of LPS-induced RWPE-1 cells decreased, apoptosis increased, and inflammation and oxidative stress decreased. This process is accompanied by the activation of the Akt/Nrf2 signaling pathway. The addition of AKT inhibitor (HY-10249A) reversed the inhibitory effect of TAD on LPS-induced inflammatory response and oxidative stress of RWPE-1 cell. TAD alleviated LPS-induced inflammation and oxidative stress of RWPE-1 cell by regulating the Akt/Nrf2 signaling pathway.
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Affiliation(s)
- Xiaoqing Song
- Center for Reproductive Medicine, The 904th Hospital of Joint Logistic Support Force, PLA, 101 Xingyuan North Road, Wuxi, 214043, Jiangsu, China
| | - Guodong Chen
- Center for Reproductive Medicine, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, 214023, Jiangsu, China
| | - Caixia Li
- Center for Reproductive Medicine, The 904th Hospital of Joint Logistic Support Force, PLA, 101 Xingyuan North Road, Wuxi, 214043, Jiangsu, China
| | - Chunyan Yang
- Center for Reproductive Medicine, The 904th Hospital of Joint Logistic Support Force, PLA, 101 Xingyuan North Road, Wuxi, 214043, Jiangsu, China
| | - Yun Deng
- Center for Reproductive Medicine, The 904th Hospital of Joint Logistic Support Force, PLA, 101 Xingyuan North Road, Wuxi, 214043, Jiangsu, China.
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Gaspar A, Silva J, Silva G, Anchelerguez R, Prats J, Sagaz A, Rovere E, Alastra M, Pino J, Jauregui A, Farrugia M, Villaroel F, Guareschi J, Vega M, Biasiori E, Moyano E, La Rosa A, Hreljac I, Vižintin Z. Nonablative transurethral Erbium:YAG laser treatment for chronic prostatitis/chronic pelvic pain syndrome: A prospective comparative study. Neurourol Urodyn 2020; 40:278-285. [PMID: 33170523 PMCID: PMC7839688 DOI: 10.1002/nau.24551] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 10/01/2020] [Accepted: 10/12/2020] [Indexed: 12/12/2022]
Abstract
Aims This prospective study aimed to compare the clinical outcomes between the use of Erbium:YAG (Er:YAG) laser in a nonablative mode, to the use of the pharmacological treatment of oral tadalafil for the treatment of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). Methods The laser group received two sessions of Erbium:YAG laser, administered intraurethrally in a long, nonablative train of long pulses (SMOOTH™ mode), applied at the level of the male prostatic urethra. Tadalafil group received oral tadalafil at a dose of 5 mg/day, consecutively for 2 months. Effectiveness was assessed using the International Prostate Symptom Score (IPSS) questionnaire, VAS (visual analogue scale) pain score, and maximum urethral flow at follow‐up visits up to 12 months after initiating treatment. Adverse effects were recorded after each treatment and follow‐up sessions. Results The results show a significant decrease in the IPSS score in both groups up to the 12‐month follow‐up. The increase in Q‐max was evident up to 3‐months follow‐up in the tadalafil group and up to 6 months in the laser group. The decrease in the VAS pain score was also significant in both treatment groups, lasting up to 3 months in the tadalafil group and up to 6 months in the laser group. Conclusions The nonablative Er:YAG SMOOTH™ laser seems to be a promising treatment for this widely occurring condition. More studies are needed to confirm its safety and efficacy.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Irena Hreljac
- Department of Clinical Affairs, Fotona d.o.o., Ljubljana, Slovenia
| | - Zdenko Vižintin
- Department of Clinical Affairs, Fotona d.o.o., Ljubljana, Slovenia
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History of Prostatitis Is an Independent Risk Factor for Erectile Dysfunction: A Cross-Sectional Study. BIOMED RESEARCH INTERNATIONAL 2020; 2020:8964673. [PMID: 33123589 PMCID: PMC7586169 DOI: 10.1155/2020/8964673] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 09/29/2020] [Accepted: 10/14/2020] [Indexed: 12/14/2022]
Abstract
Purpose To determine the role of history of prostatitis (HP) as an independent risk factor for erectile dysfunction (ED) in Chinese adult males. Methods We conducted an online survey using a crowd-sourced questionnaire in Chinese adult males. The participants were separated into two groups as adult participants with HP and with no history of prostatitis (NHP) according to the medical history record. As diagnosis criteria of ED, we used the 5 questions of the International Index for Erectile Function (IIEF-5). The general data including height, weight, monthly income, academic background, smoking history, alcohol drinking, marital status, conjugal affection, and other disease history was asked and recorded. The relationship between HP and ED using the chi-square test and logistic regression analyses was investigated and analyzed. Results In total, 1873 participants answered the questionnaire. 95 participants in the HP group and 1778 participants in the NHP group were included in this study. The rate of participants with HP was 5.343%. ED was found in 68.4% of the HP group and 43% of the NHP group (p < 0.001). Regression analysis showed that participants in HP were more likely to have ED (OR 2.135, 95% CI 1.266–3.60) after adjusting for the participant's age, body mass index (BMI), monthly income, academic background, smoking history, alcohol drinking, marital status, conjugal affection, BPH, hypertension, and diabetes mellitus, when compared with NHP. Conclusions The present study indicated a high prevalence of ED in Chinese adult males with history of prostatitis, and HP is an independent risk factor for erectile dysfunction.
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Matsukawa Y, Naito Y, Funahashi Y, Ishida S, Fujita T, Tochigi K, Kato M, Gotoh M. Comparison of cernitin pollen extract vs tadalafil therapy for refractory chronic prostatitis/chronic pelvic pain syndrome: A randomized, prospective study. Neurourol Urodyn 2020; 39:1994-2002. [PMID: 32648985 DOI: 10.1002/nau.24454] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 06/03/2020] [Accepted: 06/28/2020] [Indexed: 12/20/2022]
Abstract
AIMS To compare the efficacy of cernitin pollen extract (cernitin) or tadalafil for treating persistent chronic pelvic pain despite α1-blocker monotherapy in men with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and lower urinary tract symptoms (LUTS). METHODS A total of 100 patients with refractory CP/CPPS despite ongoing α1-blocker monotherapy were randomized to receive add-on therapy with either cernitin (4 capsules/day) or tadalafil (5 mg/d) for 12 weeks. At week 12, changes from baseline in the patients' CP/CPPS, LUTS, and voiding function, as assessed using the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI), the International Prostate Symptom Score (IPSS), and uroflowmetry, respectively, were compared between the groups. RESULTS The final analysis included 42 and 45 patients in the cernitin and tadalafil groups, respectively. Although the NIH-CPSI total, NIH-CPSI pain sub-score, and NIH-CPSI quality of life sub-score significantly improved in both groups, the cernitin (vs tadalafil) group showed significantly greater improvements in the NIH-CPSI total score (-6.8 vs -4.6; P = .02) and NIH-CPSI pain sub-score (-4.1 vs -1.5; P < .001). Half (50%) of the patients in the cernitin group showed a reduction greater than 50% in their NIH-CPSI pain sub-score; in the tadalafil group, only four patients (8.9%) showed ≥50% improvement (P < .001). In contrast, the improvement in LUTS was significantly superior in the tadalafil group. CONCLUSION Both cernitin and tadalafil significantly ameliorated chronic pelvic pain in patients with refractory CP/CPPS. The add-on of cernitin was more effective than tadalafil for pelvic pain and discomfort.
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Affiliation(s)
- Yoshihisa Matsukawa
- Department of Urology, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Yushi Naito
- Department of Urology, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Yasuhito Funahashi
- Department of Urology, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Shohei Ishida
- Department of Urology, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Takashi Fujita
- Department of Urology, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Kosuke Tochigi
- Department of Urology, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Masashi Kato
- Department of Urology, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Momokazu Gotoh
- Department of Urology, Graduate School of Medicine, Nagoya University, Nagoya, Japan
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Pineault K, Ray S, Gabrielson A, Herati AS. Phosphodiesterase type 5 inhibitor therapy provides sustained relief of symptoms among patients with chronic pelvic pain syndrome. Transl Androl Urol 2020; 9:391-397. [PMID: 32420144 PMCID: PMC7214994 DOI: 10.21037/tau.2020.03.05] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background Chronic prostatitis/chronic pelvic pain syndrome type III (CP/CPPS) is associated with pelvic pain, sexual dysfunction and irritative voiding. Sustained symptom relief has proven difficult with alpha blockers, antibiotics, and nonsteroidal anti-inflammatory drugs (NSAIDs). Phosphodiesterase type 5 (PDE5) inhibitors (PDE5is) have the potential to alleviate bladder urgency, relax the pelvic floor, and correct underlying erectile dysfunction; however, few studies have investigated the application of PDE5i’s to CP/CPPS. The purpose of this study was to assess the effect of long-term PDE5i therapy on symptoms among patients with diagnosed CP/CPPS. Methods A group of patients older than 18 years diagnosed with CP/CPPS presenting from 2009 to 2018 were followed prospectively while they were being prescribed off-label PDE5i therapy for symptoms. National Institute of Health chronic prostatitis symptom index (CPSI) scores before PDE5i therapy initiation and after at least 3 months were utilized to assess impact on symptoms. Results A total of 25 patients (mean age 44.4±12.9 years) met study criteria. The mean duration of PDE5i therapy was 1.3±1.6 years. Continued use of daily PDE5is was associated with significant decreases in total CPSI, pain, urinary symptom and quality of life scores [total CPSI: −12.8, standard deviation (SD) 9.5; pain: −6.1, SD 4.1; urinary symptoms: −2.4, SD 2.1; quality of life: −4.5, SD 3.9; P<0.001]. Conclusions This prospective data suggests that PDE5i therapy is associated with durable decreases in CP/CPPS symptoms past 3 months.
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Affiliation(s)
- Kevin Pineault
- Department of Urology, The James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Shagnik Ray
- Department of Urology, The James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Andrew Gabrielson
- Department of Urology, The James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Amin S Herati
- Department of Urology, The James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Yu ZJ, Yan HL, Xu FH, Chao HC, Deng LH, Xu XD, Huang JB, Zeng T. Efficacy and Side Effects of Drugs Commonly Used for the Treatment of Lower Urinary Tract Symptoms Associated With Benign Prostatic Hyperplasia. Front Pharmacol 2020; 11:658. [PMID: 32457631 PMCID: PMC7225336 DOI: 10.3389/fphar.2020.00658] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 04/22/2020] [Indexed: 12/11/2022] Open
Abstract
Benign prostatic hyperplasia (BPH) is the most common benign disease of the prostate gland and is caused by benign hyperplasia of the smooth muscle cells and stromal cells in this important gland. BPH is also the most common disease underlying lower urinary tract symptoms (LUTS). The incidence of BPH increases with age and affects more than half of all men 50 years or older. BPH mainly exerts effects on urinary function and can seriously reduce a patient's quality of life. At present, treatment for BPH aims primarily to improve the quality of life and reduce the risk of BPH-related complications. Pharmacological therapy is recommended for moderate-to-severe cases of LUTS that are suggestive of BPH. A range of drugs is currently available to treat this condition, including α1-adrenoceptor antagonists, 5α-reductase inhibitors (5-ARIs), phosphodiesterase type 5 inhibitors (PDE5Is), muscarinic receptor antagonists (MRAs), β3-adrenoceptor agonists, and plant extracts. Of these, the most commonly used drugs in the clinic are α1-adrenoceptor antagonists, 5-ARIs, and combination therapy. However, these drugs exert their effects via various mechanisms and are associated with adverse reactions. The purpose of this review is to provide current comprehensive perspectives on the mechanisms of action, efficacy, and adverse reactions associated with the drugs most commonly used for the treatment of BPH.
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Affiliation(s)
- Zhao-Jun Yu
- Department of Urology, The Second Affiliated Hospital of Nanchang University, Nanchang, China.,Medical Department of Graduate School, Nanchang University, Nanchang, China
| | - Hai-Lan Yan
- Department of Clinical Medicine, Xi'an Jiao Tong University Health Science Center, Xi'an, China
| | - Fang-Hua Xu
- Department of Pathology, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, China
| | - Hai-Chao Chao
- Institute of Clinical Medicine, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, China
| | - Lei-Hong Deng
- Department of Ultrasound, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Xiang-Da Xu
- Medical Department of Graduate School, Nanchang University, Nanchang, China
| | - Jian-Biao Huang
- Medical Department of Graduate School, Nanchang University, Nanchang, China
| | - Tao Zeng
- Department of Urology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
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15
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Tanaka T. Editorial Comment from Dr Tanaka to Tadalafil is sufficiently effective for severe chronic prostatitis/chronic pelvic pain syndrome in patients with benign prostatic hyperplasia. Int J Urol 2019; 27:58-59. [PMID: 31602710 DOI: 10.1111/iju.14134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Tomoaki Tanaka
- Department of Urology, Suita Municipal Hospital, Suita, Osaka, Japan
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16
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Amano T. Editorial Comment from Dr Amano to Tadalafil is sufficiently effective for severe chronic prostatitis/chronic pelvic pain syndrome in patients with benign prostatic hyperplasia. Int J Urol 2019; 27:58. [PMID: 31588586 DOI: 10.1111/iju.14125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Toshiyasu Amano
- Department of Urology, Nagano Red Cross Hospital, Nagano, Japan
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