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Yang Y, Shigemura K, Maeda K, Moriwaki M, Chen KC, Nakano Y, Fujisawa M. The harmful effects of overlooking acute bacterial prostatitis. Int J Urol 2024; 31:459-463. [PMID: 38239011 DOI: 10.1111/iju.15390] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 12/26/2023] [Indexed: 05/05/2024]
Abstract
Prostatitis is a major urological disease affecting 25%-50% of men over their lifetime. However, prostatitis is often overlooked in nonurologic departments due to its sometimes indeterminate symptoms. In this review, we describe how to recognize and treat acute bacterial prostatitis, which manifests as a clinical problem in other departments as well as urology, to help prevent this disease from being overlooked. There are several possible negative effects of not recognizing acute bacterial prostatitis (ABP). First, initial treatment can fail. In the hyperacute phase, common antibiotics are often effective, but in rare cases, such antibiotics may not be effective. In addition, once ABP progresses to form a prostate abscess, potentially avoidable surgical interventions are often needed. A second issue is the transition to chronic prostatitis. If chronic bacterial prostatitis progresses, treatment requires long-term antibiotic administration and the response rate is not high. Some patients may have to deal with urinary tract infections for the rest of their lives. Finally, there is the problem of overlooking the underlying disease. ABP is rare in healthy adult men without underlying disease, including sexually transmitted diseases as well as benign prostatic hyperplasia, urinary stones, and malignant tumors, and may not be obvious. When examining patients with fever of unknown origin, it is necessary to exclude not only infectious diseases but also collagen diseases and malignant tumors. If there are any doubts, we recommend a rectal exam and consultation with a urologist.
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Affiliation(s)
- Youngmin Yang
- Department of Urology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Katsumi Shigemura
- Department of Urology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
- Department of International Health, Kobe University Graduate School of Health Sciences, Kobe, Hyogo, Japan
| | - Koki Maeda
- Department of Urology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Michika Moriwaki
- Department of International Health, Kobe University Graduate School of Health Sciences, Kobe, Hyogo, Japan
| | - Kuan-Chou Chen
- Department of Urology, Taipei Medical University Shuang Ho Hospital, Taipei, Taiwan
| | - Yuzo Nakano
- Department of Urology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Masato Fujisawa
- Department of Urology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
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Matsuo T, Imamura R. Editorial Comments on The harmful effects of overlooking acute bacterial prostatitis. Int J Urol 2024; 31:464. [PMID: 38303139 DOI: 10.1111/iju.15419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Affiliation(s)
- Tomohiro Matsuo
- Department of Urology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Ryoichi Imamura
- Department of Urology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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Romano L, Pellegrino R, Arcaniolo D, Gravina AG, Miranda A, Priadko K, De Gennaro N, Santonastaso A, Palladino G, Crocetto F, Barone B, Cuomo A, Facchiano A, Mucherino C, Spirito L, Sciorio C, de Sio M, Romano M, Napolitano L. Lower urinary tract symptoms in patients with inflammatory bowel diseases: A cross-sectional observational study. Dig Liver Dis 2024; 56:628-634. [PMID: 37880017 DOI: 10.1016/j.dld.2023.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 10/09/2023] [Accepted: 10/11/2023] [Indexed: 10/27/2023]
Abstract
BACKGROUND Inflammatory Bowel Diseases (IBD), Crohn's Disease (CD), and Ulcerative Colitis (UC) may have extraintestinal manifestations, including disorders of the urinary tract. The prevalence of lower urinary tract symptoms (LUTS) in IBD patients remains unclear. AIMS Assess the prevalence of LUTS in patients with CD or UC, evaluate the variables implicated in any difference in LUTS prevalence between CD or UC, and assess any relationship between disease activity and LUTS METHODS: LUTS were evaluated in 301 IBD patients through standardised questionnaires: Bristol Female Lower Urinary Tract Symptoms (BFLUTS), NIH-Chronic Prostatitis Symptom Index (NIH-CPSI), and International Prostate Symptom Score (IPSS). IBD activity was determined through the Crohn's Disease Activity Index (CDAI), Partial Mayo Score (PMS), and Total Mayo Score (TMS). RESULTS BFLUTS total score for females was 6 (3-11). Patients with a higher age at diagnosis had worse filling symptoms (p = 0.049) and a worse quality of life (p = 0.005). In males, 67.1% had mild, 28.5% moderate, and 4.4% severe IPSS symptom grades. The overall NIHCPSI prevalence of chronic prostatitis-like symptoms was 26.8%. The questionnaires revealed some significant differences in the subgroups analysed. CONCLUSION LUTS should be evaluated in IBD patients by urologic-validated questionnaires for prompt diagnosis and early treatment.
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Affiliation(s)
- Lorenzo Romano
- Department of Neurosciences, Sciences of Reproduction, and Odontostomatology, University of Naples "Federico II", Naples 80131, Italy; Unit of Urology, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples 80138, Italy
| | - Raffaele Pellegrino
- Department of Precision Medicine and Hepatogastroenterology Unit, University of Campania "Luigi Vanvitelli", Naples 80138, Italy
| | - Davide Arcaniolo
- Unit of Urology, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples 80138, Italy
| | - Antonietta Gerarda Gravina
- Department of Precision Medicine and Hepatogastroenterology Unit, University of Campania "Luigi Vanvitelli", Naples 80138, Italy.
| | - Agnese Miranda
- Department of Precision Medicine and Hepatogastroenterology Unit, University of Campania "Luigi Vanvitelli", Naples 80138, Italy
| | - Kateryna Priadko
- Department of Precision Medicine and Hepatogastroenterology Unit, University of Campania "Luigi Vanvitelli", Naples 80138, Italy
| | - Nicola De Gennaro
- Department of Precision Medicine and Hepatogastroenterology Unit, University of Campania "Luigi Vanvitelli", Naples 80138, Italy
| | - Antonio Santonastaso
- Department of Precision Medicine and Hepatogastroenterology Unit, University of Campania "Luigi Vanvitelli", Naples 80138, Italy
| | - Giovanna Palladino
- Department of Precision Medicine and Hepatogastroenterology Unit, University of Campania "Luigi Vanvitelli", Naples 80138, Italy
| | - Felice Crocetto
- Department of Neurosciences, Sciences of Reproduction, and Odontostomatology, University of Naples "Federico II", Naples 80131, Italy
| | - Biagio Barone
- Department of Neurosciences, Sciences of Reproduction, and Odontostomatology, University of Naples "Federico II", Naples 80131, Italy
| | - Antonio Cuomo
- Gastroenterology Unit, "Umberto I" General Hospital, Nocera Inferiore 84014, Italy
| | - Angela Facchiano
- Gastroenterology Unit, "Umberto I" General Hospital, Nocera Inferiore 84014, Italy
| | - Caterina Mucherino
- Gastroenterology Unit, "Sant'Anna and San Sebastiano" General Hospital, Caserta 81100, Italy
| | - Lorenzo Spirito
- Unit of Urology, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples 80138, Italy
| | - Carmine Sciorio
- Urology Unit, "A.Manzoni" General Hospital, Lecco 23900, Italy
| | - Marco de Sio
- Unit of Urology, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples 80138, Italy
| | - Marco Romano
- Department of Precision Medicine and Hepatogastroenterology Unit, University of Campania "Luigi Vanvitelli", Naples 80138, Italy
| | - Luigi Napolitano
- Department of Neurosciences, Sciences of Reproduction, and Odontostomatology, University of Naples "Federico II", Naples 80131, Italy
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Lin TY, Chen IH, Weng HY, Lin YC, Ou CH, Li CY, Cheng YS. Association between chronic prostatitis and the subsequent benign prostatic hyperplasia: a population-based national cohort study. World J Urol 2024; 42:126. [PMID: 38460003 DOI: 10.1007/s00345-024-04820-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 01/16/2024] [Indexed: 03/11/2024] Open
Abstract
PURPOSE To explore the association between chronic prostatitis (CP) and the subsequent development of benign prostatic hyperplasia (BPH). METHODS Data analyzed were medical claims of Taiwan's National Health Insurance program. From 2010 to 2017, 3571 patients ≧20 years with CP diagnosed by certified urologists were enrolled. Patients with past BPH diagnosis and diagnosis of prostate cancer, inguinal hernia, interstitial cystitis, and urethritis in the past and within one year after the first CP diagnosis were excluded. Age-matched controls were randomly selected from all non-CP individuals of the same exclusion criteria in the study period with a CP/non-CP ratio of 1:4. The follow-up was made from the first CP diagnosis to death or the end of 2018. The endpoint was the newly diagnosed BPH. Cox proportional hazard regression model was used to estimate the hazard ratio (HR) and 95% confidence interval (CI) of BPH in association with CP. RESULTS Over a maximum of 8 years of follow-up, 287 (8.03%) and 258 (0.43%) BPH events were noted for the CP and non-CP group, respectively, representing a covariate adjusted HR (aHR) of 4.30 (95% CI, 3.61-5.13). Younger patients tended to suffer from higher aHRs, especially those aged 20-39 years (aHR: 11.45, 95% CI, 5.12-25.64). CONCLUSION The Taiwan national health database indicated that CP patients had a significantly higher risk of developing BPH later than non-CP patients. Interestingly, the younger the CP is diagnosed (under 40), the greater the risk.
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Affiliation(s)
- Tsung-Yen Lin
- Division of Urology, Department of Surgery, National Cheng Kung University Hospital Dou-Liou Branch, Yunlin, Taiwan
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - I-Hung Chen
- Division of Urology, Department of Surgery, National Cheng Kung University Hospital Dou-Liou Branch, Yunlin, Taiwan
| | - Han-Yu Weng
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yu-Chiao Lin
- Division of Urology, Department of Surgery, National Cheng Kung University Hospital Dou-Liou Branch, Yunlin, Taiwan
| | - Chien-Hui Ou
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chung-Yi Li
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Yu-Sheng Cheng
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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Wang X, Zhu L, Yang M, Chen Y, Liu Z. Factors related to acupuncture response in patients with chronic prostatitis/chronic pelvic pain syndrome: secondary analysis of a randomized controlled trial. World J Urol 2024; 42:112. [PMID: 38431530 DOI: 10.1007/s00345-024-04791-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 01/16/2024] [Indexed: 03/05/2024] Open
Abstract
PURPOSE Acupuncture has been recommended as an effective therapy to improve symptoms of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). We conducted this secondary analysis to explore the factors that may influence the response of patients with CP/CPPS to acupuncture. METHODS This secondary analysis was based on a randomized controlled trial demonstrating the efficacy of acupuncture among patients with CP/CPPS. Responder is defined as a patient with a decrease of ≥ 6 points in National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) total score from baseline at the 32 week. 206 patients who received acupuncture treatment and completed 32-week follow-up were included in this secondary analysis. Descriptive statistics were used to describe the demographic and clinical characteristics of both responders and non-responders in acupuncture group. Logistic regression analysis with bootstrapping was made to identify potential factors that contributed to the effectiveness of acupuncture for treating CP/CPPS. Responders and non-responders were listed as dependent variables. RESULTS In this study, 130 (63.11%) patients were assessed as responders. The results showed that men with non-sedentariness (OR 4.170 [95%CI 1.837 to 9.463; P = 0.001]), non-smoking habit (OR 2.824 [95%CI 1.453 to 5.487; P = 0.002]), without comorbidity (OR 8.788 [95%CI 1.912 to 40.295; P = 0.005]), and severe NIH-CPSI total score (OR 0.227 [95%CI 0.114 to 0.450; P < 0.0001]) benefited more from acupuncture intervention. CONCLUSION CP/CPPS patients who are active, non-smokers, without comorbidity, and had severe symptoms may be more likely to respond to acupuncture.
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Affiliation(s)
- Xinlu Wang
- Department of Acupuncture, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Lili Zhu
- Department of Acupuncture, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Min Yang
- Department of Acupuncture, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yu Chen
- Department of Chinese Medicine, New Zealand College of Chinese Medicine, Aukland, New Zealand
| | - Zhishun Liu
- Department of Acupuncture, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
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Barker ES, Chiu K, Brown VL, Morsy H, Yaeger LH, Catna A, Pakpahan R, Moldwin R, Shorter B, Lowder JL, Lai HH, Sutcliffe S. Urologic Chronic Pelvic Pain Syndrome Flares: A Comprehensive, Systematic Review and Meta-Analysis of the Peer-Reviewed Flare Literature. J Urol 2024; 211:341-353. [PMID: 38109700 PMCID: PMC11037930 DOI: 10.1097/ju.0000000000003820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 12/07/2023] [Indexed: 12/20/2023]
Abstract
PURPOSE We sought to systematically review and summarize the peer-reviewed literature on urologic chronic pelvic pain syndrome flares, including their terminology, manifestation, perceived triggers, management and prevention strategies, impact on quality of life, and insights into pathophysiologic mechanisms, as a foundation for future empirical research. MATERIALS AND METHODS We searched 6 medical databases for articles related to any aspect of symptom exacerbations for interstitial cystitis/bladder pain syndrome and chronic prostatitis/chronic pelvic pain syndrome. A total of 1486 abstracts and 398 full-text articles were reviewed, and data were extracted by at least 2 individuals. RESULTS Overall, we identified 59 articles, including 36 qualitative, cross-sectional, or case-control; 15 cohort-based; and 8 experimental articles. The majority of studies described North American patients with confirmed diagnoses. "Flare" was a commonly used term, but additional terminology (eg, exacerbation) was also used. Most flares involved significant increases in pain intensity, but less data were available on flare frequency and duration. Painful, frequent, long-lasting, and unpredictable flares were highly impactful, even over and above participants' nonflare symptoms. A large number of perceived triggers (eg, diet, stress) and management/prevention strategies (eg, analgesics, thermal therapy, rest) were proposed by participants, but few had empirical support. In addition, few studies explored underlying biologic mechanisms. CONCLUSIONS Overall, we found that flares are painful and impactful, but otherwise poorly understood in terms of manifestation (frequency and duration), triggers, treatment, prevention, and pathophysiology. These summary findings provide a foundation for future flare-related research and highlight gaps that warrant additional empirical studies.
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Affiliation(s)
- Emily S Barker
- Division of Complex Family Planning, Department of Obstetrics and Gynecology, Washington University School of Medicine, St Louis, Missouri
| | - Kimberley Chiu
- Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Washington University School of Medicine, St Louis, Missouri
| | - Victoria L Brown
- Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Washington University School of Medicine, St Louis, Missouri
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St Louis, Missouri
| | - Haidy Morsy
- Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Washington University School of Medicine, St Louis, Missouri
- Geisinger, Wilkes Barre, Pennsylvania
| | - Lauren H Yaeger
- Bernard Becker Medical Library, Washington University School of Medicine, St Louis, Missouri
| | - Arya Catna
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St Louis, Missouri
| | - Ratna Pakpahan
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St Louis, Missouri
| | - Robert Moldwin
- The Arthur Smith Institute for Urology, Zucker School of Medicine at Hofstra-Northwell, Lake Success, New York
| | | | - Jerry L Lowder
- Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Washington University School of Medicine, St Louis, Missouri
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St Louis, Missouri
| | - H Henry Lai
- Division of Urological Surgery, Department of Surgery, Washington University School of Medicine, St Louis, Missouri
- Department of Anesthesiology, Washington University School of Medicine, St Louis, Missouri
| | - Siobhan Sutcliffe
- Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Washington University School of Medicine, St Louis, Missouri
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St Louis, Missouri
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Vinnik Yu Y, Amelchenko A A. [Metabolic features of the inflammatory syndrome of chronic pelvic pain (category IIIA of chronic non-bacterial prostatitis) in young men, depending on the somatotype]. Urologiia 2024:41-48. [PMID: 38650405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
PURPOSE dentification of bioimpedance and clinical features in young men with chronic pelvic pain inflammatory syndrome (CP/CPPS NIH IIIa) depending on the somatotype. METHOD s. 150 men of the first period of adulthood from 22 to 35 years old with CP/CPPS NIH IIIa were examined from 2018 to 2022 years. The average age was 31 [28; 34] year. Somatotypes were computed according to Carter and Heath. Body composition was assessed anthropometry and bioimpedance analysis. RESULTS Ectomorphs had the least clinical, laboratory and instrumental manifestations of CP/CPPS NIH IIIa, the levels of total and free testosterone were the highest. The active cell mass predominated in the component composition of the body. Manifestations in mesomorphs had a moderate degree of severity. Endomorphs had the most severe manifestations of CP/CPPS NIH IIIa, the largest amount of fat mass was noted in the body composition than in men of other somatotypes, the hormonal status was characterized by the lowest levels of free and total testosterone, and the highest level of estradiol. DISCUSSION Based on the literature data and our own results, it can be assumed that the identified changes in the body component composition and hormonal status of men contribute to the maintenance of chronic inflammation in the prostate, organ ischemia, impaired intracranial metabolism, recurrent course of CP/CPPS NIH IIIa, which significantly reduces the patients quality of life and increases the risk of prostate inflammation with age. CONCLUSION Determining the somatotype and conducting a component analysis of body composition allows patients to be divided into groups according to the severity of manifestations of CP/CPPS NIH IIIa. The revealed patterns allow us to classify male endomorphs into the group with the most severe manifestations of CP/CPPS NIH IIIa.
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Affiliation(s)
- Yu Vinnik Yu
- Federal State Budgetary Educational Institution of Higher Education Prof. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University of the Ministry of Healthcare of the Russian Federation, Krasnoyarsk, Russia
| | - A Amelchenko A
- Federal State Budgetary Educational Institution of Higher Education Prof. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University of the Ministry of Healthcare of the Russian Federation, Krasnoyarsk, Russia
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Yang J, Bao C, Gu J. Investigating how tamsulosin combined with levofloxacin impacts wound healing in patients with chronic prostatitis who may also have perineal or urethral wounds. Int Wound J 2024; 21:e14656. [PMID: 38272823 PMCID: PMC10789924 DOI: 10.1111/iwj.14656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 12/19/2023] [Accepted: 12/22/2023] [Indexed: 01/27/2024] Open
Abstract
Chronic prostatitis, which frequently manifests with perineal or urethral ulcers, can have substantial impact on the quality of life experienced by affected individuals. Present treatment approaches primarily target the alleviation of symptoms and control of complications. In patients with chronic prostatitis, this investigation examined the potential synergistic effects of tamsulosin and levofloxacin on urinary function and urethral and perineal wounds healing. This cross-sectional observational study was carried out at Chongqing Western Hospital, China, from February to November 2023. The participants comprised 88 males aged 40-75 years who had been clinically diagnosed with chronic prostatitis and complications that accompany the wound healing process. The participants were equally distributed into two groups: one assigned to the treatment group, which received a daily combination of levofloxacin (500 mg) and tamsulosin (0.4 mg) and other to receive conventional care. The wound healing rate and improvement in urinary function were the primary outcomes evaluated monthly for 9 months. Patient satisfaction and symptom amelioration were secondary outcomes, in addition to the surveillance of adverse effects. In comparison to the control, treatment group exhibited significantly higher rate of wound closure (78.08% at 1 month and 79.38% at 9 months) and urinary function improvement (66.69% at 1 month and 67.95% at 9 months). In addition, the treatment group exhibited a greater degree of symptom amelioration; however, a rise in adverse effects was observed. In every domain, patient satisfaction scores were significantly higher in the treatment group. Thus the combination of tamsulosin and levofloxacin improved urinary function and wound repair in patients with chronic prostatitis, while also exhibiting tolerable profile of adverse effects.
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Affiliation(s)
- Jingruo Yang
- Department of Urology SurgeryChongqing Western HospitalChongqingChina
| | - Congcong Bao
- Department of Urology SurgeryChongqing Western HospitalChongqingChina
| | - Jianglin Gu
- Department of Urology SurgeryChongqing Western HospitalChongqingChina
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Yu XW, Wang CS, Yu XH. A systematic review and meta-analysis of moxibustion for chronic prostatitis. Medicine (Baltimore) 2023; 102:e36742. [PMID: 38115243 PMCID: PMC10727555 DOI: 10.1097/md.0000000000036742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 11/28/2023] [Accepted: 11/30/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Chronic prostatitis (CP) is a common condition that affects many individuals. Previous clinical trials have explored the use of moxibustion as a potential treatment for CP. However, the evidence on the effectiveness of moxibustion for CP remains limited. Therefore, this study aimed to comprehensively assess the effects of moxibustion for CP. METHODS In order to gather relevant and up-to-date information, we conducted a systematic literature search of databases including Cochrane Library, PUBMED, EMBASE, CNKI, and Wangfang from inception until June 30, 2023. Only randomized clinical trials (RCTs) that investigated the use of moxibustion for CP were included in this study. The primary outcomes of interest were the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) scores and the overall response rate. To evaluate the quality of the included studies, we used the Cochrane risk-of-bias tool. RESULTS After analyzing the data from 8 RCTs involving a total of 664 patients, we found significant differences in NIH-CPSI scores between moxibustion and other treatment modalities. Specifically, when compared with herbal medicine, moxibustion was associated with a mean difference (MD) of -1.78 in NIH-CPSI scores (95% confidence interval [CI] [-2.78, -0.78], P < .001), and when compared with western medicine, moxibustion was associated with a MD of -5.24 in NIH-CPSI scores (95% CI [-7.80, -2.67], P < .08). In terms of the overall response rate, moxibustion was found to be superior to herbal medicine, with a MD of 2.36 (95% [19, 4.67], P = .01). Additionally, when moxibustion was combined with herbal medicine, it yielded a higher overall response rate with a MD of 4.07 (95% CI [1.54, 10.74], P = .005) compared to herbal medicine alone. Moxibustion also outperformed western medicine in terms of the overall response rate, with a MD of 4.56 (95% CI [2.24, 9.26], P < .001). CONCLUSION Based on the findings of this study, moxibustion appears to be a potentially efficacious treatment for CP. The results suggest that moxibustion can improve NIH-CPSI scores and overall response rate in patients with CP. However, further high-quality studies are needed to validate these results and establish the long-term effects of moxibustion as a treatment for CP.
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Affiliation(s)
- Xi-wen Yu
- Department of Acupuncture and Moxibustion, Baicheng Medical College, Baicheng, China
| | - Cheng-si Wang
- College of Mathematical Sciences, Shanghai Jiaotong University, Shanghai, China
| | - Xiao-hong Yu
- Second Ward of Cardiology Department, First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
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Osanami A, Yamashita T, Sakurada S, Sato T, Kyoda Y, Shindo T, Fujita H, Ogawa Y, Furuhashi M. Systemic sarcoidosis presenting as a rare combination of interstitial nephritis with necrotizing vasculitis and urinary retention due to prostate involvement: a case report. BMC Nephrol 2023; 24:370. [PMID: 38093211 PMCID: PMC10720170 DOI: 10.1186/s12882-023-03430-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 12/07/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Sarcoidosis affects multiple organs and exhibits diverse clinical manifestations. Although tubulointerstitial nephritis is a known feature of renal involvement, necrotizing vasculitis is rare. Furthermore, prostate involvement with urinary retention is unusual in patients with sarcoidosis. Here, we report a case of systemic sarcoidosis with a rare combination of manifestations and different acute kidney injuries. CASE PRESENTATION A 66-year-old man developed sudden urinary retention and fever. He was diagnosed with prostatitis and admitted to our hospital. An indwelling urethral catheter was inserted, and antimicrobial therapy was initiated; however, the prostatitis was refractory. Computed tomography revealed enlarged mediastinal lymph nodes. Analysis of transbronchoscopic lymph node and prostate biopsies showed epithelioid cell granulomas, suggesting systemic sarcoidosis. During the clinical course, the serum creatinine level rapidly increased to 2.36 mg/dL without oliguria. A kidney biopsy revealed tubulointerstitial injury with moderate lymphohistiocytic infiltration and small-vessel vasculitis in the interstitium. Following oral administration of 60 mg/day prednisolone, the patient's renal function immediately improved, and urinary retention did not recur. CONCLUSIONS To the best of our knowledge, this is the first reported case of sarcoidosis with two unusual complications. Given its clinical course and pathology, this case is clinically valuable.
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Affiliation(s)
- Arata Osanami
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-Ku, Sapporo, 060-8556, Japan.
| | | | - Shintaro Sakurada
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-Ku, Sapporo, 060-8556, Japan
| | - Tatsuya Sato
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-Ku, Sapporo, 060-8556, Japan
| | - Yuki Kyoda
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Tetsuya Shindo
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Hiromi Fujita
- Department of Surgical Pathology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Yayoi Ogawa
- Hokkaido Renal Pathology Center, Sapporo, Japan
| | - Masato Furuhashi
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-Ku, Sapporo, 060-8556, Japan
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11
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Healy R, Thorne C, Manjunath A. Chronic prostatitis (chronic pelvic pain syndrome). BMJ 2023; 383:e073908. [PMID: 37977592 DOI: 10.1136/bmj-2023-073908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Affiliation(s)
- Rion Healy
- Department of Urology, North Bristol NHS Trust, UK
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12
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Lao Y, Li Z, Bai Y, Li W, Wang J, Wang Y, Li Q, Dong Z. Glial Cells of the Central Nervous System: A Potential Target in Chronic Prostatitis/Chronic Pelvic Pain Syndrome. Pain Res Manag 2023; 2023:2061632. [PMID: 38023826 PMCID: PMC10661872 DOI: 10.1155/2023/2061632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 05/24/2023] [Accepted: 11/07/2023] [Indexed: 12/01/2023]
Abstract
Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is one of the most common diseases of the male urological system while the etiology and treatment of CP/CPPS remain a thorny issue. Cumulative research suggested a potentially important role of glial cells in CP/CPPS. This narrative review retrospected literature and grasped the research process about glial cells and CP/CPPS. Three types of glial cells showed a crucial connection with general pain and psychosocial symptoms. Microglia might also be involved in lower urinary tract symptoms. Only microglia and astrocytes have been studied in the animal model of CP/CPPS. Activated microglia and reactive astrocytes were found to be involved in both pain and psychosocial symptoms of CP/CPPS. The possible mechanism might be to mediate the production of some inflammatory mediators and their interaction with neurons. Glial cells provide a new insight to understand the cause of complex symptoms of CP/CPPS and might become a novel target to develop new treatment options. However, the activation and action mechanism of glial cells in CP/CPPS needs to be further explored.
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Affiliation(s)
- Yongfeng Lao
- Second Clinical Medical College, Lanzhou University, Lanzhou, China
- Department of Urology, Lanzhou University Second Hospital, Lanzhou, China
| | - Zewen Li
- Second Clinical Medical College, Lanzhou University, Lanzhou, China
- Department of Urology, Lanzhou University Second Hospital, Lanzhou, China
| | - Yanan Bai
- Second Clinical Medical College, Lanzhou University, Lanzhou, China
- Laboratory Medicine Center, Lanzhou University Second Hospital, Lanzhou, China
| | - Weijia Li
- Second Clinical Medical College, Lanzhou University, Lanzhou, China
| | - Jian Wang
- Second Clinical Medical College, Lanzhou University, Lanzhou, China
- Department of Urology, Lanzhou University Second Hospital, Lanzhou, China
| | - Yanan Wang
- Second Clinical Medical College, Lanzhou University, Lanzhou, China
- Department of Urology, Lanzhou University Second Hospital, Lanzhou, China
| | - Qingchao Li
- Second Clinical Medical College, Lanzhou University, Lanzhou, China
- Department of Urology, Lanzhou University Second Hospital, Lanzhou, China
| | - Zhilong Dong
- Second Clinical Medical College, Lanzhou University, Lanzhou, China
- Department of Urology, Lanzhou University Second Hospital, Lanzhou, China
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13
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Song WJ, Huang JW, Liu Y, Ding W, Long Z, He LY. The impact of the COVID-19 pandemic on erectile function in Chinese CP/CPPS patients. Asian J Androl 2023; 25:680-686. [PMID: 37695217 DOI: 10.4103/aja202338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 06/29/2023] [Indexed: 09/12/2023] Open
Abstract
This study aimed to investigate the impact of the coronavirus disease 2019 (COVID-19) pandemic on erectile function in Chinese patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). A retrospective study was conducted on 657 CP/CPPS patients who visited The Third Xiangya Hospital of Central South University (Changsha, China) from November 2018 to November 2022. Patients were divided into two groups based on the timeline before and after the COVID-19 outbreak in China. The severity of CP/CPPS, penile erection status, anxiety, and depression was evaluated using the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI), International Index of Erectile Function-5 (IIEF-5), Generalized Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-9 (PHQ-9) scales, respectively. Compared with patients before the COVID-19 outbreak, more CP/CPPS patients developed severe erectile dysfunction (ED) due to depression and anxiety caused by the pandemic. After developing moderate-to-severe ED, mild and moderate-to-severe CP/CPPS patients exhibited more apparent symptoms of anxiety and depression ( P < 0.001 and P = 0.001, respectively), forming a vicious cycle. The COVID-19 pandemic has adversely affected the psychological status of CP/CPPS patients, exacerbating their clinical symptoms and complicating ED. The exacerbation of clinical symptoms further worsens the anxiety and depression status of patients, forming a vicious cycle. During the COVID-19 pandemic, paying more attention to the mental health of CP/CPPS patients, strengthening psychological interventions, and achieving better treatment outcomes are necessary.
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Affiliation(s)
- Wei-Jie Song
- Department of Urology, The Third Xiangya Hospital, Central South University, Changsha 410013, China
- Sexual Health Research Center, Central South University, The Third Xiangya Hospital, Changsha 410013, China
| | - Ji-Wei Huang
- Department of Urology, The Third Xiangya Hospital, Central South University, Changsha 410013, China
- Sexual Health Research Center, Central South University, The Third Xiangya Hospital, Changsha 410013, China
| | - Yuan Liu
- Department of Urology, The Third Xiangya Hospital, Central South University, Changsha 410013, China
- Sexual Health Research Center, Central South University, The Third Xiangya Hospital, Changsha 410013, China
| | - Wei Ding
- Department of Urology, The Third Xiangya Hospital, Central South University, Changsha 410013, China
- Sexual Health Research Center, Central South University, The Third Xiangya Hospital, Changsha 410013, China
| | - Zhi Long
- Department of Urology, The Third Xiangya Hospital, Central South University, Changsha 410013, China
- Sexual Health Research Center, Central South University, The Third Xiangya Hospital, Changsha 410013, China
| | - Le-Ye He
- Department of Urology, The Third Xiangya Hospital, Central South University, Changsha 410013, China
- Sexual Health Research Center, Central South University, The Third Xiangya Hospital, Changsha 410013, China
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14
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Zhang Y, Peng R, Chen Z, Zhang W, Liu Z, Xu S, Zhu H, Chen J, Zheng B. Evidence for a causal effect of major depressive disorder, anxiety on prostatitis risk: A univariate and multivariate Mendelian randomization study. Prostate 2023; 83:1387-1392. [PMID: 37504798 DOI: 10.1002/pros.24601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 07/05/2023] [Accepted: 07/11/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND Observational studies have shown an association between major depressive disorder (MDD), anxiety, and prostatitis. However, the causal relationship between MDD, anxiety, and prostatitis remains controversial. Therefore, we aimed to use two-sample Mendelian randomization (MR) to assess the causal effects of MDD and anxiety on prostatitis. METHODS We conducted univariable and multivariable MR analyses using summary statistics from publicly available genome-wide association studies to estimate the causal relationships between MDD, anxiety, and prostatitis risk. In the main MR analysis, the inverse-variance weighted (IVW) method was used, while secondary methods included the weighted median, weighted mode, MR-Egger regression, and MR pleiotropy residual and outlier (MR-PRESSO) tests to detect and correct for the presence of pleiotropy. RESULTS MDD had 97 independent instrumental variables (IVs) and anxiety had 15 IVs. Univariable MR analysis showed that genetically determined MDD had a detrimental causal effect on prostatitis (IVW: odds ratio [OR] = 1.47, 95% confidence interval [CI] = 1.12-1.92, p = 0.005), while no causal relationship was found between anxiety and prostatitis (IVW: OR = 0.25, 95% CI = 0.02-2.82, p = 0.26). More convincingly, after adjusting for confounding factors such as body mass index, alcohol consumption, and smoking, the genetic liability for MDD remained associated with prostatitis risk, with no strong evidence of anxiety affecting prostatitis incidence. CONCLUSION This study supports the notion that MDD has a detrimental effect on prostatitis risk, and strategies focused on addressing MDD may be one of the cornerstones for treating prostatitis. The potential preventive value of treating MDD for prostatitis should be further investigated in future research.
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Affiliation(s)
- Yong Zhang
- The Department of Urology, The Second Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
- Institute of Urology, The Clinical Medical Research Center, The First People's Hospital of Nantong City, Nantong, Jiangsu, China
| | - Rui Peng
- The Department of Urology, The Second Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
- Institute of Urology, The Clinical Medical Research Center, The First People's Hospital of Nantong City, Nantong, Jiangsu, China
| | - Zhan Chen
- The Department of Urology, The Second Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
- Institute of Urology, The Clinical Medical Research Center, The First People's Hospital of Nantong City, Nantong, Jiangsu, China
| | - Wei Zhang
- The Department of Urology, The Second Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
| | - Zhenmin Liu
- The Department of Urology, The Second Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
| | - Siyang Xu
- Clinical Medicine, Xinglin College of Nantong University, Nantong, Jiangsu, China
| | - Hua Zhu
- The Department of Urology, The Second Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
| | - Jiangang Chen
- The Department of Urology, The Second Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
| | - Bing Zheng
- The Department of Urology, The Second Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
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Pattabiraman G, Engel G, Osborn CV, Murphy SF, Schaeffer AJ, Thumbikat P. Efficacy of Targeted Mast Cell Inhibition Therapy in Chronic Prostatitis/Chronic Pelvic Pain Syndrome. Urology 2023; 180:200-208. [PMID: 37442295 PMCID: PMC10592376 DOI: 10.1016/j.urology.2023.05.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 05/02/2023] [Accepted: 05/03/2023] [Indexed: 07/15/2023]
Abstract
OBJECTIVE To identify a subgroup of patients with mast cell dysfunction in chronic prostatitis/chronic pelvic pain syndrome and evaluate efficacy of mast cell-directed therapy. MATERIALS AND METHODS Men with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) were recruited and evaluated in an open-label, interventional uncontrolled trial after therapy with cromolyn sodium and cetirizine hydrochloride. The primary endpoint was a change in mast cell tryptase concentrations after treatment while secondary endpoints were changes in the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) and AUA-SI. Isolated cells from postprostatic massage urine were evaluated for immune changes using mRNA expression analysis. RESULTS 31 patients with a diagnoses of Category III CP/CPPS were consented, 25 patients qualified and 20 completed the study after meeting a prespecified threshold for active tryptase in expressed prostatic secretions. After treatment with cromolyn sodium and cetirizine dihydrochloride for 3-week, active tryptase concentrations were significantly reduced from 49.03±14.05 ug/mL to 25.49±5.48 ug/mL (P<.05). The NIH-CPSI total score was reduced with a mean difference of 5.2±1 along with reduction in the pain, urinary and quality of life subscores (P<.001). A reduction in the AUA-SI was observed following treatment (P<.05). NanoString mRNA analysis of isolated cells revealed downregulation of immune-related pathways including Th1 and Th17 T cell differentiation and TLR signaling. Marked reduction in CD45+ cells and specifically macrophages and neutrophil abundance was observed. CONCLUSION Identification of CP/CPPS patients with mast cell dysfunction may be achieved using tryptase as a discriminating biomarker. Mast cell-directed therapy in this targeted subgroup may be effective in reducing symptoms and modulating the immune inflammatory environment.
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Affiliation(s)
- Goutham Pattabiraman
- Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Geoffrey Engel
- Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Catherine V Osborn
- Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Stephen F Murphy
- Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Anthony J Schaeffer
- Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Praveen Thumbikat
- Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, IL.
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16
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Tohi Y, Hijikata Y, Sugimoto M, Kuroda H, Takei M, Matsuki T, Kamitani T, Kakehi Y, Fukuhara S, Yamamoto Y. Development and internal validation of a screening tool for chronic prostatitis (S-CP). World J Urol 2023; 41:2759-2765. [PMID: 37712967 PMCID: PMC10582131 DOI: 10.1007/s00345-023-04574-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 08/10/2023] [Indexed: 09/16/2023] Open
Abstract
PURPOSE We developed a simple self-checkable screening tool for chronic prostatitis (S-CP) and internally validated it to encourage men (in the general population) with possible chronic prostatitis to consult urologists. METHODS The expert panel proposed the S-CP, which comprises three domains: Area of pain or discomfort (6 components), accompanying Symptom (6 components), and Trigger for symptom flares (4 components). We employed logistic regression to predict chronic prostatitis prevalence with the S-CP. We evaluated the predictive performance using data from a representative national survey of Japanese men aged 20 to 84. We calculated the optimism-adjusted area under the curve using bootstrapping. We assessed sensitivity/specificity, likelihood ratio, and predictive value for each cutoff of the S-CP. RESULTS Data were collected for 5,010 men-71 (1.4%) had a chronic prostatitis diagnosis. The apparent and adjusted area under the curve for the S-CP was 0.765 [95% confidence interval (CI) 0.702, 0.829] and 0.761 (0.696, 0.819), respectively. When the cutoff was two of the three domains being positive, sensitivity and specificity were 62.0% (95% CI 49.7, 73.2) and 85.4% (95% CI 84.4, 86.4), respectively. The positive/negative likelihood ratios were 4.2 (95% CI 3.5, 5.2) and 0.45 (95% CI 0.33, 0.60), respectively. The positive/negative predictive values were 5.7 (95% CI 4.2, 7.6) and 99.4 (95% CI 99.1, 99.6), respectively. CONCLUSION The reasonable predictive performance of the S-CP indicated that patients (in the general population) with chronic prostatitis were screened as a first step. Further research would develop another tool for diagnostic support in actual clinical settings.
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Affiliation(s)
- Yoichiro Tohi
- Department of Urology, Faculty of Medicine, Kagawa University, 1750-1, Ikenobe, Miki-Cho, Kita-Gun, Kagawa, 761-0701 Japan
| | - Yasukazu Hijikata
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Section of Clinical Epidemiology, Department of Community Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Mikio Sugimoto
- Department of Urology, Faculty of Medicine, Kagawa University, 1750-1, Ikenobe, Miki-Cho, Kita-Gun, Kagawa, 761-0701 Japan
| | | | - Mineo Takei
- Department of Urology, Harasanshin General Hospital, Fukuoka, Japan
| | | | - Tsukasa Kamitani
- Section of Education for Clinical Research, Kyoto University Hospital, Kyoto, Japan
| | - Yoshiyuki Kakehi
- Department of Urology, Faculty of Medicine, Kagawa University, 1750-1, Ikenobe, Miki-Cho, Kita-Gun, Kagawa, 761-0701 Japan
| | - Shunichi Fukuhara
- Section of Clinical Epidemiology, Department of Community Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
- Shirakawa STAR for General Medicine, Fukushima Medical University, Fukushima, Japan
| | - Yosuke Yamamoto
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
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17
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Yitgin Y, Karakose A. Correlation of resistive index of prostatic capsular artery to clinical symptoms in men with chronic prostatitis/chronic pelvic pain syndrome. Low Urin Tract Symptoms 2023; 15:180-184. [PMID: 37314032 DOI: 10.1111/luts.12493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 05/30/2023] [Accepted: 06/01/2023] [Indexed: 06/15/2023]
Abstract
OBJECTIVES To evaluate the relation between resistive index (RI) of prostatic capsular arteries by transrectal Doppler ultrasonography in chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and its correlation with lower urinary tract symptoms, erectile dysfunction and premature ejaculation parameters of CP/CPPS. METHODS In total, we included 68 patients presenting with chronic prostatitis/chronic pelvic pain syndrome. We formed two groups, as Group 1 of 35 patients with a RI ≥ 0.7 and Group 2 of 33 patients with RI < 0.7. All patients were assessed with International Prostate Symptom Score (IPSS), International Index of Erectile Function (IIEF-5), premature ejaculation diagnostic tool (PEDT) and National Institutes of Health Chronic Prostatitis Symptom Index (CPSI). In addition, the RI of the prostate capsular artery was measured in all patients using Doppler ultrasound. Statistical analyses were performed with SPSS version 18. A p value < .05 was considered significant. RESULTS Demographic characteristics were similar in the two groups. IPSS was 11.3 ± 6 in Group 1 and 9.7 ± 5.3 in Group 2. IIEF-5 was 18.6 ± 2 in Group 1 and 20.4 ± 2.3 in Group 2. PEDT was 12.4 ± 5.6 in Group 1 and 11.2 ± 4 in Group 2. CPSI (total) was 19.3 ± 12.3 in Group 1 and 10.6 ± 7.7 in Group 2. There was significant statistical difference in IPSS, IIEF-5, and CPSI between the two groups (p < .001, p < .001, p < .001 respectively). However, we found no significant difference in PEDT between the two groups (p = .19). CONCLUSIONS There is a significant correlation between the lower urinary tract symptoms and erectile dysfunction parameters and the RI of the prostatic capsular artery in CP/CPPS and RI is an effective and noninvasive method to assess the severity of the disease.
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Affiliation(s)
- Yasin Yitgin
- Department of Urology, Istinye University Faculty of Medicine, Istanbul, Turkey
| | - Ayhan Karakose
- Department of Urology, Istinye University Faculty of Medicine, Istanbul, Turkey
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Slaviero M, de Almeida BA, da Silva EMS, Konflanz C, Zitelli LC, Siqueira FM, Pavarini SP. Streptococcus canis prostatitis and endocarditis with thromboembolism in a dog with sertoli cell tumour in a cryptic testis and prostatic squamous metaplasia. Vet Res Commun 2023; 47:1759-1766. [PMID: 36717508 DOI: 10.1007/s11259-022-10065-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 12/28/2022] [Indexed: 02/01/2023]
Abstract
We describe an unusual case of prostatitis caused by Streptococcus canis evolving to endocarditis and splenic, renal, and cerebral thromboembolism in a dog, associated with a Sertoli cell tumour in a cryptic testis and diffuse prostatic squamous metaplasia. A nine-year-old, intact male, mixed-breed dog was presented to a veterinary teaching hospital with abdominal pain and prostration. Physical examination and abdominal ultrasonography revealed an atrophic right testicle located in the subcutaneous tissue. The left testicle was in the abdominal cavity with increased dimensions and irregular contours. Complete blood count analysis showed marked neutrophilic leukocytosis and thrombocytopenia. After clinical worsening, euthanasia was performed, and the dog was submitted to post-mortem examination. The main gross findings included testicular malposition with one cryptic and one ectopic testis, enlarged prostate with purulent content, distension of the urinary bladder with cloudy urine, vegetative valvular endocarditis in the mitral valve, and spleen and renal infarcts. Histological examination showed a Sertoli cell tumour in the abdominal testis, diffuse prostatic squamous metaplasia with marked keratinization associated with bacterial prostatitis, fibrinonecrotic cystitis, bacterial endocarditis with marked myxomatous degeneration in the mitral valve, and splenic, renal, and cerebral thromboembolism. Microbiological analysis identified Streptococcus canis in the prostate and mitral valve. Sertoli cell tumour of cryptic testis increases oestrogen production and leads to squamous metaplasia of the prostate, which should be considered as predisposing factors for ascending S. canis infection from the urogenital tract to the prostate. Then, haematogenous spread of S. canis from the prostate to mitral valve cause endocarditis and subsequent thromboembolism and infarcts, all decisive to poor prognosis in this case.
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Affiliation(s)
- Mônica Slaviero
- Veterinary Pathology Laboratory, College of Veterinary Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Av. Bento Gonçalves 9090, 91540-000, Porto Alegre, RS, Brazil.
- Programa de Pós-Graduação em Ciências Veterinárias, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
| | - Bruno Albuquerque de Almeida
- Veterinary Pathology Laboratory, College of Veterinary Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Av. Bento Gonçalves 9090, 91540-000, Porto Alegre, RS, Brazil
- Programa de Pós-Graduação em Ciências Veterinárias, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Emanoelly Machado Sousa da Silva
- Veterinary Pathology Laboratory, College of Veterinary Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Av. Bento Gonçalves 9090, 91540-000, Porto Alegre, RS, Brazil
- Programa de Pós-Graduação em Ciências Veterinárias, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Caroline Konflanz
- Veterinary Clinic Hospital, College of Veterinary Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Larissa Caló Zitelli
- Programa de Pós-Graduação em Ciências Veterinárias, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Veterinary Bacteriology Laboratory, College of Veterinary Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Franciele Maboni Siqueira
- Programa de Pós-Graduação em Ciências Veterinárias, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Veterinary Bacteriology Laboratory, College of Veterinary Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Saulo Petinatti Pavarini
- Veterinary Pathology Laboratory, College of Veterinary Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Av. Bento Gonçalves 9090, 91540-000, Porto Alegre, RS, Brazil
- Programa de Pós-Graduação em Ciências Veterinárias, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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19
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Shi SB, Hu HJ, Li DS. [Research progress on male infertility caused by prostatitis]. Zhonghua Nan Ke Xue 2023; 29:741-745. [PMID: 38619523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Abstract
Prostatitis, as a common disease in urology, accounts for one-fourth of the outpatient volume in urology clinics. The number of patients is increasing year by year. In particular, chronic prostatitis not only affects the quality of life of patients but also often poses challenges for doctors in outpatient clinics. In recent years, male health issues have also attracted much attention, especially male infertility. Studies have shown that prostatitis lead to male infertility through a variety of mechanisms. However, there were few comprehensive discussions on male infertility caused by prostatitis. This article provides a review of the research on the correlation between prostatitis and male infertility.
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Affiliation(s)
- Shui-Bo Shi
- MedicalCollege of Nanchang University, Nanchang, Jiangxi 330000, China
| | - Hong-Ji Hu
- MedicalCollege of Nanchang University, Nanchang, Jiangxi 330000, China
| | - Dong-Shui Li
- Department of Andrology,the First Affiliated HospitalofNanchangUniversity, Nanchang, Jiangxi 330000, China
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20
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Stephens-Shields AJ, Lai HH, Landis JR, Kreder K, Rodriguez LV, Naliboff BD, Afari N, Sutcliffe S, Moldwin R, Griffith JW, Clemens JQ, Bradley CS, Quallich S, Gupta P, Harte SE, Farrar JT. Clinically Important Differences for Pain and Urinary Symptoms in Urological Chronic Pelvic Pain Syndrome: A MAPP Network Study. J Urol 2023; 209:1132-1140. [PMID: 36848118 PMCID: PMC11062515 DOI: 10.1097/ju.0000000000003394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 02/21/2023] [Indexed: 03/01/2023]
Abstract
PURPOSE Symptom heterogeneity in interstitial cystitis/bladder pain syndrome and chronic prostatitis/chronic pelvic pain syndrome, collectively termed urological chronic pelvic pain syndrome, has resulted in difficulty in defining appropriate clinical trial endpoints. We determine clinically important differences for 2 primary symptom measures, pelvic pain severity and urinary symptom severity, and evaluate subgroup differences. MATERIALS AND METHODS The Multidisciplinary Approach to the Study of Chronic Pelvic Pain Symptom Patterns Study enrolled individuals with urological chronic pelvic pain syndrome. We defined clinically important differences by associating changes in pelvic pain severity and urinary symptom severity over 3 to 6 months with marked improvement on a global response assessment using regression and receiver operating characteristic curves. We evaluated clinically important differences for absolute and percent change and examined differences in clinically important differences by sex-diagnosis, presence of Hunner lesions, pain type, pain widespreadness, and baseline symptom severity. RESULTS An absolute change of -4 was clinically important in pelvic pain severity among all patients, but clinically important difference estimates differed by pain type, presence of Hunner lesions, and baseline severity. Pelvic pain severity clinically important difference estimates for percent change were more consistent across subgroups and ranged from 30% to 57%. The absolute change urinary symptom severity clinically important difference was -3 for female participants and -2 for male participants with chronic prostatitis/chronic pelvic pain syndrome only. Patients with greater baseline severity required larger decreases in symptoms to feel improved. Estimated clinically important differences had lower accuracy among participants with low baseline symptoms. CONCLUSIONS A reduction of 30%-50% in pelvic pain severity is a clinically meaningful endpoint for future therapeutic trials in urological chronic pelvic pain syndrome. Urinary symptom severity clinically important differences are more appropriately defined separately for male and female participants.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Robert Moldwin
- Zucker School of Medicine at Hofstra-Northwell, Lake Success, NY
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21
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Zhang MX, Li GP, Chen YF, Ge YP, Cao TH. [Pelvic floor muscle rehabilitation training combined with psychological nursing intervention in the treatment of type ⅢB prostatitis]. Zhonghua Nan Ke Xue 2023; 29:66-70. [PMID: 37846835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
Abstract
OBJECTIVE To investigate the clinical effect of pelvic floor muscle rehabilitation training combined with psychological nursing intervention in the treatment of intractable type ⅢB prostatitis. METHODS We retrospectively analyzed the clinical data on 51 cases of intractable type ⅢB prostatitis treated from October 2020 to October 2022, which were randomly assigned to receive Tamsulosin medication (the control group, n = 24) or pelvic floor muscle rehabilitation training and psychological nursing in addition (the intervention group, n = 27), all for 8 weeks. We obtained NIH-CPSI, IIEF-5, Self-Rating Anxiety Scale (SAS) scores, Self-Rating Depression Scale (SDS) scores, the level of lecithin and the count of leukocytes in the prostatic fluid and the incidence of adverse events, and compared them between the two groups of patients before and after treatment. RESULTS The total effectiveness rate was significantly higher in the intervention than in the control group (88.9% vs 62.5%, P < 0.05). Compared with the baseline, the NIH-CPSI, IIEF-5, SAS and SDS scores and the lecithin level were remarkably increased in both groups after treatment (P < 0.05), even more significantly in the intervention group than in the control (P < 0.05). No statistically significant difference was observed in the count of leukocytes before and after treatment (P > 0.05). CONCLUSION On the basis of Tamsulosin medication, the application of pelvic floor rehabilitation training combined with psychological care can significantly enhance the therapeutic effect on type IIIB prostatitis, effectively relieve prostatitis pain, improve erectile function, lessen anxiety and depression symptoms, increase the level of lecithosomes and promote the recovery of prostatic function.
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Affiliation(s)
- Meng-Xi Zhang
- Center of Health Management, Baoshan District Hospital of Integrated Chinese and Western Medicine, Shanghai 201999, China
| | - Guang-Ping Li
- Center of Health Management, Baoshan District Hospital of Integrated Chinese and Western Medicine, Shanghai 201999, China
| | - Ya-Fang Chen
- Center of Health Management, Baoshan District Hospital of Integrated Chinese and Western Medicine, Shanghai 201999, China
| | - Yan-Ping Ge
- Center of Health Management, Baoshan District Hospital of Integrated Chinese and Western Medicine, Shanghai 201999, China
| | - Ting-Hu Cao
- Center of Health Management, Baoshan District Hospital of Integrated Chinese and Western Medicine, Shanghai 201999, China
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Tian Y, Zhang X, Zhang H, Luo G. Re: the association between histological prostatitis and benign prostatic hyperplasia: a single-center retrospective study. Aging Male 2022; 25:192. [PMID: 35903983 DOI: 10.1080/13685538.2022.2099829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Ye Tian
- Department of Urology, Guizhou Provincial People's Hospital, Guiyang, China
| | | | - Heng Zhang
- Department of Urology, Guizhou Provincial People's Hospital, Guiyang, China
| | - Guangheng Luo
- Department of Urology, Guizhou Provincial People's Hospital, Guiyang, China
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Abstract
OBJECTIVE To investigate the relationship between histological prostatitis (HP) and clinical parameters related to benign prostatic hyperplasia (BPH) in male. METHOD The clinical data of 196 BPH patients who underwent transurethral resection of the prostate were collected. According to the results of hematoxylin-eosin (H&E) staining of prostate tissue, patients were divided into two groups: BPH with HP group and BPH without HP group. Differences in acute urinary retention (AUR), prostate volume (PV), serum sex hormones, lower urinary tract symptoms (LUTS) related parameters, and systemic inflammation indicators were compared between the two groups. SPSS software v.25 was used for statistical analysis. RESULTS Compared with the BPH without HP group, the BPH with HP group had greater AUR rate, PV, total IPSS, and IPSS-storage in BPH with HP group (p < 0.05). However, there were no significant differences in IPSS-voiding, post-void residual volume, maximum urinary flow rate, serum sex hormones, and systemic inflammation indicators between the two groups (p > 0.05). CONCLUSIONS This study suggests that patients with HP have larger PV, more severe LUTS, and a higher risk of AUR. HP is closely related to BPH and may be a key factor in the occurrence and clinical progress of BPH.
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Affiliation(s)
- Jinze Li
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
- West China School of Clinical Medicine, Sichuan University, Chengdu, China
| | - Yunxiang Li
- Department of Urology, Nanchong Central Hospital, The Second Clinical Medical College, North Sichuan Medical College, Sichuan, China
| | - Dehong Cao
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Yin Huang
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
- West China School of Clinical Medicine, Sichuan University, Chengdu, China
| | - Lei Peng
- Department of Urology, Nanchong Central Hospital, The Second Clinical Medical College, North Sichuan Medical College, Sichuan, China
| | - Chunyang Meng
- Department of Urology, Nanchong Central Hospital, The Second Clinical Medical College, North Sichuan Medical College, Sichuan, China
| | - Qiang Wei
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
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24
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Loh-Doyle JC, Stephens-Shields AJ, Rolston R, Newcomb C, Taple B, Sutcliffe S, Yang CC, Lai H, Rodriguez LV. Predictors of Male Sexual Dysfunction in Urologic Chronic Pelvic Pain Syndrome (UCPPS), Other Chronic Pain Syndromes, and Healthy Controls in the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network. J Sex Med 2022; 19:1804-1812. [PMID: 36180370 PMCID: PMC10916540 DOI: 10.1016/j.jsxm.2022.08.196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 08/23/2022] [Accepted: 08/30/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND Sexual dysfunction (SD), including erectile (ED) and ejaculatory dysfunction, is associated with diminished quality of life (QoL) in men with UCPPS (chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and/or interstitial cystitis/bladder pain syndrome (IC/BPS)). AIM We sought to compare SD among male patients with UCPPS, other chronic pain conditions (positive controls, PC), and healthy controls (HC) without chronic pain, and to evaluate the association of comorbidities, psychosocial factors, and urologic factors of SD in all 3 groups. METHODS Baseline data from male UCPPS participants, PC (irritable bowel syndrome, chronic fatigue syndrome, fibromyalgia) and HC enrolled in the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network Epidemiology and Phenotyping Study were included in the analysis. Sexual function was assessed using the International Index of Erectile Function-Erectile Function Domain (IIEFEF) and Ejaculatory Function Scale (EFS). Male ED was defined as a composite IIEF-EF score <21. Higher EFS score indicated worse sexual dysfunction; no threshold to define SD was identified for the EFS. Multivariable logistic and linear regression was used to investigate associations of comorbidities, psychosocial factors, and urologic factors with ED and ejaculatory, respectively. OUTCOMES Comorbidities, genital pain, and psychosocial factors are associated with SD across the study population and male patients with UCPPS had a high prevalence of ED and greater ejaculatory dysfunction. RESULTS There were 191 males with UCPPS; 44 PC; and 182 HC. Males with UCPPS had worse SD compared to PC and HC including lower mean IIEF-EF scores, greater degree of ejaculatory dysfunction, and lower quality of sexual relationships. Among all 3 cohorts, depression, stress, and pain were associated with ED in univariable and multivariable analysis, as was diabetes mellitus. Pain in the genitalia, severity of urinary symptoms, depression, stress, and history of childhood sexual trauma were associated with ejaculatory dysfunction in univariable and multivariable analysis. CLINICAL IMPLICATIONS A multidisciplinary approach that addresses the identified risk factors for SD may improve overall QoL in males with UCPPS. STRENGTHS AND LIMITATIONS Our study is strengthened by its use of validated, patient-reported questionnaires and inclusion of healthy and positive controls. Our understanding of the role of IC in this study is limited because only 1 patient in the study had IC/BPS as a sole diagnosis. CONCLUSIONS When compared to healthy controls and patients with other chronic pain conditions, males with UCPPS experience higher degrees of SD, including erectile and ejaculatory dysfunction. Loh-Doyle JC, Stephens-Shields AJ, Rolston R, et al. Predictors of Male Sexual Dysfunction in Urologic Chronic Pelvic Pain Syndrome (UCPPS), Other Chronic Pain Syndromes, and Healthy Controls in the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network. J Sex Med 2022;19:1804-1812.
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Affiliation(s)
- Jeffrey C Loh-Doyle
- USC Institute of Urology, USC/Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
| | - Alisa J Stephens-Shields
- Department of Biostatistics, Epidemiology and Informatics, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Renee Rolston
- Albert Einstein College of Medicine, Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Craig Newcomb
- Department of Biostatistics, Epidemiology and Informatics, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Bayley Taple
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Siobhan Sutcliffe
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Claire C Yang
- Department of Urology, University of Washington, Seattle, WA, USA
| | - Henry Lai
- Departments of Surgery (Urologic Surgery) and Anesthesiology, Washington University School of Medicine, Division of Urologic Surgery, St Louis MO, USA
| | - Larissa V Rodriguez
- USC Institute of Urology, USC/Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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Bradley CS, Gallop R, Sutcliffe S, Kreder KJ, Lai HH, Clemens JQ, Naliboff BD. Long-Term Symptom Trajectories in Urologic Chronic Pelvic Pain Syndrome: A MAPP Research Network Study. Urology 2022; 169:58-64. [PMID: 35961564 PMCID: PMC10590538 DOI: 10.1016/j.urology.2022.07.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 07/24/2022] [Accepted: 07/27/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To characterize Urologic Chronic Pelvic Pain Syndrome (UCPPS) pain and urinary symptom trajectories with up to 9 years of follow-up and evaluate whether initial 1-year trajectories are associated with longer-term changes. MATERIALS AND METHODS Data were analyzed from the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Network's prospective observational protocols including the Epidemiology and Phenotyping Study (EPS; baseline to Year 1), EPS Extension (EXT; Years 1-5), and Symptom Patterns Study (SPS: 3-year study; Years 3-9). Adults with Interstitial Cystitis/Bladder Pain Syndrome or Chronic Prostatitis/Chronic Pelvic Pain Syndrome provided patient-reported assessments biweekly (EPS), every 4 months (EXT), or quarterly (SPS). Primary outcomes were composite pain (0-28) and urinary (0-25) severity scores. Multi-phase mixed effects models estimated outcomes over time, adjusted for baseline severity and stratified by EPS symptom trajectory. RESULTS 163 participants (52% women; mean ± SD age 46.4 ± 16.1 years) completed EPS and enrolled in EXT; 67 also enrolled in SPS. Median follow-up was 4.6 years (range 1.3-9.0). After 1 year: 27.6%, 44.8% and 27.6% and 27.0%, 38.0% and 35.0% were improved, stable or worse in pain and urinary symptom severity, respectively. On average, pain and urinary symptom scores did not change further during EXT and SPS periods. CONCLUSIONS Women and men with UCPPS showed remarkable stability in pain and urinary symptom severity for up to 9 years, irrespective of their initial symptom trajectory, suggesting UCPPS is a chronic condition with stable symptoms over multiple years of follow-up.
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Affiliation(s)
- Catherine S Bradley
- Department of Obstetrics and Gynecology, Carver College of Medicine, University of Iowa, Iowa City, IA.
| | - Robert Gallop
- Department of Mathematics, Applied Statistics Program, West Chester University, West Chester, PA
| | - Siobhan Sutcliffe
- Departments of Surgery (Public Health Sciences) and Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO
| | - Karl J Kreder
- Department of Urology, Carver College of Medicine, University of Iowa, Iowa City, IA
| | - H Henry Lai
- Departments of Surgery (Urology) and Anesthesiology, Washington University School of Medicine, St Louis, MO
| | | | - Bruce D Naliboff
- Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA
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26
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Liu F, Xu X, Wang Z, Wu P. Abnormal prostate microbiota composition is associated with experimental autoimmune prostatitis complicated with depression in rats. Front Cell Infect Microbiol 2022; 12:966004. [PMID: 36250064 PMCID: PMC9563248 DOI: 10.3389/fcimb.2022.966004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 08/24/2022] [Indexed: 11/29/2022] Open
Abstract
Background Microbiota play essential roles in the pathogenesis of prostatitis and depression. However, the changes in prostate microbiota have not yet been explored in rats with prostatitis/depression. This study aimed to investigate the changes of prostate microbiota in rats with prostatitis/depression. Methods Rats with experimental autoimmune prostatitis (EAP) complicated with depression were constructed through injection of rat prostate antigen with immunoadjuvants followed by application of chronic unpredictable mild stress (CUMS). The rats were subjected to inflammatory factor detection and behavioral testing to confirm the establishment of the model. Subsequently, the prostate microbiota was assayed in the rats and compared by 16S rRNA gene sequencing. Results A rat model of EAP complicated with depression was established and confirmed by increases in IL-1β, IL-6, and TNF-α as well as the occurrence of depressive‐like behaviors. EAP/CUMS significantly altered the richness, evenness, and composition of prostate microbiota. Forty-six taxonomic biomarkers for prostate microbiota were enriched in rats with EAP/depression and exhibited statistically significant and biologically consistent differences. Metabolomics profiling revealed that EAP/depression was associated with reductive acetyl coenzyme A pathway, L-lysine fermentation to acetate and butanoate, protein N-glycosylation and purine nucleobases degradation I, which is regulated by DCE29, Nocardioes, Helicobacter and Dorea. Conclusion Findings from the study demonstrate the existence of abnormal prostate microbiota in EAP complicated with depression and may be helpful in the treatment of comorbid diseases of prostatitis and depression.
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Affiliation(s)
- Feng Liu
- Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, China
- Department of Urology, Affiliated Sixth People’s Hospital South Campus, Shanghai Jiao Tong University, Shanghai, China
| | - Xiaolin Xu
- Department of Urology, Affiliated Sixth People’s Hospital South Campus, Shanghai Jiao Tong University, Shanghai, China
| | - Zhong Wang
- Department of Urology, Affiliated Sixth People’s Hospital South Campus, Shanghai Jiao Tong University, Shanghai, China
| | - Peng Wu
- Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, China
- *Correspondence: Peng Wu,
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Masiutin MG, Yadav MK. Letter to the editor regarding the article "Adrenocortical hormone abnormalities in men with chronic prostatitis/chronic pelvic pain syndrome". Urology 2022; 169:273. [PMID: 35987379 DOI: 10.1016/j.urology.2022.07.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 07/15/2022] [Indexed: 12/01/2022]
Affiliation(s)
| | - Maneesh K Yadav
- Technical University of Moldova, Chisinau, Republic of Moldova
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28
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Radej S, Szewc M, Maciejewski R. Prostate Infiltration by Treg and Th17 Cells as an Immune Response to Propionibacterium acnes Infection in the Course of Benign Prostatic Hyperplasia and Prostate Cancer. Int J Mol Sci 2022; 23:ijms23168849. [PMID: 36012113 PMCID: PMC9408129 DOI: 10.3390/ijms23168849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 08/04/2022] [Accepted: 08/06/2022] [Indexed: 11/16/2022] Open
Abstract
Benign prostatic hyperplasia (BPH) and prostate cancer (PCa) belong to the most frequent diseases in ageing men. It has been proposed that prostate chronic inflammation is a risk factor for the development of both BPH and PCa. However, potential stimuli that cause or maintain inflammation in the prostate gland are still poorly characterized. Bacterial infections seems to be one of the potential sources of prostatitis. Recent studies show that Propionibacterium acnes (P. acnes) is the most prevalent microorganism in the prostate gland and may be a predisposing factor for inflammation of prostatic tissue. It indicates that P. acnes may contribute to cancer development by enhancing proinflammatory responses, as well as by modifying the prostate extracellular environment. In this review, we discuss the potential role of P. acnes in the development of BPH and PCa and highlight the importance of regulatory T CD4(+)FoxP3(+) (Treg) and Th17 cells in response to P. acnes infection in the context of both prostate diseases.
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Affiliation(s)
- Sebastian Radej
- Department of Normal Anatomy, Medical University of Lublin, 20-090 Lublin, Poland
| | - Monika Szewc
- Department of Normal Anatomy, Medical University of Lublin, 20-090 Lublin, Poland
- Correspondence:
| | - Ryszard Maciejewski
- Department of Normal Anatomy, Medical University of Lublin, 20-090 Lublin, Poland
- Institute of Health Sciences, The John Paul II Catholic University of Lublin, 20-708 Lublin, Poland
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Meng J, Jin C, Li J, Zhang S, Zhang M, Hao Z, Chen X, Song Z, Zhang L, Liang C. Metabolomics Analysis Reveals the Differential Metabolites and Establishes the Therapeutic Effect Prediction Nomogram Among CP/CPPS Patients Who Respond or Do Not Respond to LiST. Front Immunol 2022; 13:953403. [PMID: 35911714 PMCID: PMC9332892 DOI: 10.3389/fimmu.2022.953403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 06/23/2022] [Indexed: 11/16/2022] Open
Abstract
Objective Low-intensity shockwave therapy (LiST) has been applied in the clinical treatment of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), but few studies have focused on the prediction of its therapeutic effect before treatment. Methods Seventy-five CP/CPPS patients from our institute between July 2020 and May 2021 were enrolled and received 3 Hz, 0.25 mJ/mm2 LiST once a week over the course of four weeks. The scores of the NIH-CPSI, IPSS questionnaire and demographic features before treatment were recorded. The plasma before LiST treatment was also collected, while liquid chromatography-tandem mass spectrometry was used to detect the metabolites. Least absolute shrinkage and selection operator (LASSO) regression analysis was employed to identify the prediction metabolites and generate the metabolism score. Receiver operating characteristic curves and calibration curves were drawn to assess the prediction accuracy of the nomogram. Results Twelve metabolites were identified at incomparable levels before and after LiST treatment. The metabolism score generated by LASSO analysis presented a perfect prediction value (AUC: 0.848, 95% CI: 0.719-0.940) in the training cohort and further increased to 0.892 (95% CI: 0.802-0.983) on the nomogram, which accompanied with the NIH-CPSI scores and age. Similar results of the metabolism score (AUC: 0.732, 95% CI: 0.516-0.889) and total nomogram (AUC: 0.968, 95% CI: 0.909-1.000) were obtained in the testing cohort. Further enrichment of the 12 metabolites indicated that the glycine and serine metabolism pathway was involved in the LiST treatment. Conclusion We used our system to accurately and quantitatively measure plasma metabolites and establish a predictive model to identify suitable patients for LiST treatment.
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Affiliation(s)
- Jialin Meng
- Department of Urology, The First Affiliated Hospital of Anhui Medical University; Institute of Urology & Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China
| | - Chen Jin
- Department of Urology, The First Affiliated Hospital of Anhui Medical University; Institute of Urology & Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China
| | - Jiawei Li
- Department of Urology, The First Affiliated Hospital of Anhui Medical University; Institute of Urology & Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China
| | - Song Zhang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University; Institute of Urology & Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China
| | - Meng Zhang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University; Institute of Urology & Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China
| | - Zongyao Hao
- Department of Urology, The First Affiliated Hospital of Anhui Medical University; Institute of Urology & Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China
| | - Xianguo Chen
- Department of Urology, The First Affiliated Hospital of Anhui Medical University; Institute of Urology & Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China
| | - Zhengyao Song
- Department of Urology, The First Affiliated Hospital of Anhui Medical University; Institute of Urology & Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China
| | - Li Zhang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University; Institute of Urology & Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China
| | - Chaozhao Liang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University; Institute of Urology & Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China
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30
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Ishtulin AF, Korotkova NV, Matveeva IV, Minaev IV, Polyakova PM. [Vitamin B12 is a diagnostic marker of decreased men reproductive function]. Biomed Khim 2022; 68:228-231. [PMID: 35717587 DOI: 10.18097/pbmc20226803228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Although the relationship between the amount of vitamin B12 and the quality of sperm exists, but results are controversial and require several additional research. The objective of our study was to analyse the amount of vitamin B12 in the sperm samples from patients with chronic prostatitis and varicocele with accompanying asthenozoospermia, and to identify the relationship between the amount of vitamin B12 and asthenozoospermia. The research was carried out of men with chronic prostatitis and varicocele with accompanying asthenozoospermia and infertility at the age of 27±2 years. The material of the investigation was spermoplasm. A chemical microscopic examination of the ejaculate was carried out with a sperm analyzer and with the light microscopy. The amount of vitamin B12 in the spermoplasm was determined by the method of competitive ELISA. It was found that the level of vitamin B12 was 3.6 times lower in patients with chronic prostatitis III B and asthenozoospermia then in the control group. Among patients with varicocele of II and III grade and asthenozoospermia, the level of vitamin B12 was 4.4 times lower than in control group. A positive correlation relationship of average strength was revealed (r=0,683; p=0,001). Additionally, it was revealed that among patients with Chronic prostatitis III B and varicocele of II and III grades with accompanying asthenozoospermia, there was the positive correlation relationship of average strength (r=0,690; p=0,001) between the amount of vitamin B12 and sperm mobility. A decrease in vitamin B12 levels may serve as a marker of reproductive dysfunction in men.
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Affiliation(s)
- A F Ishtulin
- Academician I.P. Pavlov Ryazan State Medical University, Ryazan, Russia
| | - N V Korotkova
- Academician I.P. Pavlov Ryazan State Medical University, Ryazan, Russia
| | - I V Matveeva
- Academician I.P. Pavlov Ryazan State Medical University, Ryazan, Russia
| | - I V Minaev
- Academician I.P. Pavlov Ryazan State Medical University, Ryazan, Russia
| | - P M Polyakova
- Academician I.P. Pavlov Ryazan State Medical University, Ryazan, Russia
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Fernández-Rubio B, Luque-Márquez R, Gil-Navarro MV. Probable ertapenem-induced encephalopathy; case report and suggested alternatives for chronic prostatitis. Daru 2022; 30:159-163. [PMID: 35023080 PMCID: PMC9114266 DOI: 10.1007/s40199-021-00425-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 10/26/2021] [Indexed: 01/16/2023] Open
Abstract
Ertapenem is a carbapenem antibiotic usually reserved for complicated infections. Drug-induced neurotoxicity is a rare adverse reaction associated with ertapenem, and may be directly related to its chemical structure. We report a case of a 64-year-old male with a hematological history and chronic prostatitis that was admitted to hospital for gait instability, clumsiness, dysarthria and tremors. He started ertapenem intravenous 1 g once daily a week prior to admission. Creatinine clearance calculation by the Cockcroft-Gault method was 52 mL/min and total protein levels were low. Ertapenem's administration was discontinued and the patient's neurological symptoms improved dramatically just one day after. The result of the Naranjo Scale was six, suggesting a probable adverse drug reaction. We discussed if he could receive meropenem in case of severe infection such as septic shock. Considering the patient's medical history, the chemical structure of meropenem and the fact that there are almost no reported cases of neurotoxicity from this drug, we assume that meropenem could be used in case of severe infection in patients with history of neurotoxicity caused by ertapenem if no added risk factors are present, such as renal failure.
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Affiliation(s)
- Beatriz Fernández-Rubio
- Unidad de Gestión Clínica de Farmacia, Hospital Universitario Virgen del Rocío/CSIC, Instituto de Biomedicina de Sevilla (IBiS), 41009 Seville, Spain
| | - Rafael Luque-Márquez
- Unidad de Gestión Clínica de Enfermedades Infecciosas, Microbiología Y Medicina Preventiva, Hospital Universitario Virgen del Rocío/CSIC, Instituto de Biomedicina de Sevilla (IBiS), 41009 Seville, Spain
| | - María-Victoria Gil-Navarro
- Unidad de Gestión Clínica de Farmacia, Hospital Universitario Virgen del Rocío/CSIC, Instituto de Biomedicina de Sevilla (IBiS), 41009 Seville, Spain
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Naliboff BD, Locke K, Schrepf AD, Griffith JW, Moldwin R, Krieger JN, Rodriguez LV, Stephens-Shields AJ, Clemens JQ, Lai HH, Sutcliffe S, Taple BJ, Williams D, Pontari MA, Mullins C, Landis JR. Reliability and Validity of Pain and Urinary Symptom Severity Assessment in Urological Chronic Pelvic Pain: A MAPP Network Analysis. J Urol 2022; 207:1246-1255. [PMID: 35060778 PMCID: PMC10494963 DOI: 10.1097/ju.0000000000002438] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE We assessed the reliability and validity of an efficient severity assessment for pelvic pain and urinary symptoms in urological chronic pelvic pain syndrome, which consists of interstitial cystitis/bladder pain syndrome and chronic prostatitis/chronic pelvic pain syndrome. MATERIALS AND METHODS A total of 578 patients were assessed using brief, empirically derived self-report scales for pelvic pain severity (PPS) and urinary symptom severity (USS) 4 times during a 1-month period and baseline clinic visit that included urological, pain and illness-impact measures. Mild, moderate and severe categories on each dimension were examined for measurement stability and construct validity. RESULTS PPS and USS severity categories had adequate reliability and both discriminant validity (differential relationships with specific clinical and self-report measures) and convergent validity (common association with nonurological somatic symptoms). For example, increasing PPS was associated with pelvic tenderness and widespread pelvic pain, whereas USS was associated with urgency during a bladder filling test and increased sensory sensitivity. PPS and USS categories were independently associated with nonurological pain and emotional distress. A descriptive analysis identified higher likelihood characteristics associated with having moderate to severe PPS or USS or both. Lack of sex interactions indicated that the measures are comparable in interstitial cystitis/bladder pain syndrome and chronic prostatitis/chronic pelvic pain syndrome. CONCLUSIONS Women and men with urological chronic pelvic pain syndrome can be reliably subgrouped using brief self-report measures of mild, moderate or severe pelvic pain and urinary symptoms. Comparisons with a broad range of clinical variables demonstrate the validity and potential clinical utility of these classifications, including use in clinical trials, health services and biological research.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Chris Mullins
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health
| | - J. Richard Landis
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health
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Novikova EG, Troitsky AV, Selyatitskaya VG, Ukah HU, Notov KG, Tityaev II, Tikhonov IV. [Dynamics of sperm indicators in men with chronic prostatitis associated with secondary infertility based on the use of ANDROEXPERT SV1 suppositories]. Urologiia 2022:59-65. [PMID: 35485815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Chronic prostatitis (CP) is the most common cause of a disorder of not only sexual, but also reproductive functions in men, which is caused by a decrease in the quality of the ejaculate and is confirmed by a deterioration in spermogram parameters, up to oligoasthenoteratozoospermia and azoospermia. In such a situation, the onset of pregnancy in the natural cycle is impossible - even with a completely preserved reproductive function in a woman. As an active substance in the recovery of men with chronic prostatitis associated with secondary infertility, we proposed oxidised dextran in the form of a pharmaceutical composition, which was developed at Federal Research Centre for Fundamental and Translational Medicine, Novosibirsk, Russia; and produced by ANDROEXPERT Research and Manufacturing Company LTD, Novosibirsk, Russia. The purpose of the study was to evaluate the dynamics of spermogram parameters as a result of the use of suppositories with oxidised dextran "ANDROEXPERT SV1" in men with chronic prostatitis associated with secondary infertility. MATERIAL AND METHODS The study included 52 patients with chronic prostatitis associated with secondary infertility. The mean age of the patients was 32+/-2.2 years. The examination of patients was carried out in accordance with the algorithm recommended by the Russian Society of Urology, the European Urological Association and the standard of primary health care for chronic prostatitis (Appendix to the order of the Ministry of Health of Russia No. 775n of 09.11.2012). The patients were divided into two groups: the 1st group of patients received oxidised dextran rectally once per day for 10 days, then 20 days every other day; The 2nd (comparison group) received a placebo in the form of rectal suppositories consisting of cocoa butter in a similar way. RESULTS The volume of ejaculate among patients of the 1st group increased from 2.54+/-0.15 to 3.13+/-0.18 (ml), which amounted to 23.23%; p<0.05. The sperm concentration indicator increased from 26.40+/-4.18 to 41.12+/-5.37 (million/ml) - by 55.75%; p<0.05, which led to an increase in the total number of spermatozoa in the ejaculate by 88.5%, from 65.47+/-8.41 to 123.41+/-12.33 (million pieces); p<0.05. The number of leukocytes in the same group decreased by 2.8 times: from 1.25+/-0.17 to 0.44+/-0.10 (million/ml) - by 64.80%; p<0.05. The indicator of the severity of sperm agglutination decreased by 3 times: from 0.52+/-0.07 to 0.17+/-0.03 - by 0.35 arb. units, which was 67.31%; p<0.05. The indicators of the spermogram in patients with chronic prostatitis of the second group did not change in the course of treatment. CONCLUSION Assessing the dynamics of spermogram parameters as a result of the use of "ANDROEXPERT SV1" in men with chronic prostatitis associated with secondary infertility, there is a decrease in the number of leukocytes and a significant improvement in the parameters of the ejaculate, both its general properties and the main characteristics of spermatozoa. Thus, ANDROEXPERT SV1 suppositories show high clinical efficacy and safety in monotherapy and may be promising when choosing the management tactics for this group of patients.
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Affiliation(s)
- E G Novikova
- Federal Medical Research Centre of Fundamental and Translational Medicine, Novosibirsk, Russia
- RMDC clinic Ltd, Novosibirsk, Russia
- RZD-Medicine clinic, Novosibirsk, Russia
- Novosibirsk State Medical University, Novosibirsk, Russia
- City Hospital 1, Novosibirsk, Russia
- Clinic 3, Barnaul, Russia
| | - A V Troitsky
- Federal Medical Research Centre of Fundamental and Translational Medicine, Novosibirsk, Russia
- RMDC clinic Ltd, Novosibirsk, Russia
- RZD-Medicine clinic, Novosibirsk, Russia
- Novosibirsk State Medical University, Novosibirsk, Russia
- City Hospital 1, Novosibirsk, Russia
- Clinic 3, Barnaul, Russia
| | - V G Selyatitskaya
- Federal Medical Research Centre of Fundamental and Translational Medicine, Novosibirsk, Russia
- RMDC clinic Ltd, Novosibirsk, Russia
- RZD-Medicine clinic, Novosibirsk, Russia
- Novosibirsk State Medical University, Novosibirsk, Russia
- City Hospital 1, Novosibirsk, Russia
- Clinic 3, Barnaul, Russia
| | - H U Ukah
- Federal Medical Research Centre of Fundamental and Translational Medicine, Novosibirsk, Russia
- RMDC clinic Ltd, Novosibirsk, Russia
- RZD-Medicine clinic, Novosibirsk, Russia
- Novosibirsk State Medical University, Novosibirsk, Russia
- City Hospital 1, Novosibirsk, Russia
- Clinic 3, Barnaul, Russia
| | - K G Notov
- Federal Medical Research Centre of Fundamental and Translational Medicine, Novosibirsk, Russia
- RMDC clinic Ltd, Novosibirsk, Russia
- RZD-Medicine clinic, Novosibirsk, Russia
- Novosibirsk State Medical University, Novosibirsk, Russia
- City Hospital 1, Novosibirsk, Russia
- Clinic 3, Barnaul, Russia
| | - I I Tityaev
- Federal Medical Research Centre of Fundamental and Translational Medicine, Novosibirsk, Russia
- RMDC clinic Ltd, Novosibirsk, Russia
- RZD-Medicine clinic, Novosibirsk, Russia
- Novosibirsk State Medical University, Novosibirsk, Russia
- City Hospital 1, Novosibirsk, Russia
- Clinic 3, Barnaul, Russia
| | - I V Tikhonov
- Federal Medical Research Centre of Fundamental and Translational Medicine, Novosibirsk, Russia
- RMDC clinic Ltd, Novosibirsk, Russia
- RZD-Medicine clinic, Novosibirsk, Russia
- Novosibirsk State Medical University, Novosibirsk, Russia
- City Hospital 1, Novosibirsk, Russia
- Clinic 3, Barnaul, Russia
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Morozov A, Bazarkin A, Babaevskaya D, Taratkin M, Kozlov V, Suvorov A, Spivak L, McFarland J, Russo GI, Enikeev D. A systematic review and meta-analysis of placebo effect in clinical trials on chronic prostatitis/chronic pelvic pain syndrome. Prostate 2022; 82:633-656. [PMID: 35133667 DOI: 10.1002/pros.24311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 01/16/2022] [Accepted: 01/21/2022] [Indexed: 12/18/2022]
Abstract
BACKGROUND It is a common practice to control efficacy of pharmacological treatment with a placebo group. However, placebo itself may affect subjective and even objective results. The purpose of this study was to evaluate the placebo effect on symptoms of CP/CPPS to improve future clinical trials. METHODS A search at three databases (Scopus, MEDLINE, and Web of Science) was conducted to identify double-blind placebo-controlled clinical trials on the treatment of CP/CPPS published until April 2021. The primary outcome - National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) score. SECONDARY OUTCOMES Qmax, PVR, IPSS, and prostate volume. RESULTS A total of 3502 studies were identified. Placebo arms of 42 articles (5512 patients, median 31 patients) were included in the systematic review. Systematic review identified positive changes in the primary endpoint, meta-analysis of 10 articles found that NIH-CPSI total score results were significantly influenced by placebo, mean difference -4.2 (95% confidence interval [CI]: -6.31, -2.09). Mean difference of NIH-CPSI pain domain was -2.31 (95% CI: -3.4, -1.21), urinary domain -1.12 (95% CI: -1.62, -0.62), quality of life domain -1.67 (95% CI: -2.38, -0.96); p < 0.001 for all. In case of the objective indicator - Qmax, there were three articles included in the meta-analysis. Qmax mean change from baseline was 0.68 (95% CI: -0.85, 2.22, p = 0.38). Systematic review showed no significant changes in pain, measured by VAS or other scores, IPSS and PVR. CONCLUSIONS Placebo significantly affected the subjective parameters (NIH-CPSI) and limitedly affected various other measurements of pain (visual analog scale, McGill pain questionnaire). There was no long-term effect on IPSS and objective measurements (Qmax, PVR). This study can be used in further clinical trials to develop general rules of CPPS treatment assessment.
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Affiliation(s)
- Andrey Morozov
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Andrey Bazarkin
- Institute for Clinical Medicine, Sechenov University, Moscow, Russia
| | - Diana Babaevskaya
- Institute for Clinical Medicine, Sechenov University, Moscow, Russia
| | - Mark Taratkin
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Vasily Kozlov
- Department of Public Health and Healthcare, Sechenov University, Moscow, Russia
| | - Aleksandr Suvorov
- "Digital Biodesign and Personalized Healthcare" World-Class Research Center, Sechenov University, Moscow, Russia
| | - Leonid Spivak
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Jonathan McFarland
- Institute of Linguistics and Intercultural Communication, Sechenov University, Moscow, Russia
- Faculty of Medicine, Universidad Autónoma Madrid, Madrid, Spain
| | - Giorgio I Russo
- Department of Surgery, Urology Section, University of Catania, Catania, Italy
| | - Dmitry Enikeev
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
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Ovchinnikov RI, Popova AY, Vtorushina VV, Muradyan AA, Gamidov SI. [The use of a complex of natural antimicrobial peptides and cytokines for treatment of male infertility and chronic prostatitis]. Urologiia 2022:43-53. [PMID: 35485813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Chronic prostatitis (CP) has long been considered one of the common causes of male infertility. The influence of therapy for CP on spermatogenesis is well studied. However, recently, especially in the era of the new coronavirus infection (COVID-19), much attention has been paid to the effects of cytokines on the pathogenesis of the inflammatory process, and their impact on male fertility. AIM To study the effect of a complex of natural antimicrobial peptides and cytokines (Superlymph) on ejaculate, MAR test, oxidative stress (OS), and sperm DNA fragmentation (SDF) in men with infertility and a history of CP. In some patients, the level of cytokines before and after treatment was determined. MATERIALS AND METHODS A total of 583 infertile men with a history of CP, aged 18-75 years, were screened according to the inclusion/ exclusion criteria. In group I, patients received antioxidant stimulation of spermatogenesis (triovit, trental, mexidol) in combination with a complex of natural antimicrobial peptides and cytokines (Superlymph) one suppository 25 IU at night for 20 days for 1-3 weeks and for 6-8 weeks for 2 months. In group II, antioxidant stimulation of spermatogenesis was prescribed along with suppositories for the prevention of CP for 2 months. The evaluated criteria included sperm analysis, MAR test, oxidative stress in spermatozoa (reactive oxygen species (ROS)) and SDF. The levels of seminal plasma cytokines were also measured before and after treatment in 32 patients using the Bio-Plex Pro panel for the simultaneous determination of 17 human cytokines, the Human Cytokine 17-plex Assay. Statistica-10 software was used for statistical analysis (p<0.05). RESULTS Of 135 eligible patients, results were collected from 125 men (mean age 31.7 +/- 13.4 years). In group I, there was a more pronounced increase in motility by 42.3%, a decrease in the MAR-test level by 64.7%, oxidative stress in spermatozoa by 56.1%, and SDF by 25.6%, compared to group II (30.4 %, 10.5%, 45.7%, 21.9%), respectively. All these changes were significant with the exception of a decrease in the level of SDF. In group I, there was a predominant increase in the activity of anti-inflammatory cytokines (IL-4, 10, 13), a decrease in the level of pro-inflammatory cytokines ((IL-2, 12). In group II, there was a significant decrease in both pro-inflammatory (IL-2, 6, 8), and anti-inflammatory cytokines (IL-4). The remaining changes were insignificant. Among mild side effects, there were a change in the color of the sclera in 4 (3.2%), anal pain in 3 (2.4%), a decrease in libido in 2 (1.6%) patients. No differences between groups in the frequency of side effects were recorded (p>0.05). CONCLUSION Antioxidant stimulation of spermatogenesis in infertile men and CP is an effective and safe. The addition of a complex of natural antimicrobial peptides and cytokines (Superlymph) leads to a more profound increase in sperm motility, a decrease in the MAR-test, oxidative stress in sperm cells, which potentiates the effects of therapy. The use of Superlymph is accompanied by a more pronounced positive effect on pathospermia, an increase in anti-inflammatory and a decrease in pro-inflammatory cytokines. In the contrary, in control group, where patients received antioxidant stimulation of spermatogenesis, only a decrease in the level of main cytokines was observed. The effect of a complex of natural antimicrobial peptides and cytokines (Superlymph) on the level of SDF, as well as the relationship with fertility and childbirth rates, requires further study.
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Affiliation(s)
- R I Ovchinnikov
- Department of Andrology and Urology of National Medical Research Center of Obstetrics, Gynecology and Perinatology named after V.I. Kulakov of the Ministry of Health of Russia, Moscow, Russia
- Russian-Finnish center of reproductive medicine Scanfert, Moscow, Russia
- Department of Clinical Immunology of National Medical Research Center of Obstetrics, Gynecology and Perinatology named after V.I. Kulakov of the Ministry of Health of Russia, Moscow, Russia
- Department of Obstetrics, Gynecology, Perinatology and Reproductology of I.M. Sechenov First Moscow State Medical University of the Ministry of Health of Russia, Moscow, Russia
| | - A Yu Popova
- Department of Andrology and Urology of National Medical Research Center of Obstetrics, Gynecology and Perinatology named after V.I. Kulakov of the Ministry of Health of Russia, Moscow, Russia
- Russian-Finnish center of reproductive medicine Scanfert, Moscow, Russia
- Department of Clinical Immunology of National Medical Research Center of Obstetrics, Gynecology and Perinatology named after V.I. Kulakov of the Ministry of Health of Russia, Moscow, Russia
- Department of Obstetrics, Gynecology, Perinatology and Reproductology of I.M. Sechenov First Moscow State Medical University of the Ministry of Health of Russia, Moscow, Russia
| | - V V Vtorushina
- Department of Andrology and Urology of National Medical Research Center of Obstetrics, Gynecology and Perinatology named after V.I. Kulakov of the Ministry of Health of Russia, Moscow, Russia
- Russian-Finnish center of reproductive medicine Scanfert, Moscow, Russia
- Department of Clinical Immunology of National Medical Research Center of Obstetrics, Gynecology and Perinatology named after V.I. Kulakov of the Ministry of Health of Russia, Moscow, Russia
- Department of Obstetrics, Gynecology, Perinatology and Reproductology of I.M. Sechenov First Moscow State Medical University of the Ministry of Health of Russia, Moscow, Russia
| | - A A Muradyan
- Department of Andrology and Urology of National Medical Research Center of Obstetrics, Gynecology and Perinatology named after V.I. Kulakov of the Ministry of Health of Russia, Moscow, Russia
- Russian-Finnish center of reproductive medicine Scanfert, Moscow, Russia
- Department of Clinical Immunology of National Medical Research Center of Obstetrics, Gynecology and Perinatology named after V.I. Kulakov of the Ministry of Health of Russia, Moscow, Russia
- Department of Obstetrics, Gynecology, Perinatology and Reproductology of I.M. Sechenov First Moscow State Medical University of the Ministry of Health of Russia, Moscow, Russia
| | - S I Gamidov
- Department of Andrology and Urology of National Medical Research Center of Obstetrics, Gynecology and Perinatology named after V.I. Kulakov of the Ministry of Health of Russia, Moscow, Russia
- Russian-Finnish center of reproductive medicine Scanfert, Moscow, Russia
- Department of Clinical Immunology of National Medical Research Center of Obstetrics, Gynecology and Perinatology named after V.I. Kulakov of the Ministry of Health of Russia, Moscow, Russia
- Department of Obstetrics, Gynecology, Perinatology and Reproductology of I.M. Sechenov First Moscow State Medical University of the Ministry of Health of Russia, Moscow, Russia
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Zhang M, Jin C, Kong X, Meng J, Fan S, Ding Y, Fang Q, Dong T, Zhang H, Ni J, Liu Y, Wang H, Chen X, Hao Z, Peng B, Zhang L, Wang Z, Liang C. Identification of novel susceptibility factors related to CP/CPPS-like symptoms: Evidence from a multicenter case-control study. Prostate 2022; 82:772-782. [PMID: 35188987 DOI: 10.1002/pros.24319] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 01/28/2022] [Accepted: 02/07/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND We aimed to systematically identify novel susceptible factors related to the occurrence and development of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS)-like symptoms that were not limited to lifestyles or dietary habits in Chinese population. METHODS We recruited participants from three centers (Shanghai [northeast], Hefei [east], and Lanzhou [northwest]) from August 2020 to June 2021. Demographics, lifestyles, dietary habits, past medical history, and national institutes of health-chronic prostatitis symptom index (NIH-CPSI) were collected from the individuals via optimized questionnaires. Logistic regression analysis and multivariate adjustment models were used to calculate the odds ratio (OR) and 95% confidence interval (95% CI) to assess the association between these variables and CP/CPPS-like symptoms. RESULTS A total of 1851 participants were enrolled in this study (764 cases and 1087 controls). Age distributions differed between groups (median, range: 32, 18-74 vs. 29, 18-70, p < 0.001). After adjustment, physicochemical occupational hazards were identified significantly related to CP/CPPS-like symptom occurrence and development (ORoccurrence : 1.389, 95% CI: 1.031-1.870, p < 0.001; ORdevelopment : 2.222, 95% CI: 1.464-3.372, p < 0.001); besides, greater than or equal to four ejaculations per week significantly increased the likelihood of CP/CPPS-like symptoms compared with one ejaculation per week (ORoccurrence : 3.051, 95% CI: 1.598-5.827, p = 0.001). For these patients, who were easily felt gastrointestinal discomfort caused by spicy food intake, they had a higher incidence to affect with CP/CPPS-like symptoms (ORoccurrence : 2.258, 95% CI: 1.858-2.745, p < 0.001). In addition, history of drug allergy and genitourinary infections were identified as independent susceptible factors for the occurrence of CP/CPPS-like symptoms (ORoccurrence : 1.689, 95% CI: 1.007-2.834, p = 0.047; ORoccurrence : 3.442, 95% CI: 2.202-5.382, p < 0.001, respectively), while the history of rheumatic immune diseases was found tightly associated with the development of CP/CPPS-like symptoms (ORdevelopment : 2.002, 95% CI: 1.008-4.058, p = 0.048). CONCLUSION Infection/inflammatory/immune-related disorders, novel dietary habits, and lifestyles associated with the susceptibility of CP/CPPS-like symptoms' occurrence and development are identified. Altering these irregular conditions serves as potential strategies for the treatment of patients with CP/CPPS-like symptoms.
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Affiliation(s)
- Meng Zhang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Institute of Urology & Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, Anhui, PR China
- Shenzhen Luohu Hospital Group, Institute of Urology of Shenzhen University, The Third Affiliated Hospital of Shenzhen University, Shenzhen, PR China
| | - Chen Jin
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Institute of Urology & Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, Anhui, PR China
| | - Xiangbin Kong
- Department of Urology, Lanzhou University Second Hospital, Lanzhou, Gansu, PR China
| | - Jialin Meng
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Institute of Urology & Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, Anhui, PR China
| | - Song Fan
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Institute of Urology & Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, Anhui, PR China
| | - Yang Ding
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Institute of Urology & Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, Anhui, PR China
| | - Qiaozhou Fang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Institute of Urology & Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, Anhui, PR China
| | - Ting Dong
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Institute of Urology & Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, Anhui, PR China
| | - Houliang Zhang
- Department of Urology, Shanghai Tenth People's Hospital, Tongji University, Shanghai, PR China
| | - Jinliang Ni
- Department of Urology, Shanghai Tenth People's Hospital, Tongji University, Shanghai, PR China
| | - Yi Liu
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Institute of Urology & Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, Anhui, PR China
| | - Hua Wang
- Department of Toxicology, School of Public Health, Anhui Medical University, Hefei, Anhui, PR China
| | - Xianguo Chen
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Institute of Urology & Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, Anhui, PR China
| | - Zongyao Hao
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Institute of Urology & Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, Anhui, PR China
| | - Bo Peng
- Department of Urology, Shanghai Tenth People's Hospital, Tongji University, Shanghai, PR China
| | - Li Zhang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Institute of Urology & Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, Anhui, PR China
| | - Zhiping Wang
- Department of Urology, Lanzhou University Second Hospital, Lanzhou, Gansu, PR China
| | - Chaozhao Liang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Institute of Urology & Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, Anhui, PR China
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Wu XY, Zhang Y, Tang XY, Cheng Y, Chen J, Li LN, Xu SF, Ling Q, Wang L, Liu CX, Yang WM, Du GH. [Clinical features and spinal lesions in patients with chronic prostatitis/chronic pelvic pain syndrome]. Zhonghua Yi Xue Za Zhi 2022; 102:870-876. [PMID: 35330581 DOI: 10.3760/cma.j.cn112137-20210818-01874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Objective: To analyze the clinical features and spinal lesions related to micturitionin of chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS) patients. Methods: Patients with CP/CPPS were enrolled to this study at the outpatient department of Tongji Hospital between January and June 2019. The data of clinical features was collected and analyzed, including lower urinary tract symptoms(LUTS), bowel syndrome and pain over different parts of body, as well as lower urinary tract dysfunction, spinal lesions and pelvic organ morphological changes demonstrated by MRI. The potential role of spinal lesions in the development of CP/CPPS syndrome was investigated. Results: A total of 126 CP/CPPS patients were included, with an age[M(Q1,Q3)]of 41(31,53) years and a course of disease of 2(1,20) years. Among them, 126 (100.0%) were complicated with LUTS, 72(57.1%) with bowel dysfunction and 88(69.8%) with pain. MRI showed the cervical central disc herniation(126 cases, 100.0%), the ischemic changing in the cervical area of visceral efferant pathway(82 cases, 65.1%), the lumbar central disc herniation(65 cases, 51.6%), and the sacral nerve cysts(97 cases, 77.0%) are commonly seen. In addition, the morphological changes in the visceral organs containing smooth muscle were demonstrated, including thickened bladder wall(91 cases, 72.2%), distended seminal vesicles(70 cases, 55.6%) and distended sigmoid colon/rectum(59 cases, 46.8%). Conclusions: CP/CPPS patients were characterized by the co-existence of LUTS, bowel dysfunction and somatic pain in one individual. The presence of multi-organ symptoms, combined with the high prevalence of spinal lesions associated with micturition reflex, suggesting the potential role of the spinal lesions in the development of CP/CPPS.
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Affiliation(s)
- X Y Wu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Y Zhang
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - X Y Tang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Y Cheng
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - J Chen
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - L N Li
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - S F Xu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Q Ling
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - L Wang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - C X Liu
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - W M Yang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - G H Du
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
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Epanchintseva EA, Selyatitskaya VG. [Analysis of risk factors for the development of infertility in men from infertile couples, depending on age.]. Adv Gerontol 2022; 35:485-491. [PMID: 36401856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
According to the Russian Society of Urologists, the frequency of infertility in marriage in the Russian Federation is 8-17,2%; half of the cases are associated with the male factor. Among the risk factors for the development of male infertility, there are mainly medical reasons, lifestyle factors and negative environmental factors. Despite the fact that the problem of infertility is addressed by men of different ages, from youth to the elderly, the correction of risk factors is usually carried out without taking into account the age of the patient, which makes it difficult to develop a personalized strategy for the treatment or prevention of infertility. The aim of the study was to study the structure of the leading risk factors for the development of infertility in men from infertile couples, to identify and characterize their age-associated features. The analysis of the medical histories of 1 198 men from infertile couples and the collection of information on all available risk factors for infertility were carried out. The analysis of age features was performed by dividing the sample into 5 age groups: 1st (n=271) - men ≤29,9 years; 2nd (n=415) - 30-34,9 years; 3rd (n=291) - 35-39,9 years; 4th (n=141) - 40-44,9 years; 5th (n=80) - ≥45 years. It was shown that in the general sample of medical causes, factors associated with chronic inflammation predominate: sexually transmitted infections (STIs) - 54%; prostatitis - 32%; obesity - 27%; from non-medical: alcohol - 73%; stress - 47%; smoking - 41%. With increasing age, the frequency of obesity, STIs, prostatitis, hepatitis B/C, mumps increases statistically significantly, while the most unfavorable group of men is 40-45 years old for factors such as STIs, hepatitis B/C and mumps, and the group of men over 45 years old for factors such as obesity and prostatitis.
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Affiliation(s)
- E A Epanchintseva
- Federal Research Center of Fundamental and Translational Medicine, 2 Timakova str., Novosibirsk 630117, Russian Federation, е-mail:
- Novosibirsk Center of Reproductive Medicine GK «Mother and child», 3 Heroes of the Revolution str., Novosibirsk 630037, Russian Federation
| | - V G Selyatitskaya
- Federal Research Center of Fundamental and Translational Medicine, 2 Timakova str., Novosibirsk 630117, Russian Federation, е-mail:
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Igarashi T, Tyagi P, Mizoguchi S, Saito T, Furuta A, Suzuki Y, Egawa S, Wang Z, Yoshimura N. Therapeutic effects of nerve growth factor-targeting therapy on bladder overactivity in rats with prostatic inflammation. Prostate 2021; 81:1303-1309. [PMID: 34596255 PMCID: PMC8832524 DOI: 10.1002/pros.24227] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 08/17/2021] [Accepted: 08/27/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND The present study examined the effect of liposomes conjugated with antisense oligonucleotide of nerve growth factor (NGF-OND) on local overexpression of NGF and bladder overactivity using rats with prostatic inflammation (PI). METHODS Male Sprague-Dawley rats were divided into three groups: (1) Control group; intact rats, (2) PI-NS group; rats with PI and intravesical instillation of normal saline (NS), (3) PI-OND group; rats with PI and intravesical instillation of NGF-OND. On Day 0, PI was induced by intraprostatic 5%-formalin injection. On Day 14, NGF-OND or NS was instilled directly into the bladder after laparotomy. On Day 28, therapeutic effects of NGF-OND were evaluated by awake cystometry and histological analysis as well as reverse-transcription polymerase chain reaction measurements of messenger RNA (mRNA) levels of NGF in the bladder and prostate, inflammatory markers in the prostate, C-fiber afferent markers, and an A-type K+ channel α-subunit (Kv 1.4) in L6-S1 dorsal root ganglia (DRG). RESULTS Intravesical NFG-OND treatment reduced PI-induced overexpression of NGF in both bladder and prostate, and reduced PI-induced bladder overactivity evident as longer intercontraction intervals in association with reductions of TRPV1 and TRPA1 mRNA expression levels in DRG. mRNA expression of Kv1.4 in DRG was reduced after PI, but improved in the PI-OND group. CONCLUSIONS These results indicate that NGF locally expressed in the bladder is an important mediator inducing bladder overactivity with upregulation of C-fiber afferent markers and downregulation of an A-type K+ channel subunit in DRG following PI, and that liposome-based, local NGF-targeting therapy could be effective for not only bladder overactivity and afferent sensitization, but also PI. Thus, local blockade of NGF in the bladder could be a therapeutic modality for male LUTS due to BPH with PI.
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Affiliation(s)
- Taro Igarashi
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
- Department of Urology, Jikei University School of Medicine, Tokyo, Japan
| | - Pradeep Tyagi
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Shinsuke Mizoguchi
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Tetsuichi Saito
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Akira Furuta
- Department of Urology, Jikei University School of Medicine, Tokyo, Japan
| | - Yasuyuki Suzuki
- Department of Urology, Tokyo Metropolitan Rehabilitation Hospital, Tokyo, Japan
| | - Shin Egawa
- Department of Urology, Jikei University School of Medicine, Tokyo, Japan
| | - Zhou Wang
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Naoki Yoshimura
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
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Lee JH, Yoo TK, Kang JY, Cho JM, Park YW, Lee SW, Choi JD. Relationship between erectile dysfunction and moderate to severe prostatitis-like symptoms in middle-aged men: a propensity score-matched analysis. Int Urol Nephrol 2021; 53:2261-2266. [PMID: 34546557 DOI: 10.1007/s11255-021-02991-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 09/06/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE We assessed the relationship between chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and erectile dysfunction (ED) using propensity score matching. METHODS Data from 8727 middle-aged men who had undergone health checkups were analyzed. The National Institutes of Health Chronic Prostatitis Symptoms Index (NIH-CPSI), the International Index of Erectile Function-5 (IIEF), the Premature Ejaculation Diagnostic Tool (PEDT), testosterone measurement, basic blood chemistry, and metabolic syndrome (MetS) assessment were performed in this study. Of the 8727 men considered, 7181 formed the cohort for propensity score matching, including 597 men with moderate to severe prostatitis-like symptoms (case) and 6584 men with no prostatitis-like symptoms (control); ultimately, however, members of the case and control groups were matched at a 1:1 ratio by propensity score. RESULTS After matching, the variables of age, testosterone, PEDT and MetS were evenly distributed between the groups. After matching, the mean IIEF score of the case group was significantly lower than that of the control group (17.2 ± 5.5 vs. 14.7 ± 5.3; P < 0.001). Additionally, the severity of ED was significantly greater in the case group (no, mild, mild to moderate, moderate, and severe, respectively: 27.5%, 30.2%, 24.6%, 13.1%, and 4.7% in the control group; 10.7%, 27.0%, 33.0%, 18.9%, and 10.4% in the case group; P < 0.001). Finally, the rate of moderate to severe ED was significantly higher in the case group than in the control group (17.8% vs. 29.3%; P < 0.001). CONCLUSION Moderate to severe prostatitis-like symptoms were significantly and independently correlated with ED in middle-aged men.
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Affiliation(s)
- Jun Ho Lee
- Department of Urology, Nowon Eulji Medical Center, Eulji University School of Medicine, 327, Gongneung-ro, Nowon-gu, Seoul, 01830, Republic of Korea
| | - Tag Keun Yoo
- Department of Urology, Nowon Eulji Medical Center, Eulji University School of Medicine, 327, Gongneung-ro, Nowon-gu, Seoul, 01830, Republic of Korea
| | - Jung Yoon Kang
- Department of Urology, Nowon Eulji Medical Center, Eulji University School of Medicine, 327, Gongneung-ro, Nowon-gu, Seoul, 01830, Republic of Korea
| | - Jeong Man Cho
- Uijeongbu Eulji Medical Center, Eulji University, Uijeongbu-si, Republic of Korea
| | - Yeon Won Park
- Department of Urology, National Police Hospital, Seoul, South Korea
| | - Sin Woo Lee
- Department of Urology, Nowon Eulji Medical Center, Eulji University School of Medicine, 327, Gongneung-ro, Nowon-gu, Seoul, 01830, Republic of Korea
| | - Jae Duck Choi
- Department of Urology, Nowon Eulji Medical Center, Eulji University School of Medicine, 327, Gongneung-ro, Nowon-gu, Seoul, 01830, Republic of Korea.
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Aydogdu O, Gocun PU, Aronsson P, Carlsson T, Winder M. Prostate-to-bladder cross-sensitization in a model of zymosan-induced chronic pelvic pain syndrome in rats. Prostate 2021; 81:252-260. [PMID: 33465254 DOI: 10.1002/pros.24101] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 12/30/2020] [Accepted: 01/01/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND The aim of the present study was to investigate the effects of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) on bladder function and pathophysiology. METHODS To create a model for CPPS, rats were intraprostatically injected with zymosan or saline, serving as control. Metabolic cage experiments were performed 7, 14, or 21 days after zymosan injection and after 14 days in the control group. Thereafter, cystometry was performed in which simulated micturition cycles were induced by saline infusion and contractile responses to the cholinergic agonist methacholine and the purinergic agonist ATP were measured. Following cystometry, the prostate and urinary bladder were excised and assessed histopathologically for possible inflammatory changes. RESULTS Metabolic cage data revealed a significantly increased urinary frequency in zymosan treated rats. Likewise, the volume per micturition was significantly lower in all CPPS groups compared to controls. Cystometry showed a significant increase in the number of nonvoiding contractions, longer voiding time, and a trend towards lower compliance in CPPS rats compared to controls. Induction of CPPS led to significantly reduced cholinergic and purinergic contractile responses. Histopathological analysis demonstrated prostatic inflammation in all CPPS groups, in particular in later stage groups. Both the extent and grade of bladder inflammation were significantly higher in CPPS groups compared to controls. CONCLUSIONS The current findings demonstrate a potential prostate-to-bladder cross-sensitization leading to symptoms of bladder overactivity and signs of bladder inflammation. Future clinical studies are required to verify the outcomes of the current study and enable advancement of patient care.
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Affiliation(s)
- Ozgu Aydogdu
- Department of Pharmacology, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Pinar Uyar Gocun
- Department of Pathology, School of Medicine, Gazi University, Ankara, Turkey
| | - Patrik Aronsson
- Department of Pharmacology, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Thomas Carlsson
- Department of Pharmacology, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Michael Winder
- Department of Pharmacology, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Abstract
Chronic prostatitis (CP) is a common health condition in men. Albeight obvious, a relationship between microbial induced prostatic inflammation and sexual function has not been as thoroughly investigated. Aiming to investigate possible associations between sexuality/sexual orientation and chronic bacterial prostatitis, we retrospectively evaluated 1783 visits (2009-2019) owing to investigation of prostatitis-like symptoms and routine follow up. A total of 389 patients, provided information regarding sexual orientation and sexuality. The mean age was 45,5 years. According their report, 92.28% were heterosexual, 6.16% homosexual and 1.54% bisexual. Regarding sexuality, 26,6% reported multiple sexual partnerships while 73,4% reported single sexual partnerships. There was a statistically significant association between chronic bacterial prostatitis as initial diagnosis and having multiple sexual partnerships. In contrast, the association between CBP and sexual orientation was not statistically significant Similarly, no significant association between any therapy outcome and having multiple sexual partners was established. Our findings suggest a connection between sexual practices and the onset of CBP which should be further investigated in order to reach to scientific conclusions.
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Affiliation(s)
| | - Evangelia Samara
- Department of Urology, Tzaneio Prefecture General Hospital of Piraeus, Piraeus, Greece
| | - Gianpaolo Perletti
- Faculty of Medicine and Medical Sciences, Department of Human Structure and Repair, Ghent University, Ghent, Βelgium
- Department of Biotechnology and Life Sciences, Section of Medical and Surgical Sciences, University of Insubria, Varese, Italy
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Yang J, Zhang QJ, Zhang JY, Wang YM, Zhu GQ, Song NH, Wang ZJ, Chen JH, Xia JD. Upregulated expression of NMDA receptor in the paraventricular nucleus shortens ejaculation latency in rats with experimental autoimmune prostatitis. Andrology 2021; 9:352-360. [PMID: 32749055 DOI: 10.1111/andr.12879] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 06/20/2020] [Accepted: 07/26/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Estimated 30%-40% of patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) suffer from premature ejaculation (PE), which is difficult to cure, but the mechanism is still unknown. Based on the results of our previous clinical studies and animal experiments, we propose that the glutamatergic system dysfunction in the paraventricular nucleus (PVN) may be involved. METHODS To test this hypothesis, we used experimental autoimmune prostatitis (EAP) rats to investigate the effects of CP/CPPS on ejaculation behavior through integrating copulatory behavior testing, neuroelectrophysiologic experiments, and molecular biology technologies. RESULTS Histological examination of prostate tissue in EAP rats exhibited consistent pathological findings with that in CP/CPPS patients. Behavior testing showed that ejaculation latency (EL) of EAP rats significantly shortened compared with the controls (5.1 ± 1.8 vs 9.1 ± 2.4 min, P < .001). Sympathetic nervous system (SNS) activity testing revealed that EAP rats displayed significantly higher plasma norepinephrine (NE) level (1780 ± 493 vs 1421 ± 453 pg/mL, P = .043) and SNS sensitivity (67.8 ± 9.6 vs 44.6 ± 8.7%, P < .001). Immunohistochemical detection and Western blot analysis both displayed that NR1 subunit expression of N-methyl-D-aspartic acid (NMDA) receptors in the PVN of EAP rats was significantly upregulated (P = .007 and P < .001). Furthermore, the expression of NMDA NR1 subunit positively correlated both with SNS sensitivity (r = .917, P < .001) and prostatic inflammation scores (r = .964, P < .001). CONCLUSION This study shows that EAP rats suffer from the same PE symptom as CP/CPPS patients. CP/CPPS-induced inflammatory-immune response can significantly upregulate the expression of NMDA receptors in the PVN, which shortening the EL by enhancing SNS sensitivity. However, the exact mechanism of chronic inflammation in the prostate causing the upregulated expression of NMDA receptors needs to be further studied.
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Affiliation(s)
- Jie Yang
- Department of Urology, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Qi-Jie Zhang
- Department of Urology, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jia-Yi Zhang
- Department of Urology, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Ya-Min Wang
- Department of Urology, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Guo-Qing Zhu
- Key Laboratory of Cardiovascular Disease and Molecular Intervention, Department of Physiology, Nanjing Medical University, Nanjing, China
| | - Ning-Hong Song
- Department of Urology, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Zeng-Jun Wang
- Department of Urology, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jian-Huai Chen
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Jia-Dong Xia
- Department of Urology, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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Pascal LE, Mizoguchi S, Chen W, Rigatti LH, Igarashi T, Dhir R, Tyagi P, Wu Z, Yang Z, de Groat WC, DeFranco DB, Yoshimura N, Wang Z. Prostate-Specific Deletion of Cdh1 Induces Murine Prostatic Inflammation and Bladder Overactivity. Endocrinology 2021; 162:5992231. [PMID: 33211830 PMCID: PMC7745638 DOI: 10.1210/endocr/bqaa212] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Indexed: 12/25/2022]
Abstract
Benign prostatic hyperplasia (BPH) is an age-related debilitating prostatic disease that is frequently associated with prostatic inflammation and bothersome lower urinary tract symptoms (LUTS). Animal models have shown that formalin- and bacterial-induced prostatic inflammation can induce bladder dysfunction; however, the underlying mechanisms contributing to prostatic inflammation in BPH and bladder dysfunction are not clear. We previously reported that E-cadherin expression in BPH is downregulated in hyperplastic nodules compared with expression in adjacent normal tissues. Here, we explored the potential consequences of prostatic E-cadherin downregulation on the prostate and bladder in vivo using an inducible murine model of prostate luminal epithelial-specific deletion of Cdh1. The prostate-specific antigen (PSA)-CreERT2 transgenic mouse strain expressing tamoxifen-inducible CreERT2 recombinase driven by a 6-kb human PSA promoter/enhancer was crossed with the B6.129-Cdh1tm2Kem/J mouse to generate bigenic PSA-CreERT2/Cdh1-/- mice. Deletion of E-cadherin was induced by transient administration of tamoxifen when mice reached sexual maturity (7 weeks of age). At 21 to 23 weeks of age, the prostate, bladder, and prostatic urethra were examined histologically, and bladder function was assessed using void spot assays and cystometry. Mice with Cdh1 deletion had increased prostatic inflammation, prostatic epithelial hyperplasia, and stromal changes at 21 to 23 weeks of age, as well as changes in bladder voiding function compared with age-matched controls. Thus, loss of E-cadherin in the murine prostate could result in prostatic defects that are characteristic of BPH and LUTS, suggesting that E-cadherin downregulation could be a driving force in human BPH development and progression.
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Affiliation(s)
- Laura E Pascal
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Correspondence: Zhou Wang, PhD, Department of Urology, University of Pittsburgh Medical Center, 5200 Centre Ave, Suite G40, Pittsburgh, PA 15232, USA. ; or Laura E. Pascal, PhD, Department of Urology, University of Pittsburgh Medical Center, 5200 Centre Ave, Suite G34, Pittsburgh, PA 15232, USA.
| | - Shinsuke Mizoguchi
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Wei Chen
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Lora H Rigatti
- Division of Laboratory Animal Resources, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Taro Igarashi
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Rajiv Dhir
- Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Pradeep Tyagi
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Zeyu Wu
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Zhenyu Yang
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - William C de Groat
- Department of Pharmacology and Chemical Biology, and University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Donald B DeFranco
- Department of Pharmacology and Chemical Biology, and University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Naoki Yoshimura
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Zhou Wang
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Department of Pharmacology and Chemical Biology, and University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- UPMC Hillman Cancer Center, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Correspondence: Zhou Wang, PhD, Department of Urology, University of Pittsburgh Medical Center, 5200 Centre Ave, Suite G40, Pittsburgh, PA 15232, USA. ; or Laura E. Pascal, PhD, Department of Urology, University of Pittsburgh Medical Center, 5200 Centre Ave, Suite G34, Pittsburgh, PA 15232, USA.
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Cannarella R, Condorelli RA, Barbagallo F, La Vignera S, Calogero AE. Endocrinology of the Aging Prostate: Current Concepts. Front Endocrinol (Lausanne) 2021; 12:554078. [PMID: 33692752 PMCID: PMC7939072 DOI: 10.3389/fendo.2021.554078] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 01/05/2021] [Indexed: 12/11/2022] Open
Abstract
Benign prostate hyperplasia (BPH), one of the most common diseases in older men, adversely affects quality-of-life due to the presence of low urinary tract symptoms (LUTS). Numerous data support the presence of an association between BPH-related LUTS (BPH-LUTS) and metabolic syndrome (MetS). Whether hormonal changes occurring in MetS play a role in the pathogenesis of BPH-LUTS is a debated issue. Therefore, this article aimed to systematically review the impact of hormonal changes that occur during aging on the prostate, including the role of sex hormones, insulin-like growth factor 1, thyroid hormones, and insulin. The possible explanatory mechanisms of the association between BPH-LUTS and MetS are also discussed. In particular, the presence of a male polycystic ovarian syndrome (PCOS)-equivalent may represent a possible hypothesis to support this link. Male PCOS-equivalent has been defined as an endocrine syndrome with a metabolic background, which predisposes to the development of type II diabetes mellitus, cardiovascular diseases, prostate cancer, BPH and prostatitis in old age. Its early identification would help prevent the onset of these long-term complications.
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Li G, Chang D, Chen D, Zhang P, You Y, Huang X, Cai J, Yang X. Efficacy of radial extracorporeal shock wave therapy for chronic prostatitis/chronic pelvic pain syndrome: A protocol for systematic review. Medicine (Baltimore) 2020; 99:e22981. [PMID: 33126371 PMCID: PMC7598797 DOI: 10.1097/md.0000000000022981] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Prostatitis is a common urogenital system disease in men which affects 5% to 9% of adult men worldwide and accounts for approximately 8% of visits to urologists. In the past years, its pathogenesis is complicated and the classification of it is not clear, so the effect of treatment measures is not significant. Recently, the treatment of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) includes nonsteroidal anti-inflammatory drugs, phytotherapy, hormonal therapy, alpha-blockers, anti-anxiolytic, and acupuncture, which provide more choice for the urologist. But there still are some limitations. scholars. Many studies suggest radial extracorporeal shock wave therapy may be the better option in the treatment of CP/CPPS. However, the efficacy and safety of it still lack solid evidence. METHODS AND ANALYSIS The electronic databases of MEDLINE, PubMed, Web of Science, EMBASE, Cochrane Library, Clinicaltrials.org, China National Knowledge Infrastructure Database, Wan fang Database, China Biology Medicine Database, VIP Science Technology Periodical Database, Chinese Clinical Trial Registry will be retrieved. All the randomized controlled trials of radial extracorporeal shock wave therapy (rESWT) for patients with CP/CPPS will be included. We will evaluate the outcomes including National Institutes of Health Chronic Prostatitis Symptom Index, visual analog scale, international prostate symptom score, international index of erectile function-5, and conduct this study strictly according to the Cochrane Handbook for Systematic Reviews of Interventions. RESULTS The current study is a protocol for systematic review and meta-analysis without results, and data analysis will be carried out after the protocol. We will share our findings on October 31st of 2021. CONCLUSION rESWT as a noninvasive treatment with no pain, which will be accepted more easily. Although some studies have suggested that rESWT can relieve the symptoms of patients, the efficacy and safety of it still lack solid evidence. To address this limitation scientifically and systematically, this study will inspect the efficacy and safety of the rESWT treatment in patients with CP/CPPS by integrating various studies. ETHICS AND DISSEMINATION Formal ethical approval is not required in this protocol. We will collect and analyze data based on published studies, and since there are no patients involved in this study, individual privacy will not be under concerns. The results of this review will be disseminated to peer-reviewed journals or submit to related conferences. PROTOCOL REGISTRATION NUMBER INPLASY202090076.
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Sun YM, Zhuang BJ, Li C. [Acupoint injection of Shuxuetong for chronic prostatitis / chronic pelvic pain syndrome complicated by premature ejaculation]. Zhonghua Nan Ke Xue 2020; 25:62-67. [PMID: 32212508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To observe the clinical efficacy of acupoint injection of Shuxuetong (SXT) in the treatment of chronic prostatitis / chronic pelvic pain syndrome (CP/CPPS) complicated by premature ejaculation (PE). METHODS A total of 78 cases of CP/CPPS complicated by PE were randomly assigned to receive acupuncture injection of SXT (n = 38) and placebo acupuncture as the control (n = 40) for two 15-day courses. The therapeutic effects were evaluated based on the patients' scores on National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) and Premature Ejaculation Diagnostic Tool (PEDT) before and after treatment. RESULTS Compared with the controls, the SXT group showed a significantly higher total effectiveness rate based on either NIH-CPSI (27.5% vs 63.2%, P < 0.05) or PEDT (25% vs 47.4%, P < 0.05) and a lower deterioration rate (17.5% vs 7.9%, P < 0.05). Statistically significant differences were observed between the baselines and post-treatment scores on NIH-CPSI in the SXT group (24.82 ± 5.89 vs 15.45 ± 6.74, P < 0.05) and the controls (26.10 ± 6.59 vs 22.10 ± 8.42, P < 0.05) as well as on PEDT in the SXT group (14.87 ± 3.70 vs 10.29 ± 4.25, P < 0.05) and the controls (14.98 ± 3.09 vs 13.00 ± 4.53, P < 0.05), and both the NIH-CPSI and PEDT scores were markedly lower in the SXT than in the control group after treatment (P < 0.05). Linear regression analysis exhibited a positive correlation between the NIH-CPSI and PEDT scores before and after treatment in the SXT group (R = 0.340, P < 0.037) but not in the control group (R = 0.133, P < 0.413). CONCLUSIONS Acupoint injection of Shuxuetong can significantly improve the symptoms of CP/CPPS and CP/CPPS-induced PE as well.
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Affiliation(s)
- Yi-Ming Sun
- Department of Andrology, Heilongjiang Academy of Traditional Chinese Medicine, Harbin, Heilongjiang 150036, China
| | - Bao-Jun Zhuang
- Department of Andrology, Heilongjiang Academy of Traditional Chinese Medicine, Harbin, Heilongjiang 150036, China
| | - Chen Li
- Department of Andrology, Heilongjiang Academy of Traditional Chinese Medicine, Harbin, Heilongjiang 150036, China
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Han IH, Song HO, Ryu JS. IL-6 produced by prostate epithelial cells stimulated with Trichomonas vaginalis promotes proliferation of prostate cancer cells by inducing M2 polarization of THP-1-derived macrophages. PLoS Negl Trop Dis 2020; 14:e0008126. [PMID: 32196489 PMCID: PMC7138318 DOI: 10.1371/journal.pntd.0008126] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 04/07/2020] [Accepted: 02/10/2020] [Indexed: 12/12/2022] Open
Abstract
Trichomonas vaginalis (Tv), a protozoan parasite causing sexually-transmitted disease, has been detected in tissue of prostatitis, benign prostatic hyperplasia (BPH) and prostate cancer (PCa). IL-6, a mediator of chronic inflammation, induces the progression of prostate cancer, and influences the polarization of M2 macrophages, which are the main tumor-associated macrophages. We investigated whether IL-6 produced by human prostate epithelial cells stimulated with Tv induces the M2 polarization of THP-1-derived macrophages, which in turn promotes the progression of PCa. Conditioned medium was prepared from Tv-infected (TCM) and uninfected (CM) prostate epithelial cells (RWPE-1). Thereafter conditioned medium was prepared from macrophages after incubation with CM (M-CM) or TCM (M-TCM). RWPE-1 cells infected with Tv produced IL-6 and chemokines such as CCL2 and CXCL8. When human macrophages were treated with conditioned medium of RWPE-1 cells co-cultured with Tv (TCM), they became polarized to M2-like macrophages as indicated by the production of IL-10 and TGF-β, and the expression of CD36 and arginase-1, which are M2 macrophage markers. Moreover, proliferation of the M2-like macrophages was also increased by TCM. Blockade of IL-6 signaling with IL-6 receptor antibody and JAK inhibitor (Ruxolitinib) inhibited M2 polarization of THP-1-derived macrophages and proliferation of the macrophages. To assess the effect of crosstalk between macrophages and prostate epithelial cells inflamed by Tv infection on the growth of prostate cancer (PCa) cells, PC3, DU145 and LNCaP cells were treated with conditioned medium from THP-1-derived macrophages stimulated with TCM (M-TCM). Proliferation and migration of the PCa cells were significantly increased by the M-TCM. Our findings suggest that IL-6 produced in response to Tv infection of the prostate has an important effect on the tumor microenvironment by promoting progression of PCa cells following induction of M2 macrophage polarization. In male, T. vaginalis infection have been proposed to involve in several prostate diseases such as prostatitis, benign prostatic hyperplasia and prostate cancer. However, studies for these mechanisms have been rare. We have previously reported that T. vaginalis induce the production of inflammatory cytokines in prostate cells. Among these cytokines, IL-6 have been reported to play an important role in M2 macrophage polarization, which lead to formation of tumor microenvironment in various cancers. Here we show that IL-6 produced by T. vaginalis infection in prostate epithelial cells induces M2 polarization of macrophages and these macrophages promote proliferation of prostate cancer cells. These findings suggest that T. vaginalis indirectly induces progression of prostate cancer by creating a tumor microenvironment through an inflammatory response.
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Affiliation(s)
- Ik-Hwan Han
- Department of Environmental Biology and Medical Parasitology, Hanyang University College of Medicine, Seoul, Korea
| | - Hyun-Ouk Song
- Department of Parasitology, School of Medicine, Catholic University of Daegu, Daegu, Korea
| | - Jae-Sook Ryu
- Department of Environmental Biology and Medical Parasitology, Hanyang University College of Medicine, Seoul, Korea
- * E-mail:
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Li J, Dong L, Yan X, Liu X, Li Y, Yu X, Chang D. Is Acupuncture Another Good Choice for Physicians in the Treatment of Chronic Prostatitis/Chronic Pelvic Pain Syndrome? Review of the Latest Literature. Pain Res Manag 2020; 2020:5921038. [PMID: 32256909 PMCID: PMC7085851 DOI: 10.1155/2020/5921038] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 02/12/2020] [Indexed: 02/07/2023]
Abstract
This study aimed to evaluate the efficacy and safety of acupuncture for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). A search of PUBMED, EMBASE, Central Register of Controlled Trials (CENTRAL), Web of Science, Chinese Biomedicine Literature (CBM), China National Knowledge Infrastructure (CNKI), Wang-Fang Database, Chinese Scientific Journal Database (VIP), and other available resources was made for studies (up to February 2019). Searches were limited to studies published in English and Chinese. Only randomized controlled trials (RCTs) related to the efficacy and/or safety of acupuncture for CP/CPPS were included. Two investigators independently evaluated the quality of the studies. A total of 11 studies were included, involving 748 participants. The results revealed that compared with sham acupuncture (MD: -6.53 [95% CI: -8.08 to -4.97]) and medication (MD: -4.72 [95% CI: -7.87 to -1.56]), acupuncture could lower total NIH-CPSI score more effectively. However, there are no significant differences between acupuncture and sham acupuncture in terms of IPSS score. In terms of NIH-CPSI voiding domain subscore, no significant differences were found between acupuncture and medication. Compared with sham acupuncture (OR: 0.12 [95% CI: 0.04 to 0.40) and medication (OR: 3.71 [95% CI: 1.83 to 7.55]), the results showed favorable effects of acupuncture in improving the response rate. Acupuncture plus medication is better than the same medication in improving NIH-CPSI total score and NIH-CPSI pain domain subscore. In conclusion, the evidence suggests that acupuncture may be an effective intervention for patients with CP/CPPS. However, due to the heterogeneity of the methods and high risk of bias, we cannot draw definitive conclusions about the entity of the acupuncture's effect on alleviating the symptoms of CP/CPPS. The adverse events of acupuncture are mild and rare.
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Affiliation(s)
- Junjun Li
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Liang Dong
- The Reproductive & Women-Children Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xuhong Yan
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xiaozhang Liu
- The Reproductive & Women-Children Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Ying Li
- The Reproductive & Women-Children Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xujun Yu
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
- The Reproductive & Women-Children Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Degui Chang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Cai T, Santi R, Tamanini I, Galli IC, Perletti G, Bjerklund Johansen TE, Nesi G. Current Knowledge of the Potential Links between Inflammation and Prostate Cancer. Int J Mol Sci 2019; 20:ijms20153833. [PMID: 31390729 PMCID: PMC6696519 DOI: 10.3390/ijms20153833] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 07/28/2019] [Accepted: 08/05/2019] [Indexed: 01/08/2023] Open
Abstract
Inflammation is inherent in prostatic diseases and it is now accepted that it may facilitate cellular proliferation in both benign and malignant conditions. The strong relationship between prostatic inflammation and pathogenesis of benign prostatic hyperplasia (BPH) is supported by epidemiologic, histopathologic and molecular evidence. Contrariwise, the role of inflammation in prostate carcinogenesis is still controversial, although current data indicate that the inflammatory microenvironment can regulate prostate cancer (PCa) growth and progression. Knowledge of the complex molecular landscape associated with chronic inflammation in the context of PCa may lead to the introduction and optimization of novel targeted therapies. In this perspective, evaluation of the inflammatory component in prostate specimens could be included in routine pathology reports.
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Affiliation(s)
- Tommaso Cai
- Department of Urology, Santa Chiara Regional Hospital, 38122 Trento, Italy
| | | | - Irene Tamanini
- Department of Urology, Santa Chiara Regional Hospital, 38122 Trento, Italy
| | | | - Gianpaolo Perletti
- Department of Biotechnology and Life Sciences, Università degli Studi dell'Insubria, 21100 Busto Arsizio, Italy
| | | | - Gabriella Nesi
- Department of Health Sciences, University of Florence, 50139 Florence, Italy.
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