Urologic chronic pelvic pain syndrome: Difference between revisions
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Revision as of 00:51, 8 March 2021
Urologic chronic pelvic pain syndrome (UCPPS) is an umbrella term adopted for use in research into urologic pain syndromes associated with the male and female pelvis. UCPPS specifically refers to chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) in men and interstitial cystitis or painful bladder syndrome (IC/PBS) in women.[1]
Chronic pelvic pain (category IIIB) is often misdiagnosed as chronic bacterial prostatitis and needlessly treated with antibiotics exposing the patient to inappropriate antibiotic use and unnecessarily to adverse effects with little if any benefit in most cases. Within a Bulgarian study, where by definition all patients had negative microbiological results, a 65% adverse drug reaction rate was found for patients treated with ciprofloxacin in comparison to a 9% rate for the placebo patients. This was combined with a higher cure rate (69% v 53%) found within the placebo group.[2]
Treatment Multimodal therapy is the most successful treatment option in chronic pelvic pain,[3] and includes physical therapy,[4] myofascial trigger point release,[4] relaxation techniques,[4] α-blockers,[5] and phytotherapy.[6][7] The UPOINT diagnostic approach suggests that antibiotics are not recommended unless there is clear evidence of infection.[8]
Research
In 2007, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the United States National Institutes of Health, began using UCPPS as a term to refer to chronic pelvic pain syndromes, mainly interstitial cystitis/bladder pain syndrome (IC/BPS) in women and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) in men.[9]
- ^ Adamian L, Urits I, Orhurhu V, Hoyt D, Driessen R, Freeman JA, Kaye AD, Kaye RJ, Garcia AJ, Cornett EM, Viswanath O (May 2020). "A Comprehensive Review of the Diagnosis, Treatment, and Management of Urologic Chronic Pelvic Pain Syndrome". Curr Pain Headache Rep. 24 (6): 27. doi:10.1007/s11916-020-00857-9. PMID 32378039.
- ^ J. Dimitrakov; J. Tchitalov; T. Zlatanov; D. Dikov. "A Prospective, Randomized, Double-Blind, Placebo-Controlled Study Of Antibiotics For The Treatment Of Category Iiib Chronic Pelvic Pain Syndrome In Men". Third International Chronic Prostatitis Network. Retrieved 4 September 2009.
The results of our study show that antibiotics have an unacceptably high rate of adverse side effects as well as a statistically insignificant improvement over placebo...
- ^ Potts JM (2005). "Therapeutic options for chronic prostatitis/chronic pelvic pain syndrome". Current Urology Reports. 6 (4): 313–7. doi:10.1007/s11934-005-0030-5. PMID 15978236. S2CID 195364765.
- ^ a b c Potts J, Payne RE (May 2007). "Prostatitis: Infection, neuromuscular disorder, or pain syndrome? Proper patient classification is key". Cleve Clin J Med. 74 Suppl 3: S63–71. doi:10.3949/ccjm.74.suppl_3.s63. PMID 17549825.
- ^ Yang G, Wei Q, Li H, Yang Y, Zhang S, Dong Q (2006). "The effect of alpha-adrenergic antagonists in chronic prostatitis/chronic pelvic pain syndrome: a meta-analysis of randomized controlled trials". J. Androl. 27 (6): 847–52. doi:10.2164/jandrol.106.000661. PMID 16870951.
...treatment duration should be long enough (more than 3 months)
- ^ Shoskes DA, Zeitlin SI, Shahed A, Rajfer J (1999). "Quercetin in men with category III chronic prostatitis: a preliminary prospective, double-blind, placebo-controlled trial". Urology. 54 (6): 960–3. doi:10.1016/S0090-4295(99)00358-1. PMID 10604689.
- ^ Elist J (2006). "Effects of pollen extract preparation Prostat/Poltit on lower urinary tract symptoms in patients with chronic nonbacterial prostatitis/chronic pelvic pain syndrome: a randomized, double-blind, placebo-controlled study". Urology. 67 (1): 60–3. doi:10.1016/j.urology.2005.07.035. PMID 16413333.
- ^ Sandhu J, Tu HY (2017). "Recent advances in managing chronic prostatitis/chronic pelvic pain syndrome". F1000Res. 6: 1747. doi:10.12688/f1000research.10558.1. PMC 5615772. PMID 29034074.
{{cite journal}}: CS1 maint: unflagged free DOI (link) - ^ Clemens JQ, Mullins C, Kusek JW, Kirkali Z, Mayer EA, Rodríguez LV, et al. (August 2014). "The MAPP research network: a novel study of urologic chronic pelvic pain syndromes". BMC Urol. 14: 57. doi:10.1186/1471-2490-14-57. PMC 4134515. PMID 25085007.
{{cite journal}}: CS1 maint: unflagged free DOI (link)