Talk:Chronic prostatitis/chronic pelvic pain syndrome

Disambiguation

Could this page replace or be megered with the main proststits article?

- No, because it's a different thing — Preceding unsigned comment added by 77.225.149.15 (talk) 19:53, 6 April 2012 (UTC)

Major new overview study published in top journal

The Journal of Urology (known as "the white journal" by urologists since it is one of the top medical journals in the world) has just published a major new study that looks back over 30 years of research into this field. You can read it here. I think this should be used as a starting point for any further editing of the page. If there is no objection, I shall use it as a reference for a lot of future changes. ► RATEL ◄ 14:38, 28 April 2008 (UTC)

NIH alfusozin study

Objection to posting findings of the study because not yet published in a journal. This was a large, multi-center, NIH run study whose findings have a direct impact on patient care today. Abstract is published in the Journal of Urology AUA edition. Not reasonable to wait on every bit of medical evidence to go through the 6-12 months it takes to be published in a journal if level of quality (patient numbers, study design, track record of investigators) is strong enough. Is this not more important than a list of famous dead people who may have had prostatitis based on newspaper accounts? I completely agree that minor abstracts should not be given the weight of peer reviewed journal articles and that not all journal articles are of equal weight. I would also support removing the information if no article is forthcoming. Nevertheless, I believe that deleting this edit sets the bar too high, and would call into question some of the other more speculative parts of the CPPS wiki entry. Wlosy (talk) 15:32, 21 May 2008 (UTC)

• Please read rules for reliable sources for medical articles. Thank you and keep contributing. ► RATEL ◄ 15:36, 21 May 2008 (UTC)

Failure of alfusozin does not mean other alpha blockers will fail also. Alfusozin is relatively selective for the alpha1a receptor subtype. Alpha receptors that control pain in the spinal cord may be other subtypes. Note that studies of less selective alpha blockers in CPPS (Cardura, Hytrin) while smaller in numbers, were all positive studies. Wlosy (talk) 22:03, 26 May 2008 (UTC)

Actually, the abstract ends with the conclusion:

This large NIH/NIDDK sponsored multicenter randomized placebo controlled North American trial will provide an evidence based foundation to help physicians decide whether or not to prescribe alpha-blockers for men with newly diagnosed CP/CPPS.

The inference that the study relates to all alpha blockers may justifiably be drawn. However, I see no problem leaving the edit you made, for now.► RATEL ◄ 22:40, 26 May 2008 (UTC)

Mepartricin

Im surprised this article doesnt mention this drug (and the [Mepartricin] article only describes it as a stomatological preparation). It has shown to be effective in treating CPPS and I can only confirm that from my personal experience. Evidence: http://www.goldjournal.net/article/S0090-4295%2803%2900885-9/abstract —Preceding unsigned comment added by 80.188.222.34 (talk) 16:45, 15 April 2010 (UTC)

==Name== I have never seen a page named like this chronic prostatitis and chronic pelvic pain syndrome are synonyms. Usually we use one or the other not both.Doc James (talk · contribs · email) 11:24, 29 May 2010 (UTC)

Recent changes

There are some SPA editors making huge changes, mostly deletions of long-standing sourced content, without reason, and simultaneous addition of unsourced material that amounts to SPAM while failing the tests of wikipedia is not a crystal ball and rules for sourcing of data in medical articles. The SPAs are Noodlebike (talk · contribs · deleted contribs · page moves · block user · block log) and Arkaroola (talk · contribs · deleted contribs · page moves · block user · block log). I notice the rules on edit warring were also breached. TickleMeister (talk) 09:03, 19 August 2010 (UTC)

Recent review

Review [1] Doc James (talk · contribs · email) 22:17, 25 January 2011 (UTC)

Unfortunately, because this field has seen quite large advances in knowledge in the last 12 years, a review that starts at 1974 will come up with some strange results. The finding that antibiotics are the most effective treatment, for instance, flies in the face of recent research that recommends against their use, since they are found to be no better than placebo (PMID 14550427 et al). See also PMID 18472971 PMID 17954024 and many more like them. RxWatch (talk) 00:24, 26 January 2011 (UTC)

Merge with Chronic prostatitis

Neither ICD 9 or 10 use this term. We routinely refer to the condition as chronic prostatitis.--Doc James (talk · contribs · email) 22:27, 25 January 2011 (UTC)

Chronic prostatitis is shorthand for CP/CPPS, and redirects to this article. RxWatch (talk) 00:25, 26 January 2011 (UTC)

You are correct. Thus I propose we move it to Chronic prostatitis as this is the ICD 9 term and both terms are frequently used interchangeably in reviews.--Doc James (talk · contribs · email) 00:34, 26 January 2011 (UTC)

ICD 9 is a little behind the terms the urological profession and researchers are using (see Table 2 here). But I don't have an objection to the name change, as long as we ripple it all over the database. RxWatch (talk) 00:46, 26 January 2011 (UTC)

Medline plus uses the term "Chronic nonbacterial prostatitis" That might work even better. Then change Chronic prostatitis to a disambig that lists these two terms? Doc James (talk · contribs · email) 01:09, 26 January 2011 (UTC)

Chronic nonbacterial prostatitis — gee, that's an oldie that nobody uses anymore. Do we have to conform to medline or ICD9, and can't we just stick to the NIDDK's definition? RxWatch (talk) 01:33, 26 January 2011 (UTC)

If you look at Pubmed there are recent reviews 2009 that use the term. I had never heard of CP/CPPS until I realised that it was the same as chronic prostatitis. Doc James (talk · contribs · email) 02:47, 26 January 2011 (UTC)

You are right that CP/CPPS is used more. It is just such a combersum term. Will leave it where it is per NIDDK. Doc James (talk · contribs · email) 02:51, 26 January 2011 (UTC)

I have noticed an unfortunate trend to longer (and more inclusive) names for diseases, institutions, departments of institutions, etc., necessitating an ever-increasing use of opaque initialisms.  :-( 108.48.209.190 (talk) 22:20, 3 March 2013 (UTC)

female prostate

This page is heavily geared towards men with chronic prostatis. I would create a separate page for chronic pelvic pain syndrome as it pertains to women. — Preceding unsigned comment added by Mjams (talk • contribs) 14:55, 1 October 2016 (UTC)

ummm see Skene's gland and articles linked at Skene's_gland#Clinical_significance Jytdog (talk) 18:42, 1 October 2016 (UTC)

New ref

seems good: http://www.mayoclinicproceedings.org/article/S0025-6196(16)30503-1/pdf%7C Best Regards, Barbara (WVS) (talk) 19:36, 6 November 2016 (UTC)

Brain

I have put the brain research section under the heading Research. This is an enigmatic syndrome and finally there is light at the end of the tunnel with this NIH/NIDDK funded research, so excluding it all would be stupid. Ratel (talk) 07:07, 26 March 2017 (UTC)

There are two issues with this. First, you have synthesized a mini-review here in WP, which you do not have the right to do as a Wikipedia editor. Second, if there are no reviews discussing this, it is UNDUE. If there are reviews, please summarize them here in WP, giving appropriate WEIGHT to various perspectives on this. The funding has nothing to do with it. Please also see User:Jytdog#NPOV_part_1:_secondary_sources. Jytdog (talk) 12:18, 26 March 2017 (UTC)

Not a synthesis, no attempt to make an argument or draw it all together, simply stating the individual findings in precis form. Perhaps you should re-look at what synthesis means?

Is WP really forbidden from enumerating research directions in conditions, especially conditions about which the medical profession openly acknowledges it knows almost nothing? I would expect a good encyclopedia to outline the directions of further research, not only into the brain but elsewhere too. This is groundbreaking research, reviews have not caught up yet; there are however these reviews PMID 26905019 PMID 27922040 and PMID 2692001 but I would expect more to be published soon. In summary, I will insert the material on the brain again, once I have access to the full paper PMID 26905019 as a source (which should occur soon).Ratel (talk) 22:18, 26 March 2017 (UTC)

Per WP:NPOV which is policy, we give WEIGHT per secondary sources. I went looking and found some brief discussions of this and will add some content based on those reviews. But WP is not cutting edge - our mission is "accepted knowledge" (per WP:NOTEVERYTHING, which is policy); "accepted knowledge" is not at all the same thing as "cutting edge", which we don't do in WP. Jytdog (talk) 22:44, 26 March 2017 (UTC)

Oh please, covering research in a condition with unknown etiology is hardly "cutting edge". Facepalm. Ratel (talk) 23:16, 26 March 2017 (UTC)

• The conclusion of PMID 26905019 is interesting and some of it could go into our article (my emphasis):

The neuroanatomical route of bladder pain is complex. Although the peripheral nervous system is responsible for the initial response to noxious stimuli, the CNS is responsible for the affective and autonomic disturbances that accompany bladder pain. In chronic diseases such as IC/BPS the CNS undergoes molecular, physiological and structural changes that result in pain despite a lack of noxious input from the periphery. Investigating these supraspinal changes will identify new therapeutic strategies to help patients with IC/BPS and other chronic pelvic diseases.

The fact that the brain can continue the pain independently is novel and important. Ratel (talk) 20:36, 27 March 2017 (UTC)

Section deleted with comment "source poor"

The section on pelvic floor musculature was deleted with the words "source poor". However, the source in question frequently cites primary sources, is a reliable secondary source, and is written by one of the leading researchers in this area at Stanford University.

You can see his publications about this issue here: https://profiles.stanford.edu/rodney-anderson?tab=publications

Furthermore, if there are other sources you prefer, go ahead and add them, but please don't just delete the whole section. This is a major theory of CPPS causation which was scarcely mentioned in the page until now. We cannot just delete all mention of it.

There are other theories of causation in the article now. Some of those theories ("food allergies") were developed on message boards and have little or no academic support. If we delete this section, then the most prominent and well-supported theories of causation will be removed from the article when fringe or unsupported theories remain.

The reliable sources policy appears to favor citing secondary sources, which is why I included that one. WP:MEDRS does not stipulate that the source must be a primary source.

Thomas pow s (talk) 18:43, 8 March 2019 (UTC)

Looking at this text. Harmony books is NOT a medical publisher. This is not a medical textbook. It is popular press. We need sources that meet WP:MEDRS. Also you need to provide page numbers, year of publication, Etc. But the first thing is a proper source. Doc James (talk · contribs · email) 04:35, 9 March 2019 (UTC)

<block>

Muscle Spasm in the Pelvic Floor

One theory is that CPPS is caused by chronic spasm in the pelvic floor musculature. This spasm causes tissue damage and sensitization of nearby nerves. The tissue damage cannot heal because the spasm is ongoing and prevents blood flow to the affected area, thereby preventing healing.

Treatment involves physical therapy to break the spasm, and also a program of "paradoxical relaxation" to prevent chronic tensing of the pelvic musculature which caused the spasm in the first place. </block>