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Der Urologe. Ausg. A Oct 2020The advent of new high throughput sequencing technologies has paved the way for microbiome research, opening up entirely new perspectives on the complex and diverse... (Review)
Review
The advent of new high throughput sequencing technologies has paved the way for microbiome research, opening up entirely new perspectives on the complex and diverse ecosystems of the human body. One of the main findings was that it became clear that in contrast to the widely held dogma the urinary tract is not a sterile environment. As for all niches of the human body, a well-balanced microbiome is an essential part for the physiological functioning of the urinary tract and therefore it must be considered a prerequisite for health. The dysbalance of the microbiome is now seen as having a considerable impact on the pathogenesis of a plethora of diseases. Its role in benign disorders, such as interstitial cystitis, urinary urge incontinence and chronic prostatitis/chronic pelvic pain syndrome as well as participation in malignant conditions, such as prostate cancer has recently been revealed. The contribution of the urinary microbiome to the pathogenesis and progression of lower urinary tract symptoms due to benign prostatic obstruction are currently under investigation.
Topics: Humans; Lower Urinary Tract Symptoms; Male; Microbiota; Prostatic Hyperplasia; Prostatitis
PubMed: 32914231
DOI: 10.1007/s00120-020-01318-2 -
Prostate Cancer and Prostatic Diseases Sep 2023We performed this systematic review and meta-analysis to investigate the efficacy and safety of Li-ESWT combined with or without medications for patients with Chronic... (Meta-Analysis)
Meta-Analysis Review
The efficacy and safety of low-intensity extracorporeal shock wave treatment combined with or without medications in Chronic prostatitis/chronic pelvic pain syndrome: a systematic review and meta-analysis.
BACKGROUND
We performed this systematic review and meta-analysis to investigate the efficacy and safety of Li-ESWT combined with or without medications for patients with Chronic prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS).
METHODS
A comprehensive search was conducted of PUBMED, Cochrane Library, and Web of Science databases from inception to February 2022 for randomized controlled trials (RCTs) assessing the efficacy and safety of Li-ESWT with or without the combination of medications compared with the control group. The National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI), Visual Analogue Scale/Score (VAS), International Index of Erectile Function (IIEF), and International prostate symptom score (IPSS) were used to assess the improvements of symptoms in CP/CPPS patients.
RESULTS
651 patients from 12 randomized controlled studies were included in this study. The total NIH-CPSI scores, pain domain scores, and quality of life (QOL) scores were significantly lower in the Li-ESWT group than those in the control group at the termination of treatment, and 1, 4, 12, and 24 weeks after treatment. And these scores were significantly reduced in the Li-ESWT group than in baselines. In the subgroup analysis, reductions of these scores lasted longer and were greater in Li-ESWT combined with medications than in Li-ESWT alone. In the Li-ESWT group, the VAS score; IIEF score; and IPSS score were significant improvements than those in control group at the termination of treatment, and 1, 4, and 12 weeks after treatment; 4, 12, and 24 weeks after treatment; and 1, 4, and 12 weeks after treatment, respectively.
CONCLUSIONS
Li-ESWT is a safe, non-invasive, and effective option for patients with CP/CPPS, whether combined with medications or not, should be recommended for widespread use in clinical practice.
Topics: Male; Humans; Prostatitis; Prostatic Neoplasms; Chronic Disease; Pelvic Pain; Databases, Factual; Chronic Pain
PubMed: 35798855
DOI: 10.1038/s41391-022-00571-0 -
Frontiers in Immunology 2020Experimental autoimmune prostatitis (EAP) is a well-established model induced by an autoimmune response to prostate antigen. The symptomatic, pathological, and...
Experimental autoimmune prostatitis (EAP) is a well-established model induced by an autoimmune response to prostate antigen. The symptomatic, pathological, and immunological characteristics of EAP animals are highly consistent with human chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), which makes EAP an ideal model for this disease. Here, we investigate the influence of EAP on male rat sexual function and the efficacy of anti-inflammatory therapy with celecoxib. EAP rat models were established using male Wistar rats. Rats were randomly assigned to a normal control group, an EAP model group, or an EAP model with celecoxib treatment group (celecoxib group). Behavioral changes, sexual behavioral changes, and erectile function were estimated using an open-field test, a sucrose consumption test, mating experiments, and by intracavernous pressure/mean arterial pressure ratio (ICP/MAP). Histological changes in the prostate were observed by HE staining, and the serum inflammatory factors IL-1β and TNF-α levels were measured by enzyme-linked immunosorbent assay. In addition, serotonin (5-hydroxytryptamine, 5-HT), 5-HT receptor, 5-HT receptor, and serotonin transporter (SERT) expression levels in the hippocampus and spinal cord (T13-L1, L5-S2) were examined by immunohistochemistry and western blot analysis. Results showed that EAP rats exhibited characteristics of depression, decreased sexual drive, premature ejaculation, and increased threshold of penile erection. Moreover, all these changes were effectively alleviated by celecoxib. Significant increases in prostatic interstitial infiltration by inflammatory cells and in serum IL-1β and TNF-α levels were observed in EAP rats, and these were partially reduced by celecoxib. Additionally, the expression pattern of serotonin system regulators in the hippocampus and spinal cord were altered in EAP model rats, including a decrease in 5-HT levels and an increase in 5-HT receptor levels. In conclusion, autoimmune prostatitis impaired rat sexual function, and this was effectively prevented by anti-inflammatory therapy with celecoxib. Moreover, a serotonin system disorder in the central nervous system was likely mediated via inflammation in EAP rats.
Topics: Animals; Anti-Inflammatory Agents, Non-Steroidal; Autoimmune Diseases; Celecoxib; Depression; Disease Models, Animal; Erectile Dysfunction; Hippocampus; Inflammation; Interleukin-1beta; Male; Prostate; Prostatitis; Rats; Rats, Wistar; Serotonin; Sexual Behavior; Treatment Outcome
PubMed: 33013933
DOI: 10.3389/fimmu.2020.574212 -
The Journal of Infectious Diseases Apr 2020Sexual transmission and persistence of Zika virus (ZIKV) in the male reproductive tract has raised concerned for potential damaging effects on function. Animal studies...
BACKGROUND
Sexual transmission and persistence of Zika virus (ZIKV) in the male reproductive tract has raised concerned for potential damaging effects on function. Animal studies have demonstrated that ZIKV virus can infect and damage the testis and epididymis, and these results has been correlated to lower sperm counts in ZIKV-infected humans. The prostate plays a vital role in the male reproductive tract, with acute and chronic prostatitis linked to male infertility.
METHODS
In this study, we evaluated the effects of ZIKV virus on the prostate in mice and nonhuman primates.
RESULTS
In mice, ZIKV infected the prostate and triggered inflammation that persisted even after virus clearance. Evidence of chronic prostatitis associated with ZIKV infection remained for several months. Similar histological findings were observed in the prostate of ZIKV-infected rhesus macaques.
CONCLUSIONS
These studies establish that ZIKV replicates in the prostate and can cause acute and chronic inflammatory and proliferative changes in mouse and nonhuman primate models.
Topics: Acute Disease; Animals; Chronic Disease; Disease Models, Animal; Epididymis; Macaca mulatta; Male; Mice; Mice, Inbred C57BL; Prostatitis; Semen; Testis; Zika Virus; Zika Virus Infection
PubMed: 31616920
DOI: 10.1093/infdis/jiz533 -
The American Journal of Emergency... Jun 2021Prostatitis is one of the most common urologic diseases in ambulatory patients. However, prostatitis data are limited from the emergency department (ED) setting.
INTRODUCTION
Prostatitis is one of the most common urologic diseases in ambulatory patients. However, prostatitis data are limited from the emergency department (ED) setting.
METHODS
A data set was examined of patients age 18 years or older who received urinalysis and urine culture or were tested for gonorrhea, chlamydia, or trichomonas in the ED from a health care system in northeast Ohio.
RESULTS
Of 19,308 ED encounters of male patients, 77 encounters (0.4%) involved the diagnosis of prostatitis. Men with prostatitis were younger (52.4 vs 66.3 years), were less likely to be hospitalized (27.3% vs 43.1%), had shorter clinical encounters (1336.5 vs 3019.3 min), and were less likely to arrive by emergency medical services or police (6.5% vs 45.5%) than men diagnosed with urinary tract infection (UTI) without prostatitis (n = 2527) (P ≤ .007 for all). Of the men with urinalysis, those with prostatitis had less bacteria (0.9+ vs 1.8+), blood (0.9+ vs 1.5+), glucose (4.0% vs 13.0%), leukocyte esterase (0.9+ vs 2.3+), nitrite positive (8.0% vs 21.4%), protein (0.5+ vs 1.2+), squamous epithelial cells (0.6 vs 1.7 per high-power field [HPF]), red blood cells (18.3/HPF vs 29.5/HPF), and white blood cells (31.6/HPF vs 57.6/HPF) than men diagnosed with UTI and no prostatitis (P ≤ .005 for all). Escherichia coli was the most common bacterium growing in the urine (58.8%; n = 10) and the blood (100.0%; n = 2) of men with prostatitis; however 73.0% (n = 17) of urine cultures and 90.9% (n = 22) of blood cultures had no bacterial growth. Of 77 patient encounters with prostatitis, 16 (20.8%) underwent testing for Neisseria gonorrhoeae and Chlamydia trachomatis and 3 (3.9%) for Trichomonas vaginalis. Of those tested, only 1 person was infected, with C trachomatis.
CONCLUSION
Prostatitis was uncommonly diagnosed in men undergoing urinalysis and urine culture or testing for sexually transmitted infections in the ED.
Topics: Adult; Aged; Aged, 80 and over; Chlamydia Infections; Emergency Service, Hospital; Gonorrhea; Humans; Male; Middle Aged; Prostatitis; Sexually Transmitted Diseases; Trichomonas Infections; Urinalysis; Urinary Tract Infections
PubMed: 33618038
DOI: 10.1016/j.ajem.2021.01.054 -
Andrologia Nov 2021In the past two decades, thousands of documents in the field of prostatitis have been published. This bibliometric analysis aimed to assess the characteristics, hotspots...
In the past two decades, thousands of documents in the field of prostatitis have been published. This bibliometric analysis aimed to assess the characteristics, hotspots and frontiers trend of global scientific output on prostatitis. With the trend of moderate growth, altogether 2,423 papers were reviewed. The leading role of the United States in global prostatitis research was obvious, while China had developed rapidly in recent years. Queen's University and JOURNAL OF UROLOGY were the most prolific affiliation and journal respectively. Nickel, J. C made the greatest contribution to the field of prostatitis. Five hotspots have been confirmed: (a) male infertility associated with prostatitis and the molecular mechanisms; (b) diagnosis and treatment of prostatitis; (c) inflammation, pain and bladder irritation symptoms; (d) relationship between chronic prostatitis/chronic pelvic pain syndrome, benign prostatic hyperplasia and prostate cancer; (e) epidemiology, complications of prostatitis and improvement of acupuncture. This bibliometric analysis reveals that the international cooperation was becoming more and more close. Hotspot analysis shows that the molecular mechanism of prostatitis will be a hotspot in the future, mainly focussing on inflammatory immunity and oxidative stress.
Topics: Acupuncture Therapy; Bibliometrics; China; Humans; Male; Prostatic Hyperplasia; Prostatitis; United States
PubMed: 34365673
DOI: 10.1111/and.14206 -
International Urology and Nephrology Dec 2023Prostatitis is known as the inflammation of the prostate. The treatments of prostatitis are either pharmacological or non-pharmacological treatment. However, some of the... (Review)
Review
BACKGROUND
Prostatitis is known as the inflammation of the prostate. The treatments of prostatitis are either pharmacological or non-pharmacological treatment. However, some of the treatments are not effective and very invasive which can lead to side effects. Thus, low-intensity extracorporeal shockwave therapy (LI-ESWT) is used as an alternative treatment for prostatitis due to its convenient and non-invasive procedure. However, a definite protocol for this treatment is not available due to the variability of the treatment protocols and the lack of research comparing the efficacy of these protocols.
OBJECTIVE
To review and compare the efficacy of different LI-ESWT protocols in treating prostatitis.
METHODS
The study was performed by comparing the intensity, duration, frequency and combination with different types of pharmacotherapy drugs of the different LI-ESWT protocols from various studies. The finding from various studies which consist of disease improvement and quality of life (QoL) were also presented in this review.
RESULT
From the findings, the protocol can be categorized into three different intensities which are at 3000 pulses, < 3000 pulses and > 3000 pulses. Most studies reported that each protocol is very effective and safe to use and can improve CP symptoms, urinary symptoms, erectile function and QoL. It is also found that no complications or adverse effects occur to the patient.
CONCLUSION
Most of the LI-ESWT protocols described are safe and effective in treating CP through the absence of treatment-related adverse effects and maintenance of clinical effects.
Topics: Male; Humans; Quality of Life; Prostatitis; Extracorporeal Shockwave Therapy; Penile Erection
PubMed: 37145375
DOI: 10.1007/s11255-023-03616-y -
The Prostate Jan 2020Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a disorder that is characterized by persistent pelvic pain in men of any age. Although several studies...
BACKGROUND
Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a disorder that is characterized by persistent pelvic pain in men of any age. Although several studies suggest that the transient receptor potential vanilloid 1 (TRPV1) channel is involved in various pathways of chronic pain, the TRPV1 channel has not been implicated in chronic pelvic pain associated with CP/CPPS.
METHODS
Male C57BL/6J (B6) and TRPV1 knockout (TRPV1 KO) mice (5-7 weeks old) were used to study the development of pelvic allodynia in a murine model of CP/CPPS called experimental autoimmune prostatitis (EAP). The prostate lobes, dorsal root ganglia (DRG), and spinal cord were excised at day 20. The prostate lobes were assessed for inflammation, TRPV1 expression, and mast cell activity. DRG and spinal cord, between the L6-S4 regions, were analyzed to determine the levels of phosphorylated ERK1/2 (p-ERK 1/2). To examine the therapeutic potential of TRPV1, B6 mice with EAP received intraurethral infusion of a TRPV1 antagonist at day 20 (repeated every 2 days) and pelvic pain was evaluated at days 20, 25, 30, and 35.
RESULTS
Our data showed that B6 mice with EAP developed pelvic tactile allodynia at days 7, 14, and 20. In contrast, TRPV1 KO mice with EAP do not develop pelvic tactile allodynia at any time point. Although we observed no change in the levels of TRPV1 protein expression in the prostate from B6 mice with EAP, there was evidence of significant inflammation and elevated mast cell activation. Interestingly, the prostate from TRPV1 KO mice with EAP showed a lack of mast cell activation despite evidence of prostate inflammation. Next, we observed a significant increase of p-ERK1/2 in the DRG and spinal cord from B6 mice with EAP; however, p-ERK1/2 expression was unaltered in TRPV1 KO mice with EAP. Finally, we confirmed that intraurethral administration of a TRPV1 antagonist peptide reduced pelvic tactile allodynia in B6 mice with EAP after day 20.
CONCLUSIONS
We demonstrated that in a murine model of CP/CPPS, the TRPV1 channel is key to persistent pelvic tactile allodynia and blocking TRPV1 in the prostate may be a promising strategy to quell chronic pelvic pain.
Topics: Animals; Arginine; Autoimmune Diseases; Extracellular Signal-Regulated MAP Kinases; Ganglia, Spinal; Hyperalgesia; Male; Mast Cells; Mice; Mice, Inbred C57BL; Mice, Knockout; Oligopeptides; Pelvic Pain; Phosphorylation; Prostatitis; Spinal Cord; TRPV Cation Channels
PubMed: 31573117
DOI: 10.1002/pros.23913 -
Urology Aug 2021To investigate the relationship between magnetic resonance imaging evidence of prostatitis with clinical symptomatology. Non-malignant abnormalities in peripheral zone...
OBJECTIVE
To investigate the relationship between magnetic resonance imaging evidence of prostatitis with clinical symptomatology. Non-malignant abnormalities in peripheral zone are common in prostate multiparametric prostate magnetic resonance imaging (mpMRI). These findings are sometimes reported as "prostatitis" or "inflammation" and lead to patient anxiety and urologic referral.
METHODS
Retrospective review of patients undergoing prostate mpMRI (2016-2017) was performed. Two cohort groups based on the presence of "prostatitis" or "inflammation" in the radiology report were identified. Clinical characteristics included age, prostate specific antigen, biopsy/intervention history, true lower urinary tract symptoms (LUTS), pain, use of urologic medications, prostate volume, and PIRADS score. Pathologic finding of inflammation was recorded. Groups were compared using chi-square for dichotomous variables and t-tests for continuous variables.
RESULTS
One hundred and four patients were identified with "prostatitis/inflammation" and 273 without. Report of LUTS was high in both groups (58% and 62% for prostatitis and no prostatitis respectively, P= .49), though report of moderate/severe LUTS (physician description or IPSS of 8-19 and 20+) was more common in the no prostatitis group (7% vs 18%, P= .008). Use of urologic medication was similar between the 2 groups (31% and 37% for prostatitis and no prostatitis respectively, P = .23). Biopsy finding of inflammation was more common in the prostatitis group (57% vs 43% P = .027). Reports of pelvic pain, dysuria, or urinary findings of inflammation were uncommon in both groups.
CONCLUSION
While mpMRI findings of prostatitis may indicate NIH Category IV prostatitis, there is no evidence of correlation with categories I, II or III prostatitis nor with symptomatic LUTS, and patients should be reassured that further investigation is not warranted.
Topics: Adult; Aged; Aged, 80 and over; Humans; Male; Middle Aged; Multiparametric Magnetic Resonance Imaging; Prostatitis; Retrospective Studies
PubMed: 33539898
DOI: 10.1016/j.urology.2021.01.039 -
Frontiers in Immunology 2023Prostatitis is an inflammatory disease of the prostate gland, which affects 2-16% of men worldwide and thought to be a cause for prostate cancer (PCa) development....
BACKGROUND
Prostatitis is an inflammatory disease of the prostate gland, which affects 2-16% of men worldwide and thought to be a cause for prostate cancer (PCa) development. Carcinoembryogenic antigen-related cell adhesion molecules (CEACAMs) are deregulated in inflammation and in PCa. The role of CEACAMs in prostate inflammation and their possible contribution to the malignant transformation of prostate epithelial cells is still elusive. In this study, we investigated the expression of CEACAMs in an prostatitis model and their potential role in malignant transformation of prostate epithelial cells.
METHODS
Normal prostate epithelial RWPE-1 cells were treated with pro-inflammatory cytokines to achieve an inflammatory state of the cells. The expression of CEACAMs and their related isoforms were analyzed. Additionally, the expression levels of selected CEACAMs were correlated with the expression of malignancy markers and the migratory properties of the cells.
RESULTS
This study demonstrates that the pro-inflammatory cytokines, tumor necrosis factor alpha (TNFα) and interferon-gamma (IFNγ), induce synergistically an up-regulation of CEACAM1 expression in RWPE-1 cells, specifically favoring the CEACAM1-L isoform. Furthermore, overexpressed CEACAM1-L is associated with the deregulated expression of JAK/STAT, NFκB, and epithelial-mesenchymal transition (EMT) genes, as well as an increased cell migration.
CONCLUSION
We postulate that CEACAM1 isoform CEACAM1-4L may synergistically contribute to inflammation-induced oncogenesis in the prostate.
Topics: Male; Humans; Prostatitis; Prostate; Inflammation; Tumor Necrosis Factor-alpha; Transcription Factors; Cell Transformation, Neoplastic; Cytokines
PubMed: 37691945
DOI: 10.3389/fimmu.2023.1236343