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American Family Physician Aug 2010Prostatitis ranges from a straightforward clinical entity in its acute form to a complex, debilitating condition when chronic. It is often a source of frustration for... (Review)
Review
Prostatitis ranges from a straightforward clinical entity in its acute form to a complex, debilitating condition when chronic. It is often a source of frustration for the treating physician and patient. There are four classifications of prostatitis: acute bacterial, chronic bacterial, chronic prostatitis/chronic pelvic pain syndrome, and asymptomatic. Diagnosis of acute and chronic bacterial prostatitis is primarily based on history, physical examination, urine culture, and urine specimen testing pre- and post-prostatic massage. The differential diagnosis of prostatitis includes acute cystitis, benign prostatic hyperplasia, urinary tract stones, bladder cancer, prostatic abscess, enterovesical fistula, and foreign body within the urinary tract. The mainstay of therapy is an antimicrobial regimen. Chronic pelvic pain syndrome is a more challenging entity, in part because its pathology is poorly understood. Diagnosis is often based on exclusion of other urologic conditions (e.g., voiding dysfunction, bladder cancer) in association with its presentation. Commonly used medications include antimicrobials, alpha blockers, and anti-inflammatory agents, but the effectiveness of these agents has not been supported in clinical trials. Small studies provide limited support for the use of nonpharmacologic modalities. Asymptomatic prostatitis is an incidental finding in a patient being evaluated for other urologic problems.
Topics: Acute Disease; Anti-Bacterial Agents; Chronic Disease; Diagnosis, Differential; Humans; Male; Pain; Prostatitis
PubMed: 20704171
DOI: No ID Found -
Australian Family Physician Apr 2013Prostatitis is a spectrum of disorders that impacts a significant number of men. Acute bacterial prostatitis may be a life-threatening event requiring prompt recognition...
Prostatitis is a spectrum of disorders that impacts a significant number of men. Acute bacterial prostatitis may be a life-threatening event requiring prompt recognition and treatment with antibiotic therapy. Chronic bacterial prostatitis has a more indolent course and also requires antibiotic therapy for resolution. Chronic prostatitis/chronic pelvic pain syndrome is the most common manifestation of prostatitis and may be the most difficult to treat. Asymptomatic inflammatory prostatitis is an incidental finding of unclear significance. Understanding the diagnostic and management strategies for each of these entities is critical for general practitioners in caring for their male patients.
Topics: Asymptomatic Diseases; Chronic Disease; Humans; Male; Pelvic Pain; Prostatitis
PubMed: 23550248
DOI: No ID Found -
Differentiation; Research in Biological... 2011The origins of benign prostatic diseases, such as benign prostatic hyperplasia (BPH) and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), are poorly... (Review)
Review
The origins of benign prostatic diseases, such as benign prostatic hyperplasia (BPH) and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), are poorly understood. Patients suffering from benign prostatic symptoms report a substantially reduced quality of life, and the relationship between benign prostate conditions and prostate cancer is uncertain. Epidemiologic data for BPH and CP/CPPS are limited, however an apparent association between BPH symptoms and cardiovascular disease (CVD) has been consistently reported. The prostate synthesizes and stores large amounts of cholesterol and prostate tissues may be particularly sensitive to perturbations in cholesterol metabolism. Hypercholesterolemia, a major risk factor for CVD, is also a risk factor for BPH. Animal model and clinical trial findings suggest that agents that inhibit cholesterol absorption from the intestine, such as the class of compounds known as polyene macrolides, can reduce prostate gland size and improve lower urinary tract symptoms (LUTS). Observational studies indicate that cholesterol-lowering drugs reduce the risk of aggressive prostate cancer, while prostate cancer cell growth and survival pathways depend in part on cholesterol-sensitive biochemical mechanisms. Here we review the evidence that cholesterol metabolism plays a role in the incidence of benign prostate disease and we highlight possible therapeutic approaches based on this concept.
Topics: Acyl Coenzyme A; Anticholesteremic Agents; Cardiovascular Diseases; Cholesterol; Clinical Trials as Topic; Gene Expression; Humans; Hypercholesterolemia; Macrolides; Male; Prostate; Prostatic Hyperplasia; Prostatic Neoplasms; Prostatitis; Signal Transduction
PubMed: 21862201
DOI: 10.1016/j.diff.2011.04.005 -
Nature Reviews. Cancer Apr 2007About 20% of all human cancers are caused by chronic infection or chronic inflammatory states. Recently, a new hypothesis has been proposed for prostate carcinogenesis.... (Review)
Review
About 20% of all human cancers are caused by chronic infection or chronic inflammatory states. Recently, a new hypothesis has been proposed for prostate carcinogenesis. It proposes that exposure to environmental factors such as infectious agents and dietary carcinogens, and hormonal imbalances lead to injury of the prostate and to the development of chronic inflammation and regenerative 'risk factor' lesions, referred to as proliferative inflammatory atrophy (PIA). By developing new experimental animal models coupled with classical epidemiological studies, genetic epidemiological studies and molecular pathological approaches, we should be able to determine whether prostate cancer is driven by inflammation, and if so, to develop new strategies to prevent the disease.
Topics: Carcinogens; Chromosome Aberrations; Chronic Disease; Diet; Epigenesis, Genetic; Humans; Infections; Inflammation; Male; Models, Biological; Mutation; Prostatic Neoplasms; Prostatitis; Risk Factors
PubMed: 17384581
DOI: 10.1038/nrc2090 -
Archivio Italiano Di Urologia,... Jul 2016Types of prostatitis can be defined as groups of syndromes in adult men associated with infectious and noninfectious causes characterized frequently by lower abdominal... (Review)
Review
Types of prostatitis can be defined as groups of syndromes in adult men associated with infectious and noninfectious causes characterized frequently by lower abdominal and perineal signs and diverse clinical symptoms and complications. Etiopathogenesis of chronic prostatitis is not well defined. Moreover, its treatment outcomes are not satisfactory. Presence of c-kit positive interstitial cells in human prostate is already known. It has been demonstrated that these cells can be pacemaker cells which trigger spontaneous slow-wave electrical activity in the prostate and can be responsible for the transport of glandular secretion from acinar cells into major and minor prostatic ducts and finally into urethra. In the light of all these data, when presence of a possible inflammatory pathology is thought to involve prostate that secretes and has a reservoir which drains its secretion (for prostate, prostatic urethra), two points are worth mentioning. Impairment of secretion mechanism and collection of secretion within the organ with reflux of the microbial material from its reservoir back into prostate gland. Both of these potential conditions can be explained by ductal neuromuscular mechanism, which induces secretion. We think that in this neuromuscular mechanism interstitial Cajal cells have an important role in chronic prostatitis. Our hypothesis is that curability of prostatitis is correlated with the number of Cajal cells not subjected to apoptosis.
Topics: Adult; Animals; Apoptosis; Chronic Disease; Humans; Interstitial Cells of Cajal; Male; Prostate; Prostatitis
PubMed: 27377090
DOI: 10.4081/aiua.2016.2.133 -
BMJ Clinical Evidence Aug 2015Chronic prostatitis can cause pain and urinary symptoms, and can occur either with an active infection (chronic bacterial prostatitis [CBP]) or with only pain and no... (Review)
Review
INTRODUCTION
Chronic prostatitis can cause pain and urinary symptoms, and can occur either with an active infection (chronic bacterial prostatitis [CBP]) or with only pain and no evidence of bacterial causation (chronic pelvic pain syndrome [CPPS]). Bacterial prostatitis is characterised by recurrent urinary tract infections or infection in the prostate with the same bacterial strain, which often results from urinary tract instrumentation. However, the cause and natural history of CPPS are unknown and not associated with active infection.
METHODS AND OUTCOMES
We conducted a systematic overview and aimed to answer the following clinical questions: What are the effects of treatments for chronic bacterial prostatitis? What are the effects of treatments for chronic pelvic pain syndrome? We searched: Medline, Embase, The Cochrane Library, and other important databases up to February 2014 (Clinical Evidence overviews are updated periodically; please check our website for the most up-to-date version of this overview).
RESULTS
At this update, searching of electronic databases retrieved 131 studies. After deduplication and removal of conference abstracts, 67 records were screened for inclusion in the overview. Appraisal of titles and abstracts led to the exclusion of 51 studies and the further review of 16 full publications. Of the 16 full articles evaluated, three systematic reviews and one RCT were included at this update. We performed a GRADE evaluation for 14 PICO combinations.
CONCLUSIONS
In this systematic overview, we categorised the efficacy for 12 interventions based on information relating to the effectiveness and safety of 5 alpha-reductase inhibitors, allopurinol, alpha-blockers, local injections of antimicrobial drugs, mepartricin, non-steroidal anti-inflammatory drugs (NSAIDs), oral antimicrobial drugs, pentosan polysulfate, quercetin, sitz baths, transurethral microwave thermotherapy (TUMT), and transurethral resection of the prostate (TURP).
Topics: Humans; Male; Prostatitis
PubMed: 26313612
DOI: No ID Found -
International Braz J Urol : Official... 2024
Topics: Male; Humans; Prostate; Prostatitis; Tuberculosis, Male Genital
PubMed: 37624660
DOI: 10.1590/S1677-5538.IBJU.2023.0299 -
Frontiers in Cellular and Infection... 2023To explore whether type III prostatitis is related to bacterial infection by detecting the composition and function of microorganisms in expressed prostatic secretion...
OBJECTIVE
To explore whether type III prostatitis is related to bacterial infection by detecting the composition and function of microorganisms in expressed prostatic secretion (EPS) of patients with chronic prostatitis (CP) and healthy people.
METHODS
According to the inclusion and exclusion criteria, 57 subjects were included in our study, divided into the healthy group, type II prostatitis group, and type III prostatitis group. 16s rRNA sequencing technique was used to detect and analyze the microbial composition of EPS in each group. Additionally, the metagenomics sequencing technique was used to further explore the function of different bacteria in the type III prostatitis group. Data analysis was performed by bioinformatics software, and the results were statistically significant when P<0.05.
RESULTS
Many microorganisms exist in EPS in both CP patients and healthy populations. However, the relative abundance of , , , , and in CP patients (including type II and III) were significantly different. Still, the relative abundance of different bacteria in type II prostatitis patients was much higher than in type III. The metagenomics sequencing results for the type III prostatitis group showed that the different bacteria had certain biological functions.
CONCLUSION
Based on our sequencing results and previous studies, we suggest that type III prostatitis may also be caused by bacterial infection.
Topics: Male; Humans; Prostatitis; RNA, Ribosomal, 16S; Chronic Disease; Bacterial Infections; Bacteria
PubMed: 37465760
DOI: 10.3389/fcimb.2023.1189081 -
Fertility and Sterility 1963
Topics: Anxiety; Ejaculation; Erectile Dysfunction; Humans; Infertility; Infertility, Male; Male; Massage; Premature Ejaculation; Prostate; Prostatitis; Psychotherapy; Sexual Dysfunction, Physiological; Tranquilizing Agents
PubMed: 14060309
DOI: 10.1016/s0015-0282(16)34928-7 -
The Cochrane Database of Systematic... 2001Chronic abacterial prostatitis is a common disabling but enigmatic condition with a symptom complex of pelvic area pain and lower urinary tract symptoms. The scope of... (Review)
Review
BACKGROUND
Chronic abacterial prostatitis is a common disabling but enigmatic condition with a symptom complex of pelvic area pain and lower urinary tract symptoms. The scope of treatments recommended for chronic abacterial prostatitis is a testament to how little is known about what causes the condition and how to treat it. As a result, chronic abacterial prostatitis often causes physician frustration, patient confusion and dissatisfaction, variable thresholds for referral, and potentially inappropriate antibiotic use.
OBJECTIVES
Examine the evidence regarding the effectiveness of therapies for chronic abacterial prostatitis.
SEARCH STRATEGY
Studies were identified through a search of MEDLINE (1966-2000), the Cochrane Library, bibliographies of identified articles and reviews, and contact with an expert.
SELECTION CRITERIA
Studies were eligible if they: (1) are randomized controlled trials (RCTs) or controlled clinical trials (CCTs) (2) involve men with chronic abacterial prostatitis (3) control group receives placebo, sham intervention, active pharmacologic or device therapy for chronic abacterial prostatitis and (4) outcomes data are provided. Eligibility was assessed by at least two independent observers.
DATA COLLECTION AND ANALYSIS
Study information on patients, interventions, and outcomes was extracted independently by 2 reviewers. The main outcome was the efficacy of treatment for chronic abacterial prostatitis vs. control in improving urologic symptom scale scores or global report of urinary tract symptoms. Secondary outcomes included changes in the prostate examination, uroflowmetry, urodynamics, analysis of urine, expressed prostatic secretions and seminal fluid, and prostate ultrasonography.
MAIN RESULTS
The 15 treatment trials involved: medications used to treat benign prostatic hyperplasia (n=4 trials); anti-inflammatory medications (n=2 trials); antibiotics (n=1 trial); thermotherapy (n=5 trials); and miscellaneous medications (n=3 trials). The disparity between studies did not permit quantitative analysis. There were a total of 600 enrollees (age range 38-45). All but one of the trials were done outside the United States.
REVIEWER'S CONCLUSIONS
The treatment trials are few, weak methodologically, and involve small sample sizes. The routine use of antibiotics and alpha blockers for chronic abacterial prostatitis is not supported by the existing evidence. The small studies examining thermal therapy appear to demonstrate benefit of clinical significance and merit further evaluation. Additional treatment trials are required and they should report important patient characteristics (e.g., race), study design details and utilize clinically relevant and validated assessment measures.
Topics: Chronic Disease; Clinical Trials as Topic; Humans; Male; Pelvic Pain; Prostatic Hyperplasia; Prostatitis; Treatment Outcome
PubMed: 11279750
DOI: 10.1002/14651858.CD002080