Chronic Pelvic Pain Syndrome Research Articles

The Benefits of Phytotherapy in Chronic Pelvic Pain Syndrome

Chronic pelvic pain syndrome (CPPS) presents a diagnostic challenge due to its multifactorial nature, often involving urological, gynecological, and psychological components. This study focuses on the effectiveness of prophylactic phytotherapy in preventing CPPS recurrence, aiming to mitigate symptoms and psychosocial impact. The study includes 74 patients following a six-month treatment regimen with Graminex, Seronoa Repens, Curcuma Longa, and Acediboswellic ke-to-acetyl-11. Symptom assessment employs the IPSS and NIH-CPSI questionnaires, conducted at 3, 6, 8, 9, and 12 months. Patients exhibit significant improvements in IPSS scores, with maintenance of treatment impact observed at 3, 6, and 9 months. Interruption of therapy leads to symptom recurrence, but upon resumption, responses are more effective. The third group, under observation for three months, reports positive outcomes. Both IPSS and NIH-CPSI scores show a consistent impact on urinary symptoms and pelvic pain, indicating the therapy's effectiveness. The study demonstrates a concordance in the positive effects of phytotherapy across different age groups, emphasizing its efficacy in alleviating urinary symptoms and pelvic pain in CPPS patients. Symptom remission or improvement in quality of life is reported, with a notable tropism for symptom reduction in the cold season. Patient adherence to treatment is high, and even after treatment interruption, resumed therapy yields significant improvements. The observed benefits include the absence of pelvic pain, dysuria, and enhanced sexual competence, contributing to an overall improvement in the quality of life for patients with CPPS.

Chronic Prostatitis and Chronic Pelvic Pain Syndrome – the Current State of the Problem

Chronic Prostatitis and Chronic Pelvic Pain Syndrome – the Current State of the Problem

Efficacy of Palmitoylethanolamide, Epilobium and Calendula suppositories for the treatment of patients with chronic prostatitis/chronic pelvic pain syndrome type III.

The management of chronic prostatitis/ chronic pelvic pain syndrome type III (CP/CPPS) has been always considered complex due to several biopsychological factors underlying the disease. In this clinical study, we aimed to evaluate the efficacy of the treatment with Palmitoylethanolamide, Epilobium and Calendula extract in patients with CP/CPPS III. From June 2023 to July 2023, we enrolled 45 consecutive patients affected by CP/CPPS type III in three different institution. We included patients aged between 18 and 75 years with symptoms of pelvic pain for 3 months or more before the study, a total National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) score ≥ 12 point and diagnosed with NIH category III, according to 4-glass test Meares-Stamey test. Patients were then allocated to receive rectal suppositories of PEA, Epilobium and Calendula, 1 suppository/ die for 1 month. All patients have been tested with standard urinalysis in order to assess urinary leukocytes (U-WBC). The primary endpoint of the study was the reduction of NIHCPSI. The secondary outcomes were the change of peak flow, post-void residual (PVR), IIEF-5, VAS score, PSA and decrease of U-WBC. A total of 45 patients concluded the study protocol. At baseline, the median age of all the patients included in the cohort was 49 years, the median PSA was 2.81 ng/ml, the median NIH-CPSI was 18.55, the median IIEF-5 was 18.27, the median U-WBC was 485.3/mmc, the median VAS score was 6.49, the median PVR was 26.5 ml and the median peak flow was 16.3 ml/s. After 1 month of therapy we observed a statistically significant improvement of NIH-CPSI, U-WBC, PSA, IIEF-5, peak flow, PVR and VAS. In this observational study, we showed the clinical efficacy of the treatment with PEA, Epilobium and Calendula, 1 suppository/die for 1 month, in patients with CP/CPPS III. The benefits of this treatment could be related to the reduction of inflammatory cells in the urine that could imply a reduction of inflammatory cytokines. These results should be confirmed in further studies with greater sample size.

Causal associations between gut microbiota and chronic prostatitis/chronic pelvic pain syndrome: a two-sample Mendelian randomization study

BackgroundRecent researches have increasingly indicated a strong correlation between the gut microbiota and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). Nevertheless, the impact of gut microbiota on CP/CPPS still requires further elucidation.MethodsEmploying the summary statistics provided by the MiBioGen consortium, we executed a two-sample Mendelian randomization (MR) analysis. The study involved 18,340 participants and considered gut microbiota as the instrumental variable. Chronic prostatitis summary statistics, representing 500 cases and 208,308 controls, were extracted from the GWAS Catalog release data as the disease outcome. Various methods, including weighted inverse variance, MR-Egger and weighted median, were employed to assess how gut microbiota interact and correlate with CP/CPPS. Sensitivity analysis was used to eliminate heterogeneity and horizontal pleiotropy.ResultsOur findings, primarily derived from the IVW approach, provided evidence for a causal link between five categories of gut microbiota and CP/CPPS. Resultantly, the genus Christensenellaceae (OR = 0.39, 95% CI 0.17–0.87, P = 0.02), genus Eisenbergiella (OR = 0.62, 95% CI 0.40–0.97, P = 0.04), genus Hungatella (OR = 0.49, 95% CI 0.28–0.85, P = 0.01) and genus Terrisporobacter (OR = 0.39, 95% CI 0.20–0.75, P = 0.00) exhibited a protective impact on CP/CPPS, while family Prevotellaceae (OR = 1.78, 95% CI 1.01–3.15, P = 0.05) had the opposite effect. No notable heterogeneity of instrumental variables or horizontal pleiotropy was detected.ConclusionsThe findings of this study, which used a two-sample Mendelian randomization approach, indicate a causal link between gut microbiota and CP/CPPS. This could be valuable in offering fresh perspectives for additional mechanistic and clinical investigations of microbiota-related CP/CPPS. Nevertheless, additional randomized controlled trials are necessary for validation.

Evaluation and management of chronic anorectal and pelvic pain syndromes: Italian Society of Colorectal Surgery (SICCR) position statement.

Chronic pelvic pain is a hidden issue which needs to involve many different usually uncoordinated specialists. For this reason there is a risk that treatments, in the absence of well-defined pathways, common goals, and terminology, may be poorly effective. The aim of the present paper is to summarize the evidence on anorectal pelvic pain, offering useful evidence-based practice parameters for colorectal surgeons' daily activity. Analysis of chronic anorectal and pelvic pain syndromes, the diagnostic and clinical optimal needs for evaluation, and the innumerable low evidence treatments and therapeutic options currently available suggests that a multimodal individualized management of pain may be the most promising approach. The limited availability of dedicated centers still negatively affects the applicability of these principles.

4F - Tailored physiotherapy for male Chronic Pelvic Pain Syndrome: A case study on evidence-based physiotherapeutic interventions

4F - Tailored physiotherapy for male Chronic Pelvic Pain Syndrome: A case study on evidence-based physiotherapeutic interventions

Predicting Acupuncture Efficacy in Chronic Prostatitis/Chronic Pelvic Pain Syndrome: A Study on Model Development and Result Visualization.

Acupuncture is one of primary treatment options for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), but its efficacy varies among patients. This study aimed to develop and validate a nomogram for predicting the efficacy of acupuncture in CP/CPPS. This study enrolled 220 patients with CP/CPPS who received acupuncture. Patients were divided into a responder group and nonresponder group based on the reduction in the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI). Potential variables were selected using the least absolute shrinkage and selection operator regression, and a nomogram was established using the multivariable logistic regression model. The performance of the nomogram was assessed by the receiver operating characteristic curves and calibration curves. Two Hundred Twenty men were randomly assigned to the training cohort (n = 154) and the internal test cohort (n = 66). The developed nomogram included age, current drinking status, sedentary lifestyle, habit of staying up late, expectations for acupuncture, comorbidities, NIH-CPSI pain subscale and total scores. The area under the curve of the prediction model was 0.777 (95% CI: 0.702-0.851) in the training cohort, 0.752 (95% CI: 0.616-0.888) in the internal test cohort, demonstrating satisfactory discriminative ability as indicated by the calibration curve. The nomogram accurately identified CP/CPPS patients who would benefit from acupuncture. Factors such as youth, abstention from alcohol, avoiding sedentary habits and staying up late, having high expectations for acupuncture, being free from comorbidities, and baseline high scores on both the NIH-CPSI pain subscale and total scores may positively affect the efficacy of acupuncture. Further validation of our findings requires multicenter and large-sample prospective studies.

Prospects for Using 3D Modeling and Biomarkers in Differential Diagnosis of Endometrioid Ovarian Cysts

Background. Ovarian heterotopias are quite successfully diagnosed with ultrasound examinations. Considering the high risk of spread of the disease, as well as reproductive consequences (infertility, pelvic adhesive processes, chronic pelvic pain syndrome, dysmenorrhea), early differential diagnosis of endometrioid cysts and, accordingly, early initiation of treatment are of particular importance.Objective: to combine ultrasound criteria using 3D visualization and the content of biomarkers to verify stage 1–2 endometrioid ovarian cysts.Material and methods. In 59 infertile women with endometrioid ovarian cysts, in the dynamics of the menstrual cycle, ultrasound examinations were performed using Acuson S2000 (Siemens, Germany) and Voluson E8 (General Electric, USA) with the possibility of Doppler measurements and three-dimensional reconstruction of tissue images. Also, in laboratories “Invitro”, “Hemotest”, “Nauka” (Samara, Russia) the biomarkers were determined: interleukins IL-1β, IL-6, cancer antigen 125 (CA-125), human epididymis protein 4 (HE4) and the index by Risk of Ovarian Malignancy Algorithm (ROMA). The control group included 195 fertile women of reproductive age. In patients with endometrioid cysts, the diagnosis was subsequently confirmed morphologically.Results. Small unilateral and bilateral ovarian cysts corresponding to stage 1–2 endometriosis by revised American Fertility Society classification (rAFS) were clearly differentiated in 56 (94.9%) patients, in 3 (5.4%) of them the ultrasound result was questionable. In 48 (81.4%) women the lesion was unilateral and in 11 (18.6%) it was bilateral. The structure of cystic formations in all cases was hypoechoic, heterogeneous, in 36 (61.0%) cases it was finely cellular, without blood flow.Conclusion. Ovarian endometriomas in “gray scale” are round formations of reduced echogenicity and fine suspension, with an even, clear contour, not fused with the surrounding tissues, avascular, changing size depending on menstrual cycle phase. An ovarian mass may have a capsule with locus signals on Doppler. The sensitivity of ultrasound examination in “gray scale” in the presence of an endometrioid cyst is 94.6%.

Lessons learned from the experiences of patients with chronic pelvic pain syndrome (CPP syndrome) with a multidisciplinary consultation: a qualitative study

IntroductionChronic pelvic pain syndrome is a complex multifactorial condition with an increasing prevalence probably due to a rising awareness. Chronic pelvic pain syndrome is pain in the pelvic area and...

A Hypothesis for Anatomical Pathways of Chronic Pelvic Pain of "Unknown Origin".

Interstitial cystitis/bladder pain syndrome (IC/BPS) is a disabling bladder condition. ESSIC, the IC/BPS society defines two types of IC/BPS: with Hunner's lesion (HL) and without. Pathogenesis is stated as unknown, with no cure possible. Scheffler in 2021 reported cystoscopically validated cure of HL IC/BPS by repair of uterosacral ligaments (USLs) and in 2022, Goeschen reported non-HL IC/BPS cure in 198 women following USL repair. Both Scheffler and Goeschen hypothesized IC/BPS may be a phenotype of the Integral Theory's Posterior Fornix Syndrome "PFS" (chronic pelvic pain, OAB, and emptying dysfunctions) and therefore potentially curable. The hypothesis explores whether visceral plexuses (VPs), due to weakened USLs support, serve as a primary source of pelvic pain impulses, leading to development of an inflammatory condition - for example, IC/BPS, a chronic inflammatory condition, which shares similarities with vulvodynia and complex regional pain syndrome (CRPS). According to our hypothesis, such conditions involve axon reflexes. Stimuli such as gravity applied to unsupported nerve branches within the visceral pelvic plexus, trigger centrally propagating impulses, which then progress antidromally to influence innervated tissues through cytokine release and nociceptor stimulation, perpetuating inflammatory processes at the end organs, and pain perception. The hypothesis raises the question, "are IC/BPS, vulvodynia, other pain sites, even nonbacterial "chronic prostatitis" in the male, different phenotypes of the chronic pelvic pain syndrome which includes PFS. If so, the hypothesis opens several new research directions and would predict inflammatory findings in tender end organ pain sites.

Extracorporeal shockwave therapy in treatment of chronic prostatitis/chronic pelvic pain syndrome: Systematic review and meta-analyses.

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) prevalence varies from 8.4% to 25% of the male population and is associated with diminished health-related quality of life. Managing CP/CPPS remains challenging and there is not any common option to treat all patients effectively because of the complex disease nature. The currently available data for the extracorporeal shockwave therapy (eSWT) effect on pain relief and well-being were analyzed in the present study. We adhered to PRISMA 2022 guidelines for reporting the quantitative and qualitative data synthesis. A literature search was conducted in March 2023 using PubMed/Medline, Scopus, and Google Scholar. Randomized prospective studies of eSWT alone or eSWT plus conventional medicinal treatment were included. The risk of bias was estimated using the RoB 2.0. Primary outcomes were self-reported scores, including the NIH-CPSI questionnaire and VAS, at 1 month or 2, 3, and 6, months follow-up. The CP/CPPS patients who receive eSWT have more pronounced pain relief and improvement of other subjective NIH-CPSI scores compared with control groups that received placebo or medication therapy. The effect of eSWT seems to be long-lasting and was confirmed in the 6-month follow-up (p < 0.01). Based on the meta-analysis of accessible studies, we receive the equivalence eSWT applicability for the CP/CPPS treatment and can be offered to patients because of its noninvasiveness, high level of safety, and successful clinical results demonstrated in this analysis.

Network pharmacological analysis and experimental study of melatonin in chronic prostatitis/chronic pelvic pain syndrome.

This study is aimed at exploring the potential mechanisms of melatonin (MT) in treating chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) using network pharmacology and experimental study. The target genes of MT were acquired from the Swiss Target Prediction, SuperPred, SEA, and PharmMapper databases, and the CP/CPPS targets were collected based on OMIM, DisGeNET, and GeneCards databases. The intersection of MT and CP/CPPS target genes was analyzed. A PPI network was constructed using Cytoscape to identify core targets. The shared targets underwent GO and KEGG enrichment analyses by Using R software. Molecular docking of MT with core targets was performed using AutoDock and PyMOL. GROMACS software was used for molecular dynamics simulation. And using cell experiments to verify the potential effect of MT in CP/CPPS. Network pharmacology analysis reveals 284 shared targets between MT and CP/CPPS, with AKT1, SRC, HSP90AA1, PTGS2, BCL2L1, ALB, CASP3, NFKB1, HIF1A, and ESR1 identified as key targets. Enrichment analysis indicates that MT affects CP/CPPS through various biological processes, and pathway analysis emphasizes the significance of PI3K-Akt, MAPK, Ras, FoxO, HIF-1, EGFR, and apoptosis pathways. Molecular docking confirms strong binding between MT and core targets. It is worth noting that the molecular dynamics simulation showed that the average binding free energy of AKT1, PTGS2, ALB, HSP90AA1 proteins, and MT was - 26.15, - 29.48, - 18.59, and - 20.09kcal/mol, respectively. These results indicated that AKT1, PTGS2, ALB, and HSP90AA1 proteins were strongly bound to MT. Cell experiments demonstrate that MT can inhibit the secretion of IL-1β, IL-6, and TNF-α in LPS-induced RWPE-1 cells, alleviate inflammation, and suppress cell apoptosis and oxidative stress. Network pharmacology, molecular docking, molecular dynamics simulation, and cell experiments showed that MT could play a role in CP/CPPS by regulating multiple targets and pathways. These findings provide an important scientific basis for further exploration of the molecular mechanism and clinical application of MT in CP/CPPS treatment and are expected to provide new ideas and directions for the development of novel therapeutic strategies.

Safety and efficacy of extracorporeal shockwave therapy on chronic prostatitis/chronic pelvic pain syndrome: a prospective, randomized, double-blind, placebo-controlled study

PurposeThis study aimed to investigate the efficacy and safety of extracorporeal shock wave therapy (ESWT) over an 8-week period in individuals diagnosed with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) compared to a control group. Materials and methodsThis prospective, double-blind, placebo-controlled study enrolled 46 participants diagnosed with CP/CPPS, who were randomly assigned to either the treatment group or the control group in a 2:1 ratio. In the treatment group, ESWT was administered at the perineum once a week for 8 weeks. CP/CPPS-related symptoms were assessed using the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH–CPSI). Pain and erectile function were measured using the Visual Analogue Scale (VAS) and the International Index of Erectile Function-Erectile Function (IIEF-EF). ResultsThe primary efficacy assessment variable, the change in NIH–CPSI total score at 4 weeks after the end of the 8-week treatment compared to baseline, was significantly improved (P = 0.0225) in the treatment group (−11.27 ± 8.39) compared to the control group (−5.44 ± 5.73). Regarding the secondary efficacy assessment variables, the treatment group showed significant decreases compared to the control group in change in NIH–CPSI total score (P = 0.0055) at the end of the 8-week treatment compared to baseline, along with significant decreases in pain and quality of life scores, as well as VAS assessments at the end of the 8-week treatment and 4 weeks after the end of treatment (P < 0.05). Moreover, in the evaluation conducted to assess improvement in sexual function, the treatment group showed a significant increase compared to baseline than the control group in the IIEF total score at 4 weeks after the end of the treatment (P = 0.0364). No patients experienced severe side effects related to ESWT during the therapeutic period or the follow-up duration. ConclusionsThe efficacy assessment in this clinical trial indicates that extracorporeal shock wave therapy is expected to have a symptomic improvement effect on CP/CPPS.

Regulatory role of BNP in the spinal center of rats with nonbacterial prostatitis.

A growing body of evidence has shown that activating spinal cord glial cells (typically astrocytes and microglial cells) is closely related to hyperpathia and persistent pain. To investigate the expression of GFAP and CR3/CD11b in cornu dorsale medullae spinalis of rats with nonbacterial prostatitis, to explore the therapeutic efficacy and action mechanism of intrathecal injection of BNP alleviating chronic neuropathic pain. Eighteen male SPF SD rats were randomly divided into sham operation control group, nonbacterial prostatitis group (NBP) and intrathecal injection BNP group, the NBP model was established by intraprostatic injection of CFA, and the spinal cord of L6-S1 segment was extracted seven days after intrathecal injection of BNP; The expression of GFAP and CR3/CD11b in dorsal horn of spinal cord were detected by immunofluorescence and Western blot. The cumulative optical density values of GFAP and CR3/CD11b immunofluorescence assay in the NBP group were higher than those in the sham operation group, with statistical significance (p⁢ï⁢¼⁢ 0.01); The expression of GFAP and CR3/CD11b in intrathecal injection BNP group were lower than those in NBP group, the differences were statistically significant (p⁢ï⁢¼⁢ 0.01). Western blot results showed that the expression of GFAP and CR3/CD11B in NBP group were higher than those in sham operation group, with statistical significance (p⁢ï⁢¼⁢ 0.05). The expression of GFAP and CR3/CD11B in intrathecal injection BNP group were lower than those in NBP group, the differences were statistically significant (p⁢ï⁢¼⁢ 0.05). Intrathecal injection of BNP can down-regulate the expressions of GFAP and CR3/CD11b in L6-S1 spinal cord of NBP rat model and to further inhibit chronic pain caused by NBP.

Efficacy and factors of myofascial release therapy combined with electrical and magnetic stimulation in the treatment of chronic pelvic pain syndrome.

The objective of this study was to evaluate the efficacy and factors of myofascial release therapy combined with electrical and magnetic stimulation in the treatment of chronic pelvic pain syndrome (CPPS). A total of 79 female patients diagnosed with CPPS from January 2021 to December 2022 were prospectively analyzed. Every patient received 3 weeks of treatment which included myofascial release therapy combined with electrical and magnetic stimulation. The visual analog score (VAS) of pelvic floor muscle (PFM) trigger points (TrPs) and the changes in pelvic floor surface electromyography before and after treatment were compared. Multiple linear regression was used to analyze the influencing factors of each outcome index. There were significant differences in VASs of muscle TrPs before and after treatment (P < 0.05). For the surface electromyography of PFMs, the differences in pre-baseline rest, post-baseline rest, isometric contractions for muscle endurance evaluation, and coefficient of variation were statistically significant (P < 0.05). Linear regression analysis showed that disease course (X 1), dyspareunia (X 5), and urinary incontinence (X 6) were influencing factors for the decline of pre-baseline rest (r5 = 1.067, R 2 = 0.089), post-baseline rest (r1 = 0.055, r5 = 0.99, R 2 = 0.119), VASs of ischial spine (r5 = 0.916, R 2 = 0.102), obturator internus (r5 = 0.796, r6 = -0.703, R 2 = 0.245), and pubococcygeus (r5 = 0.885, R 2 = 0.149) after treatment in the CPPS group. This study confirmed that individualized myofascial release therapy combined with electrical and magnetic stimulation has significant efficacy for patients with CPPS. At the same time, it is more effective for CPPS patients with longer course of disease, dyspareunia, and without urinary incontinence.

Применение препарата Простатекс плюс у пациентов с хроническим абактериальным простатитом на фоне ДГПЖ

Применение препарата Простатекс плюс у пациентов с хроническим абактериальным простатитом на фоне ДГПЖ

Effectiveness of complex therapy uncomplicated chronic pelvic pain syndrome

BACKGROUND: Therapeutic measures for chronic pelvic pain are of a pronounced interdisciplinary nature and consist of a complex of various means of influence: pharmacotherapy, physiotherapy and psychotherapy, physical therapy, surgical treatment. The solution to problems is usually achieved by prescribing venotonic drugs of systemic action, which increase venous tone, normalize capillary permeability and resistance, improve the rheological properties of blood, and for the same purpose use antihomotoxic drugs of plant origin. In addition, physiotherapy methods have become widespread in the treatment of patients with pelvic pain syndrome. Currently, pulsed magnetic therapy technologies have been developed in detail, but we hypothesized that the combined use of extracorporeal magnetic stimulation of the pelvic organs and the use of local regeneration cream can ensure mutual enhancement of the effectiveness of therapeutic effects. AIM: To study the clinical effectiveness and characteristics of vascular reactions in response to combined treatment of pelvic pain syndrome with herbal preparations and extracorporeal magnetic stimulation of the pelvic floor. MATERIALS AND METНODS: A randomized placebo-controlled study was conducted in 91 patients with chronic pelvic pain (more than 6 months in history). The patients were divided into 3 groups and did not differ significantly in the main studied parameters (age, parity, menstrual function, severity and duration of pain). The 1st group (n=30) patients independently carried out daily monotherapy with a cream stick of plant origin ― rectally, the 2nd group group (n=31) included women who, from the 5th to the 15th day of the menstrual cycle, had a menstrual cycle for 10 days procedures for extracorporeal magnetic stimulation of the neuromuscular apparatus of the pelvic floor; after completing the course of physiotherapy, a herbal preparation of rectal origin was prescribed daily; group 3 (n=30) included female patients who underwent physiotherapy procedures. RESULTS: It was found that patients suffering from chronic pelvic pain need to undergo complex treatment, including physiotherapy techniques and rectal preparations of herbal origin. In groups receiving combination therapy for chronic pelvic pain, a long-term clinical effect was obtained; these data correlate with ultrasound parameters. CONCLUSION: It has been established that women suffering from chronic pelvic pain should undergo a comprehensive treatment including physiotherapy techniques, in particular extracorporeal magnetic stimulation of the pelvic organs, and rectal preparations of herbal origin.

Hedyotis diffusa Willd inhibits inflammation and oxidative stress to protect against chronic prostatitis via the NRF2/ARE signaling pathway.

Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) is a common and serious disease with unclear pathogenesis and recurrent symptoms. Hedyotis diffusa Willd (HDW) has been recognized for its potential in managing various chronic inflammatory diseases. This research aimed to interrogate the mechanism of HDW in treating CP/CPPS. Complete Freund Adjuvant (CFA) and LPS were utilized to establish the rat and cell models of CP/CPPS. Results showed that HDW decreased levels of inflammation-related factors in CP rat prostate tissue and LPS-elicited RWPE-1 cell injury model. Moreover, HDW administration impaired oxidative stress in the prostate and RWPE-1 cells. In addition, HDW treatment activated the NRF2/ARE signaling in rat prostate tissue and cell models. Interestingly, NRF2/ARE pathway inhibitor ML385 reversed the inhibition effects of cell apoptosis, inflammation, and oxidative stress triggered by HDW. In summary, HDW alleviated inflammation and oxidative stress by activating NRF2/ARE signaling in CP/CPPS rat model and human prostate epithelial cell injury model.

Letter: Urologic Chronic Pelvic Pain Syndrome Flares: A Comprehensive, Systematic Review and Meta-analysis of the Peer-reviewed Flare Literature

Letter: Urologic Chronic Pelvic Pain Syndrome Flares: A Comprehensive, Systematic Review and Meta-analysis of the Peer-reviewed Flare Literature

The role of testosterone and estradiol levels in seminal plasma in the ejaculate microbiota in men

The role of testosterone and estradiol levels in seminal plasma in the ejaculate microbiota in men