Health Chronic Prostatitis Symptom Index Research Articles

Chronic pelvic pain syndrome symptoms significantly affect medical students' well-being.

Aims:This study aims to determine the prevalence of chronic pelvic pain syndrome (CPPS) symptoms among male-medical students in Riyadh, Saudi Arabia.Settings and Design:It is a cross-sectional study at King Saudi Bin Abdulaziz University for Health Sciences, College of Medicine at Riyadh, Saudi Arabia.Subjects and Methods:A total of 300 male medical students were given a hardcopy questionnaire to be filled anonymously that includes demographic characteristics, several questions regarding the health status, habits of the participants, and the National Institutes of Health Chronic Prostatitis Symptom Index for evaluating CPPS symptoms.Statistical Analysis Used:SPSS (v21) was used for the analysis. Qualitative data presented by frequencies and percentages and quantitative data presented by median and interquartile range (Q1 to Q3). The Chi-square test and binary logistic regression were used to assess the relationship between the outcome variables with demographical data.Results:In total 300 male medical students were surveyed, 245 medical students returned the questionnaire giving a response rate of 81.6%. The prevalence of CPPS symptoms among all participants was 57.9%. Majority of the participants does not have any associated medical/psychological conditions 152 (62%). Students with irritable bowel syndrome (IBS) or/and anxiety have statistically significant association with CPPS symptoms (P < 0.05). A total of 23% of students with CPPS reported being impaired with their quality of life (QOL), while 77% are satisfied.Conclusions:The prevalence of CPPS symptoms among male medical students is high. Anxiety, IBS, and lack of activity might be associated with CPPS symptoms, which have a significant negative impact on the QOL. For the future direction, a large-scale global study should be conducted to link the effects of CPPS symptoms on male medical students well-being.

Effect of Qianlietongyu Capsule Combined with Tamsulosin Hydrochloride in the Treatment of Prostatitis Complicated with Premature Ejaculation

To discuss the clinical effect of Qianlietongyu capsule combined with tamsulosin hydrochloride in the treatment of prostatitis complicated with premature ejaculation and its impact on the sexual life of patients. We selected 70 patients with prostatitis complicated with premature ejaculation untreated in our hospital from July 2020 to July 2021 and divided them into control group (35 cases) and observation group (35 cases). Treated control group with compound lidocaine cream, after receiving the same treatment as control group, treated observation group with tamsulosin hydrochloride and Qianlietongyu capsule. After 1 mo treatment, observation group possessed lower National Institutes of Health chronic prostatitis symptom index score than control group, but it possessed higher intravaginal ejaculation latency time than control group (p<0.05); after treatment, observation group possessed lower interleukin 8 and tumor necrosis factor alpha levels, higher maximum urinary flow rate and lower bladder residual urine volume than control group (p<0.05). After treatment, the total clinical effective rate and sexual life satisfaction of observation group were 94.29 % (33/35) and 88.57 % (31/35) respectively, those in control group were 77.1 % (27/35) and 68.57 % (24/35) respectively, the differences possessed statistical significance (p<0.05). In clinical treatment of patients with prostatitis complicated with premature ejaculation, tamsulosin hydrochloride combined with Qianlietongyu capsule can significantly improve the effect of patients’ clinical symptoms and related biochemical indicators, improve the overall clinical treatment effect and promote patients to obtain more ideal sexual life satisfaction after treatment.

Clinical Observations of Percutaneous Tibial Nerve Stimulation Combined with Sacral Nerve Root Magnetic Stimulation for the Treatment of Male Chronic Pelvic Pain and Chronic Prostatitis.

To investigate the clinical efficacy of percutaneous tibial nerve stimulation combines sacral nerve root magnetic stimulation in the treatment of chronic pelvic pain syndrome and chronic prostatitis. 60 male patients diagnosed with chronic pelvic pain syndrome or chronic prostatitis were analyzed in this study. Patients in the experimental group were treated with percutaneous tibial nerve stimulation (7 Hz) combined with sacral nerve root magnetic stimulation (5 Hz) whilst patients in the control group receiving treatment with only percutaneous tibial nerve stimulation. The National Institutes of Health-Chronic Prostatitis Symptom Index was used to evaluate prostatitis in the 2 groups before and at 4 weeks after treatment. All patients showed improvements in scores before and after treatment in the two groups (p < 0.05). Further comparison between the two groups showed that patients in the experimental experienced more significant improvements in each of the indicators compare that to the control group patients (p < 0.05). Both percutaneous tibial nerve stimulation and percutaneous tibial nerve stimulation combined with magnetic stimulation of the sacral nerve roots have benefits for patients, but the benefits are more excellent when used together than when used alone.

Acupuncture for chronic prostatitis: A randomized controlled trial: 针刺治疗慢性前列腺炎:随机对照研究

ObjectiveTo explore whether there is a specific clinical effect of acupuncture in the treatment of chronic prostatitis. MethodsA total of 52 patients with chronic prostatitis were randomly divided into an acupuncture group (24 cases) and a placebo acupuncture group (28 cases). During the treatment, 1 case was dropped out in the placebo acupuncture group and 51 patients accomplished the clinical trial finally in two groups. In the acupuncture group, Shènshū (肾俞BL23), Zhōngliáo (中髎BL33), Huìyáng (会阳BL35) and Sānyīnjiāo (三阴交SP6) were selected. In the placebo acupuncture group, the non-meridian points located lateral to BL23, BL33, BL35 and SP6 were selected, respectively. The duration of treatment was 8 weeks in each group. In the first 4 weeks of treatment, the treatment was given once every two days, three times weekly. In the last 4 weeks of treatment, the treatment was given once every three days, twice a week. Totally, 20 acupuncture treatments were required in the whole trial. Before treatment, in week 4 and 8 of treatment and in follow-up, National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) score and the comprehensive effect were evaluated in the two groups successively. ResultsIn week 4 and 8 of treatment, NIH-CPSI score in the acupuncture group was lower than that before treatment, respectively (both P < 0.05). In week 8 of treatment, NIH-CPSI score in the placebo acupuncture group was lower than that before treatment (P < 0.05). NIH-CPSI score in the acupuncture group was lower than the placebo acupuncture group in week 8 of treatment (P < 0.05). In follow-up, NIH-CPSI score of the two groups all decreased as compared with the score before treatment (both P < 0.05), and the score in the acupuncture group was lower than the placebo acupuncture group (P < 0.05). In the comparison of comprehensive effect, the total effective rate was 91.7% in the acupuncture group and was 74.1% in the placebo acupuncture group. The therapeutic effect in the acupuncture group was better than that of the placebo acupuncture group (P < 0.05). ConclusionAcupuncture relieves pelvic pain and urination symptoms and has a certain of long-term effect in patients with chronic prostatitis.

Genetic Polymorphisms of IFNG, IFNGR1, and Androgen Receptor and Chronic Prostatitis/Chronic Pelvic Pain Syndrome in a Chinese Han Population.

Background Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) refers to a common disorder with unclear etiology and unsatisfactory treatment, which reduces the male's quality of life. Objective To examine the effects of genetic polymorphisms of IFNG, IFNGR1, and androgen receptor (AR) on CP/CPPS. Methods The single nucleotide polymorphisms (SNPs) of IFNG, IFNGR1, and AR were genotyped with the improved multiplex ligation detection reaction. The GTEx, RegulomeDB, HaploReg, and 3DSNP databases were adopted to predict the regulatory functions of the genotyped SNPs. The correlation between SNPs and CP/CPPS was analyzed with the χ2 test, logistic regression, and two genetic models (codominant and log-additive models). The nomogram was built to predict the risk of CP/CPPS occurrence. Results On the whole, 130 CP/CPPS patients and 125 healthy controls were recruited in the study, and 18 SNPs of IFNG, IFNGR1, and AR were genotyped. The results of functional annotation indicated that the 18 genotyped SNPs might have regulatory effects in the whole blood. The rs144488434 was correlated with the elevated CP/CPPS risk (odds ratio (OR): 2.40, 95% confidence interval (CI): 1.12-5.13, χ2 = 5.37, and P = 0.021) by the χ2 test. In the built genetic models, rs10457655 was correlated with the elevated National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) scores (codominant model: GA/GG: crude mean difference (MD) = 0.98, 95% CI: -1.71-3.67 and AA/GG: crude MD = 9.10, 95% CI: 0.58-17.62, P = 0.10). In subgroup analysis, rs2069718 was correlated with the elevated CP/CPPS risk (log-additive model: crude OR = 2.18, 95% CI: 1.03-4.64, and P = 0.034) in patients ≥ 35 years. The nomogram integrating age, rs2069718, rs10457655, and rs144488434 showed good performance to predict the risk of CP/CPPS. Conclusions Genetic polymorphisms of IFNG, IFNGR1, and AR might act as the genetic factors for CP/CPPS susceptibility, which deserved further explorations.

PREVALENCE AND RISK FACTORS OF PROSTATITIS LIKE SYMPTOMS AMONG MALES BETWEEN AGE 15-45 YEARS OLD IN TAIF GOVERNORATE, KSA

Background: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is one of the most frequent and mysterious disorder seen in the daily practice of urology, it is a chronic deactivate syndrome composed of pelviperineal pain of vague etiology, frequently accompanied by voiding plus sexual symptoms. Many studies have found multiple different factors rise risk of prostatitis consist of dietary factors, sexual factors, perineal factors, and sedentary lifestyle. Our aim is to assess the prevalence of prostatitis-like symptoms in males between age 15-45 years old in Taif gouvernante and risk factors related to prostatitis. Methodology: cross-sectional study targeting 409 males aged between 15 to 45 years old living in Taif governorate using a predesigned questionnaire, including demographic characteristics, Arabic Version of the National Institutes of Health Chronic Prostatitis Symptom Index, and risk factors of prostatitis. Results: In this study, we collected data from 409 participants, mostly aged between 21-25 years (64.1 %). In general, the mean score of pain, urinary symptoms, and impact of symptoms on QoL were 3.33 (3.75), 2.1 (2.36) and 3.0 (2.71). We found that marital status and smoking status had significant effect on pain score where divorced, widow and single participants had significant lower pain (P=0.008), and smokers had higher pain score. Some lifestyle is related to pain score. Conclusion: we found that participants in Al Taif city reported lower scores of prostatitis related symptoms. Some habits were related with incidence of prostatitis including consuming of alcohol and smoking as well as experience of GIT disorder. The pain score is increased as reported by participants by increasing stress, decrease in physical activity, sitting for long periods, and wear of tight clothes.

Efficacy and safety evaluation of low-intensity extracorporeal shock wave therapy on prostatitis-like symptoms: An open-label, single-arm trial.

The present work aims to evaluate the clinical efficacy and safety of low-intensity extracorporeal shock wave therapy (Li-ESWT) on patients with prostatitis-like symptoms (PLS). Patients with PLS were recruited and received four-week Li-ESWT (once per week), which was conducted at a frequency of 3Hz with a preferred energy flow density of 0.25mJ/mm2 . The scores of the National Institute of Health Chronic Prostatitis Symptoms Index (NIH-CPSI), International Prostate Symptom Score (IPSS), International Index of Erectile Function (IIEF-5), and Visual Analogue Scale (VAS) were recorded to assess the remission of disease in the 0, 1st, 2nd, 3rd, 4th, 5th, 8th and 16th weeks. A decrease of the NIH-CPSI score ≥6 was regarded as the effectiveness standard of Li-ESWT. Among 91 enrolled patients, the scores of all validated questionnaires presented significant improvements in the 4th week (p<.05) compared with that in baseline, except for IIEF-5. The treatment effective rates in the 1st, 2nd, 3rd, 4th, 5th, 8th and 16th weeks were 28.57%, 38.46%, 47.25%, 51.65%, 57.30%, 68.18% and 69.44%, respectively. No pronounced undesirable side effect has occurred. Li-ESWT is effective and safe in treating PLS. The efficacy can be maintained within three months.

Relationship between erectile dysfunction and moderate to severe prostatitis-like symptoms in middle-aged men: a propensity score-matched analysis.

We assessed the relationship between chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and erectile dysfunction (ED) using propensity score matching. Data from 8727 middle-aged men who had undergone health checkups were analyzed. The National Institutes of Health Chronic Prostatitis Symptoms Index (NIH-CPSI), the International Index of Erectile Function-5 (IIEF), the Premature Ejaculation Diagnostic Tool (PEDT), testosterone measurement, basic blood chemistry, and metabolic syndrome (MetS) assessment were performed in this study. Of the 8727 men considered, 7181 formed the cohort for propensity score matching, including 597 men with moderate to severe prostatitis-like symptoms (case) and 6584 men with no prostatitis-like symptoms (control); ultimately, however, members of the case and control groups were matched at a 1:1 ratio by propensity score. After matching, the variables of age, testosterone, PEDT and MetS were evenly distributed between the groups. After matching, the mean IIEF score of the case group was significantly lower than that of the control group (17.2 ± 5.5 vs. 14.7 ± 5.3; P < 0.001). Additionally, the severity of ED was significantly greater in the case group (no, mild, mild to moderate, moderate, and severe, respectively: 27.5%, 30.2%, 24.6%, 13.1%, and 4.7% in the control group; 10.7%, 27.0%, 33.0%, 18.9%, and 10.4% in the case group; P < 0.001). Finally, the rate of moderate to severe ED was significantly higher in the case group than in the control group (17.8% vs. 29.3%; P < 0.001). Moderate to severe prostatitis-like symptoms were significantly and independently correlated with ED in middle-aged men.

Does the microbiota spectrum of prostate secretion affect the clinical status of patients with chronic bacterial prostatitis?

To explore the influence of the microbiota of prostate secretion on the clinical status of patients with chronic bacterial prostatitis. This was an observational, single-center, comparative study. We evaluated the survey cards of 230 outpatients aged 18-45years with a history of prostatitis from 2012 to 2019. As a result, 170 outpatients were selected for the study. All patients underwent an assessment of symptoms using International Prostate Symptom Score-quality of life, National Institutes of Health-Chronic Prostatitis Symptom Index, International Index of Erectile Function, pain visual analog scale. A bacteriological study (after the Meares-Stamey test) of post-massage urine was carried out on an extended media set. The following parameters were determined in each patient: leukocyturia and bacteriuria, serum testosterone and total prostate-specific antigen levels. Uroflowmetry, transrectal prostate ultrasound with color duplex mapping and ejaculate analysis were also carried out. Aerobic-anaerobic bacterial associations were identified in all patients. Three comparison groups were identified depending on the microbiota's spectrum (in post-massage urine): aerobes prevailed in group1 (n=67), anaerobes prevailed in group2 (n=33), and the levels of aerobic and anaerobic bacteriuria were higher than ≥103 colony-forming units per mL in group3 (n=70). It was found that the severity of clinical symptoms (urination disorders, sexual dysfunction etc.) of chronic bacterial prostatitis, laboratory and instrumental changes (testosterone, prostate-specific antigen, prostate volume etc.) in groups2 and 3 were significantly higher than in group1. In patients with chronic bacterial prostatitis, a predominance of anaerobes or a combination of aerobes and anaerobes in a titer of ≥103 colony-forming units per mL in post-massage urine is associated with worse clinical status.

Boswellia resin extract and propolis derived polyphenols in patients with type III chronic prostatitis/chronic pelvic pain syndrome: An Italian prospective multicenter study

ObjectiveTo assess the efficacy and safety of a treatment regimen based on rectal administration of Boswellia resin extract and propolis derived polyphenols in patients with type IIIa and type IIIb chronic prostatitis and chronic pelvic pain syndrome (CP/CPPS). MethodsPatients with type IIIa and type IIIb CP/CPPS received one rectal suppository a day for 15 days per month for 3 consecutive months. Participants were evaluated with National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI), the International Prostate Symptom Scores (IPSS), International Index of Erectile Function (IIEF), four-glass test, uroflowmetry, and prostate-specific antigen assessments at baseline and at Week 4, and Week 12. Primary endpoints were improvement in pain domain of NIH-CPSI and improvement of NIH-CPSI total score. Secondary outcomes included improvement of micturition and quality of life (QoL) domains of NIH-CPSI questionnaire. ResultsA total of 61 males were enrolled. No adverse events were reported. Significant improvements from baseline to Day 30 were reported for NIH-CPSI total score (mean difference: −9.2; p<0.01), NIH-CPSI pain domain (mean difference: −5.5; p<0.01), NIH-CPSI micturition domain, NIH-CPSI QoL domain, and IPSS total score (mean difference: −5.6; p<0.01). No significant changes from baseline in terms of IIEF score or maximum flow rate were observed. At final follow-up (Day 90), further significant improvements in terms of NIH-CPSI total score (mean difference: −12.2; p<0.01), NIH-CPSI pain domain (mean difference: −6.6; p<0.01), NIH-CPSI micturition domain, NIH-CPSI QoL domain, and IPSS total score were reported. ConclusionRectal administration of Boswellia resin extract and propolis derived polyphenols is well tolerated and delivers a significant symptomatic improvement in most patients with type IIIa and type IIIb CP/CPPS.

Efficacy of Acupuncture for Chronic Prostatitis/Chronic Pelvic Pain Syndrome : A Randomized Trial.

Acupuncture has promising effects on chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), but high-quality evidence is scarce. To assess the long-term efficacy of acupuncture for CP/CPPS. Multicenter, randomized, sham-controlled trial. (ClinicalTrials.gov: NCT03213938). Ten tertiary hospitals in China. Men with moderate to severe CP/CPPS, regardless of prior exposure to acupuncture. Twenty sessions of acupuncture or sham acupuncture over 8 weeks, with 24-week follow-up after treatment. The primary outcome was the proportion of responders, defined as participants who achieved a clinically important reduction of at least 6 points from baseline on the National Institutes of Health Chronic Prostatitis Symptom Index at weeks 8 and 32. Ascertainment of sustained efficacy required the between-group difference to be statistically significant at both time points. A total of 440 men (220 in each group) were recruited. At week 8, the proportions of responders were 60.6% (95% CI, 53.7% to 67.1%) in the acupuncture group and 36.8% (CI, 30.4% to 43.7%) in the sham acupuncture group (adjusted difference, 21.6 percentage points [CI, 12.8 to 30.4 percentage points]; adjusted odds ratio, 2.6 [CI, 1.8 to 4.0]; P< 0.001). At week 32, the proportions were 61.5% (CI, 54.5% to 68.1%) in the acupuncture group and 38.3% (CI, 31.7% to 45.4%) in the sham acupuncture group (adjusted difference, 21.1 percentage points [CI, 12.2 to 30.1 percentage points]; adjusted odds ratio, 2.6 [CI, 1.7 to 3.9]; P<0.001). Twenty (9.1%) and 14 (6.4%) adverse events were reported in the acupuncture and sham acupuncture groups, respectively. No serious adverse events were reported. Sham acupuncture might have had certain physiologic effects. Compared with sham therapy, 20 sessions of acupuncture over 8 weeks resulted in greater improvement in symptoms of moderate to severe CP/CPPS, with durable effects 24 weeks after treatment. China Academy of Chinese Medical Sciences and the National Administration of Traditional Chinese Medicine.

Acupuncture Used as a Method of Peripheral Nerve Stimulation in Chronic Prostatitis: A Case Study

Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) is defined as chronic pelvic pain lasting for at least 3 months, often associated with lower urinary tract symptoms and/or sexual dysfunction [1]. Prostatitis is a common condition, with 35–50% of men affected by symptoms suggesting prostatitis during their lifetime. It is associated with negative psychological effects and substantial health care costs [2]. There are currently many approaches for its management, using both pharmacological and non‐pharmacological interventions, though there is a lack of evidence for the efficacy of these treatments. A systematic review [3] examined the evidence for 16 different pharmacological treatments of CP/CPPS. Ninety-nine studies included 9119 men. Treatment approaches included alpha-blockers, 5-alpha reductase inhibitors, antibiotics, anti-inflammatories, allopurinol and botulinum toxin injections. The authors found low‐ to very low‐quality evidence that these interventions cause a reduction in prostatitis symptoms, without an increased incidence of adverse events in the short term. They reported lack of evidence regarding the effects of these drugs on sexual dysfunction, quality of life, or anxiety and depression. The efficacy of acupuncture on CP/CPPS was examined in a systematic review and meta-analysis [4] of 10 published trials (n=770). Analysis revealed that acupuncture significantly reduced the National Institute of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) score and provided pain relief, compared to standard medication, and reduced symptoms when compared to sham. Four acupuncture sessions were the minimum “dose” to reach clinical efficacy, and prolonged acupuncture sessions continuously improved urinary symptoms and quality of life. Peripheral Nerve Stimulation (PNS) is an effective tool for the treatment of chronic pain. Miniaturized devices that are less invasive than previous generations has brought this treatment modality into mainstream use. Recent clinical evidence suggests clinically significant and sustained reductions in pain can persist well beyond the PNS treatment period [5]. Acupuncture is a minimally invasive method of PNS. Acupuncture points have been shown to overlie major neuronal bundles, which correlate with cutaneous branches of major nerves [6]. These nerves converge and interact with visceral nociceptive inputs at the spinal cord level. This anatomical correlation provides the basis on which acupuncture applied to a specific region could treat a variety of conditions such as prostatitis, remote to the site of treatment.

Neuroinflammatory gene expression in chronic prostatitis/chronic pelvic pain syndrome patients: insights into etiology and phenotype biology.

BackgroundChronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) has diverse clinical phenotypes and its etiology is multifactorial. Studies to date of gene expression in humans have been limited to small numbers of target genes. NanoString can simultaneously measure hundreds of genes. We wished to study gene expression in blood and urine of CP/CPPS patients compared to controls for neuroinflammatory genes and characterize the results by patient phenotype.MethodsBlood and urine were collected from 10 men with CP/CPPS and 7 asymptomatic controls. RNA was isolated from urine pellets using Qiagen RNeasy kits. Whole blood was collected and RNA isolated. 100 ng of RNA was used for gene expression analysis with the 770-gene NanoString Human Neuroinflammation gene panel. Data was imported into Rosalind (OnRamp Bioinformatics) for normalization, calculation of fold-changes and P values, and identification of enriched pathways. Gene expression was considered significantly different if there was a greater than 1.5× change compared to controls and corrected P was <0.05.ResultsMean patient age was 42.2 years, median symptom duration was 15.5 months, median UPOINT domains was 3 and mean total National Institute of Health-Chronic Prostatitis Symptom Index Score was 28.8. In blood, there were 5 genes with significantly different expression to controls, the largest differences found in FOS1 (neuropathic pain control), PROS1 (blood clotting) and DDX58 (antiviral innate immunity). Gene set analysis showed differences in inflammation, angiogenesis and cytokine signaling. In urine there were 48 genes with significantly different expression including SLAMF8 (lymphocyte activation) and LAIR1 (inhibits B and T cell function). Gene set analysis showed differences in carbohydrate metabolism, neurons and neurotransmission, adaptive immunity and inflammatory signaling. Subgroup analysis by UPOINT domain showed unique gene expression in the Organ Specific and Neurologic/Systemic domains in both blood and urine for neurogenic pain and cytokine signaling associated genesConclusionsMen with CP/CPPS have a diverse set of neuroinflammatory genes with differential expression compared to controls. Clinical phenotypes have distinct patterns of gene expression. These findings could lead to novel biomarker development, emphasize the importance of multimodal therapy targeting diverse pathways and further validate the biologic basic of clinical phenotyping.

COMPARATIVE EFFICACY OF COMBINED LOW-INTENSITY EXTRACORPOREAL SHOCKWAVE THERAPY AND ORAL THERAPY VS ORAL THERAPY ALONE FOR CHRONIC PELVIC PAIN SYNDROME: A META-ANALYSIS OF RANDOMIZED CONTROLLED TRIAL

Objective: This study aimed to compare the efficacy of Low-Intensity Extracorporeal Shockwave Therapy (Li-ESWT) and oral therapy combination compared to sole oral therapy for reducing symptoms in CP/CPPS patients. Material &amp; Methods: A systematic search was conducted from the electronic database including PubMed, Clinicaltrial.gov, and Cochrane Library, published up to July 2020 following the PRISMA guideline. We screened RCTs with the inclusion criteria and assessed the quality with the Cochrane Risk of Bias tool. The primary outcome was the National Institute of Health Chronic Prostatitis Symptom Index (NIH-CPSI) and subgroup analysis for triple therapy users was conducted to improve interpretability. The analysis was performed using Review Manager 5.3. Results: A total of 2 RCTs consisted of 91 CP/CPPS patients were analyzed. Pooled analysis showed that compared to the oral therapy only group, combination therapy had a significant lower NIH-CPSI total score at the endpoint of the treatment (MD -7.46, 95% CI -9.85 to -5.07, p&lt;0.001) and NIH-CPSI component pain score (MD -3.48, 95% CI -5.04 to -1.93, p&lt;0.0001), urinary symptoms score (MD -0.96, 95% CI -1.47 to -0.45, p&lt;0.001), and quality of life (QoL) impact score (MD -2.94; 95% CI -3.68 to -2.20, p=&lt;0.001). Conclusion: This review revealed that patients undergoing combination Li-ESWT therapy have lower total NIH-CPSI scores than patients receiving oral therapy alone, this finding is consistent with each component of the score: pain, urinary symptoms, and impact on QoL.

Using the UPOINT system to manage men with chronic pelvic pain syndrome

ABSTRACT Objective : To outline our approach for the evaluation and management of patients with chronic prostatitis and chronic pelvic pain syndrome (CP/CPPS) based on our interpretation and application of currently available evidence. Methods : CP/CPPS in men is a medical condition that plagues both the patient and the practitioner, as it is widely believed to be poorly understood and difficult to treat. While pelvic pain is typically the predominant symptom, many men may exhibit voiding symptoms, sexual dysfunction and psychiatric complaints. Still, most studies of CP/CPPS management have evaluated singular treatments, without focussing on individual patients’ clinical phenotypes. This is a clinically practical mini-review based on the authors’ interpretation and application of currently available evidence related to management of CP/CPPS. Results : Patient evaluation should consist of history and physical examination (with focus on the genitourinary and digital rectal examination), laboratory tests (including urine analysis and urine culture with consideration of pre- and post-prostate massage urine cultures), post-void residual, and questionnaires including the National Institutes of Health Chronic Prostatitis Symptoms Index, which helps assess symptom severity and treatment response. Once CP/CPPS is diagnosed, the UPOINT phenotype system, which classifies patients into six domains: Urinary, Psychosocial, Organ Specific, Infectious, Neurological/systemic and Tenderness of skeletal muscles, is used to guide treatment. Each domain is characterised by specific complaints and thus is responsive to distinct treatments. As patients may be grouped into multiple domains, each patient’s overall multimodal treatment can vary. Conclusion : Using the UPOINT phenotype system is a holistic approach that can yield significant benefits for patients with CP/CPPS.

Effectiveness of external myofascial mobilisation in the management of male chronic pelvic pain of muscle spastic type: A retrospective study

ABSTRACT Objective To evaluate the outcome of men with muscle spastic chronic pelvic pain syndrome (CPPS) who underwent a comprehensive five-session fascial connectivity based external myofascial mobilisation (EMM) approach. Patients and methods A retrospective chart review of patients who underwent EMM for CPPS at the Pelvic Pain Unit of Hamad Medical Corporation, Qatar between January 2019 and October 2020 was conducted. Patient’s symptoms were measured with the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) scale and the numerical rating scale (NRS) before and after the completion of the sessions. The patients were given five EMM sessions as a ‘once-a-week’ programme. Results A total of 31 patients who completed all the EMM sessions were included. The mean (range) age of patients was 38 (20–54) years. The mean (SD) NIH-CPSI score at initial evaluation was 29.41 (8.3) and decreased to 9.14 (3.45) after the fifth visit. All the patients in the study group had a reduction of >6 points in the NIH-CPSI score, indicating a robust treatment response. The NRS reading also revealed significant improvement in pain (P < 0.001). Conclusions : An EMM approach based on fascial connectivity led to significant symptom improvement in all the studied patients. EMM may be an effective treatment option for muscle spastic type of CPPS. Future high-quality studies with control groups are needed to confirm the present findings. Durability and long-term results are yet to be determined. ABBREVIATIONS CP/CPPS: chronic prostatitis/chronic pelvic pain syndrome; EMM: external myofascial mobilisation; EO: external oblique; FM: fascial manipulation; GMx: gluteus maximus; HAC: hip adductor complex; HMC: Hamad Medical Corporation; IO: internal oblique; LD: latissimus dorsi; MFR: myofascial release; MM: myofascial mobilisation; NIH-CPSI: National Institute of Health-Chronic Prostatitis Symptom Index; NRS: numerical rating scale; PFPT: pelvic floor physical therapy; QoL, quality of life; TLF: thoracolumbar fascia; UPOINT: urinary (U), psychosocial (P), organ-specific (O), infection (I), neurological/systemic (N) and tenderness of pelvic floor skeletal muscles (T)

Comparative Efficacy of Oral Chinese Patent Medicine for Chronic Prostatitis/Chronic Pelvic Pain Syndrome With Sexual Dysfunction: A Bayesian Network Meta-Analysis of Randomized Controlled Trials.

Background: Oral Chinese patent medicine (OCPM) combined with western medicine (WM) are believed to be effective for the therapy of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) with sexual dysfunction (SD). These western medicines mainly involve antibiotics, phosphodiesterase type-5 inhibitor (PDE-5i), α-blockers. But there is no randomized controlled trial (RCT) that directly compares the efficacy of different OCPM. Hence, we operated a network meta-analysis (NMA) to contrast the efficacy of different OCPM for CP/CPPS with SD. Methods: Relevant studies were searched in PubMed, Cochrane Library, Web of Science, Embase, China National Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP), and Wanfang database. All of the RCTs concentrated on the use of OCPM to cure CP/CPPS with SD from the inception of the databases to November 2020. We appraised the risk of bias under the Cochrane Handbook and CONSORT statement. The data were statistically analyzed via STATA 13.0 and WinBUGS 1.4.3 instrument. Results: Altogether, 30 pieces of literature with 2,996 participants containing 11 oral Chinese patent medicine and 11 interventions were included in the NMA. In terms of The National Institutes of Health chronic prostatitis symptom index (NIH-CPSI), Qianlie Shutong Capsules (QLSTC) + WM had the most possible of being the optimal treatment. In the light of the International Index of Erectile Function (IIEF-5), Congrong Yishen Granules (CRYSG) + WM had the most possible of being the optimal treatment. Shugan Yiyang Capsules (SGYYC) + WM performed the highest likelihood efficacy under cluster rank graph combined NIH-CPSI and IIEF-5. Liuwei Dihuang Pills/Yougui capsules (LWDHP/YGC) + WM had highly possible to be the optimal treatment not only for the clinical effective rate of CP/CPPS but also for the clinical effective rate of SD. Considering four outcomes, QLSTC, CRYSG, SGYYC, LWDHP/YGC, Qianlie Beixi Capsules (QLBXC) plus WM were the best therapy approach for CP/CPPS with SD, especially LWDHP/YGC + WM and QLBXC + WM. Conclusion: Based on the NMA, QLSTC, CRYSG, SGYYC, LWDHP/YGC, QLBXC plus WM demonstrated the maximum probability of being the optimal therapies. Owing to the limitations of this research, these results should be confirmed by elaborate RCTs. Systematic Review Registration: [https://www.crd.york.ac.uk/prospero/], identifier [CRD42021224060].

Potential Alterations of Functional Connectivity Analysis in the Patients with Chronic Prostatitis/Chronic Pelvic Pain Syndrome.

Background Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is one of the most common diseases in urology, but its pathogenesis remains unclear. As a kind of chronic pain which the patients suffered for more than 3 months, we investigated the influence on patients' brain functional connectivity in resting state. Methods We recruited a cohort of 18 right-handed male patients with CP/CPPS and 21 healthy male right-handed age-matched controls. Their resting-state fMRI data and structural MRI data were preprocessed and processed by RESTPlus V1.22. To assess the integrity of the default mode network (DMN), we utilized the voxel-wised analysis that we set medial prefrontal cortex (mPFC) and posterior cingulate gyrus (PCC) as seed points to compare the global functional connectivity (FC) strength. Results Compared with healthy control, the FC strength between left mPFC and posterior DMN decreased in the group of CP/CPPS (P < 0.05, GFR correction, voxel P < 0.01, cluster P < 0.05), and the FC strength between the left anterior cerebellar lobe and posterior DMN increased (P < 0.05, GFR correction, voxel P < 0.01, cluster P < 0.05). In the patient group, there was a positive correlation between the increased FC strength and the score of the Hospital Anxiety and Depression Scale (HADS) anxiety subscale (r = 0.5509, P = 0.0178) in the left anterior cerebellar lobe, a negative correlation between the decreased FC strength and the score of the National Institutes of Health Chronic Prostatitis Symptom Index (r = −0.6281, P = 0.0053) in the area of left mPFC, and a negative correlation between the decreased FC strength and the score of HADS anxiety subscale (r = −0.5252, P = 0.0252). Conclusion Patients with CP/CPPS had alterations in brain function, which consisted of the default mode network's compromised integrity. These alterations might play a crucial role in the pathogenesis and development of CP/CPPS.

Reliability and validity of the National Institutes of Health Chronic Prostatitis Symptom Index questionnaire in the Turkish Population

Background/aimTo develop the first Turkish version of the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) questionnaire and to investigate its validity and reliability in men with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and healthy controls.Material and methodsA total of 204 patients, 116 CP/CPPS and a control group which consisted of 88 healthy individuals were included in this prospective study. The NIH-CPSI form was first translated into Turkish and later on back into English. Using the Turkish version of the NIH CPSI, 40 patients completed the same questionnaires twice at 2-week intervals for test-retest concordance. To evaluate internal consistency and test-retest reliability, Cronbach’s alpha value, and the Spearman correlation test were utilized respectively.ResultsOur findings demonstrated statistically significant differences in NIH-CPSI scores between the patients and control groups (P <0.001). Cronbach’s alpha coefficient value of NIH-CPSI was 0.864. Reliability of test-retest was 0.909 (P <0.001). Additionally, the Spearman correlation test showed that the results obtained using the Turkish NIH-CPSI were significantly correlated.ConclusionThe first Turkish version of the NIH-CPSI was found to be a reliable and valid instrument for Turkish patients with chronic prostatitis in both clinical and research settings.

Low-intensity extracorporeal shock wave therapy for male chronic pelvic pain syndrome: a systematic review and meta-analysis.

BackgroundA systematic review of the evidence was conducted to evaluate the efficacy of low-intensity extracorporeal shock wave therapy (LI-ESWT) for patients with chronic pelvic pain syndrome (CPPS).MethodsA comprehensive search was undertaken of the Cochrane Register, PubMed, and Embase databases for controlled trials that evaluated patients with CPPS who were treated with LI-ESWT and that were published before August 2019. The National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) was the most frequently used tool to evaluate the treatment efficacy of LI-ESWT. The NIH-CPSI comprises subscales for pain [using a visual analog scale (VAS)], urinary function, and quality of life (QoL).ResultsSix studies analyzing 317 patients were published from 2009 to 2019. The overall meta-analysis of the data indicated that LI-ESWT demonstrated efficacy in the treatment of CPPS at 12 weeks [risk difference (RD): 0.46; 95% confidence interval (CI), 0.28–0.63; P<0.00001]. The studies were divided into 3 groups based on time after LI-ESWT (1, 12, and 24 weeks) and were compared in total NIH-CPSI scores, QoL, VAS scores, and urinary symptoms. The total NIH-CPSI scores, QoL, VAS scores, and urinary symptom scores improved significantly at 12 weeks after LI-ESWT (P<0.05), but not at 1 week or 24 weeks (P>0.05).ConclusionsBased on these studies, LI-ESWT may transiently improve the total NIH-CPSI scores, QoL, pain scores, and urinary symptom scores of patients with CPPS. Future research may elucidate the mechanisms underlying the effects of LI-ESWT on CPPS. Well-designed and long-term multicenter randomized controlled trials are urgently needed to estimate the real potential and ultimate use of these devices in patients with CPPS.