Chronic Prostatitis

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RESEARCH ARTICLE	-----	AYURVEDIC TREATMENT FOR CHRONIC PROSTATITIS / CHRONIC PELVIC PAIN SYNDROME: A RANDOMIZED CONTROLLED STUDY	-----	Sherkhane Rahul Nagnath, Gupta SJ

RESEARCH ARTICLE ----- AYURVEDIC TREATMENT FOR CHRONIC PROSTATITIS / CHRONIC PELVIC PAIN SYNDROME: A RANDOMIZED CONTROLLED STUDY ----- Sherkhane Rahul Nagnath, Gupta SJ

No satisfactory treatment is available till date so this study was taken with the aim to explore a new treatment modality based on Ayurvedic principles. To assess efficacy of Ayurvedic therapy National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) was the primary outcome parameter for this study.

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The role of flower pollen extract in managing patients affected by chronic prostatitis/chronic pelvic pain syndrome: a comprehensive analysis of all published clinical trials

The role of flower pollen extract in managing patients affected by chronic prostatitis/chronic pelvic pain syndrome: a comprehensive analysis of all published clinical trials

Chronic prostatitis has been described as one of the most common illnesses in men aged <50 year [1] with differing clinical presentations [2]. According to the clas- sification of the National Institute of Health (NIH) [3], class III chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is the most frequent category [4]. Symptoms such as pelvic pain, painful voiding and ejaculation and disturbed sexual functioning are common, often result- ing in a significant impact on quality of life [5]. Recently, it has been established that the annual cost of a patient affected by prostatitis exceeds that of a patient with type 1 diabetes and that his quality of life is analogous to a patient with a heart attack or acute Crohn's disease [5]. Available therapies for CP/CPPS are not highly effective and require further in-depth analysis and consideration of such alternate strategies [6]. The traditional treatment of CP/CPPS is known as the “three A’s”: antibiotics, anti- inflammatory medications, and alpha blockers. The use of antibiotics remains controversial, especially due to the fact that bacteria cannot be isolated from the urogenital samples of CP/CPPS patients [7]. On the other hand, even if anti-inflammatory medications, aspirin or other NSAIDs such as ibuprofen can decrease pain, they can only be taken for a limited period of time due to their high prevalence of drug-related adverse effects. In other words, the standard treatment for CP/CPPS has not yet been definitively established [7]. In this scenario, even if phytotherapeutics seems to be an interesting option be- cause of their generally low side effects, demonstrated efficacy, and high treatment compliance by patients, few compounds have been subject to scientific scrutiny and prospective controlled clinical trials [8, 9].
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Clinical, Paraclinical and Therapeutic Aspects of Chronic Prostatitis

Clinical, Paraclinical and Therapeutic Aspects of Chronic Prostatitis

DOI: 10.4236/oju.2017.78014 119 Open Journal of Urology in the prostatic canals causing chronic prostatitis. The coexistence of urethritis and bilharzian infestation would aggravate and maintain chronic prostatitis. Dysuria is by far the main reason for consultation, as noted by other authors (Budia [9] and El Meliegy AI et al. ) in 2015 [10]. This dysuria is either the con- sequence of a stenosis of the urethra which is complicated by chronic prostatitis, or due to a defect of opening of the vesical neck sheathed by chronic prostatitis. For some authors, premature ejaculation in patients with chronic prostatitis would be due to prostatic inflammation that would alter the sensation and mod- ulation of the ejaculatory reflex [11] [12] [13]. Fu W et al. , [14] even establish a significant link between hypofertility and chronic prostatitis. We think that hy- pofertility, in the case of figure would be due; either to a decrease in the mobility of the spermatozoa or to an oligozoospermia. From chronic prostatitis, the in- fection can retrograde, reach the vas deferens, testicles and significantly destroy the germ line. On the other hand, chronic prostatitis would compromise the production of fructose, carnitine and zinc. These important elements, contained in the prostatic fluid, play a major role in the mobility and survival of spermato- zoa. Pelvic and perineal pain is also one of the reasons for consultation. It is most often a dull, embarrassing pain, sometimes permanent, felt by the patient in a sitting position. For others it is a pain that occurs after a painful ejaculation evocative of a spermocystitis. In a study conducted in 2013, Wegenlehner F. [15] et al. point out that 63% of patients consult for pelvic and perineal pain. We be- lieve that these pains are the result of a series of events, including: infection, in- flammation and local disturbance of innervation. Despite the pain and the infec- tious context, the patients present a satisfactory general state.
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Phenolic constituents from Alisma plantago-aquatica Linnaeus and their anti-chronic prostatitis activity

Phenolic constituents from Alisma plantago-aquatica Linnaeus and their anti-chronic prostatitis activity

In continuation of our search for novel bioactive sub- stances from this medicine plant, which has been proven to possess anti-chronic prostatitis activity, one new polyphenolic acid, plantain A (1), was isolated from A. plantago-aquatica by using various chromatographic methods, with four known phenolic compounds (2–5) (Fig. 1). The structures of the other isolated components ferulic acid (2), rynchopeterine A (3), rynchopeterine B (4) and rosmarinic acid (5) were determined by compari- son to the 1 H- and 13 C-NMR spectral data in the litera-

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The Immunitary role in chronic prostatitis and growth factors as promoter of BPH

The Immunitary role in chronic prostatitis and growth factors as promoter of BPH

Under the light o reported literature Prostate gland must be considered an immunology’s subject in some disease at BHP and chronic prostatitis and this aspect must not to be overlooked especially in therapy. In resistances pro ile other antimicrobials as, ampicillin, carbenicillin, doxicillin, gentamicin, imipenem, piperacillina tazob, Fosfomicin parenteral and other. In this paper we have see only some molecule currently in use to show the relationship between dynamics, kinetics, drug delivery strategy and medicinal chemistry properties. Prostate gland is considered a pharmacological sanctuaries and for this reason using the best strategies it can result in more % of global clinical ef icacy. Rigth spectrum anti-microbial covering, right time of the cure, the right anti logosis and anti edemigen therapy associated to 5- ARI to induce apoptosis and alfa blockers can be the golden endpoint to prevent the progression of BHP. Also a good blood glucose control prevent recurrent urinary infectious (glucose is normally used by microbs growth) and uric acid blood monitoring and control and therapy can be useful to reduce global stinging Situation (crystals).
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Efficacy of acupuncture for chronic prostatitis/chronic pelvic pain syndromes: study protocol for a randomized, sham acupuncture controlled trial

Efficacy of acupuncture for chronic prostatitis/chronic pelvic pain syndromes: study protocol for a randomized, sham acupuncture controlled trial

Methods: This study is designed as a randomized, sham acupuncture-controlled trial. We will compare patients with CP/CPPS in an acupuncture group and a sham acupuncture group. Sixty-eight patients will be randomly allocated to receive acupuncture or sham acupuncture. The treatments will consist of 30-min sessions, three times weekly, for 8 weeks. The primary outcome measure is change in the weekly mean National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) total score from baseline through the 8-week treatment period. Secondary measures include the NIH-CPSI subscale scores, the total International Prostate Symptom Score (IPSS), patients ’ response rate, and patient satisfaction after treatment. We will also assess changes in the NIH-CPSI total score from baseline at the 20 th and 32 nd week of follow-up.
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The evolving clinical picture of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS): A look at 1310 patients over 16 years

The evolving clinical picture of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS): A look at 1310 patients over 16 years

The continued enthusiasm of the NIH collaboration led to the development of a validated symptom index tool 5 – the NIH Chronic Prostatitis Symptom Index (CPSI) – that has allowed for objective evaluation of patients and their response to treatment. This tool has proved invaluable in evaluating various treatments for CP/CPPS in clinical trials, 6-8 has proved helpful in evaluating CP/CPPS prevalence 9 and has been used to validate tiers of disease severity. 10

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Therapeutic effects of Qian Yu decoction and its three extracts on carrageenan induced chronic prostatitis/chronic pelvic pain syndrome in rats

Therapeutic effects of Qian Yu decoction and its three extracts on carrageenan induced chronic prostatitis/chronic pelvic pain syndrome in rats

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), characterized by long-term pelvic or perineal pain without evidence of urinary tract infection, accounts for 90-95% of prostatitis cases [1]. As category III prostatitis classified by the National Institute of Health, CP/CPPS has been subdivided into inflammatory (category IIIa) and non-inflammatory (category IIIb) forms, depending on whether white blood cells can be found in semen, post- prostatic massage urine and expressed prostatic secretion of patients [2]. However, recent studies have questioned the differentiation between categories IIIa and IIIb, since both categories have increases in markers of inflammation, such as tumor necrosis factor alpha (TNF-α), interleukin-1beta (IL-1β), nitric oxide (NO), cyclooxygenase-2 (COX-2) and prostaglandin E2 (PGE2) [3–7]. CP/CPPS is now thought to result from an interplay between psychological factors and dysfunctions in the immune, neurological and endo- crine systems [8]. Yet still, the exact cause is unknown, and treating is difficult.
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An aberrant prostate antigen–specific immune response causes prostatitis in mice and is associated with chronic prostatitis in humans

An aberrant prostate antigen–specific immune response causes prostatitis in mice and is associated with chronic prostatitis in humans

defective in thymic expression of self antigens and central tolerance, develop spontaneous prostatitis. In this study, we found that Aire-deficient mice developed spontaneous B and T cell immune responses to a prostate autoantigen, seminal vesicle secretory protein 2 (SVS2), which we believe to be novel. We show that thymic expression of this self antigen was Aire dependent. Moreover, prostatitis was induced in WT mice through immunization with SVS2, demonstrating that immunity to SVS2 was sufficient to induce prostatitis. The clinical relevance of this antigen was highlighted by our observation that patients with chronic prostatitis possessed specific autoantibodies against the human SVS2-like seminal vesicle protein semenogelin. These results provide direct evidence that spontaneous
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Acupuncture for chronic prostatitis/chronic pelvic pain syndrome: study protocol for a randomized controlled trial

Acupuncture for chronic prostatitis/chronic pelvic pain syndrome: study protocol for a randomized controlled trial

Methods: Ten hospitals will recruit 440 participants with CP/CPPS in China from October 2017 to December 2019. Participants will be randomly allocated to acupuncture or sham acupuncture with a 1:1 ratio using computerized simple random sampling. The whole study consists of 2-week baseline, 8-week treatment, and 24-week follow up. Twenty 30-mintute sessions of acupuncture or sham acupuncture treatment will be provided between week 1 and 8. The two co-primary outcomes are the proportion of responders at week 8 and week 32. Secondary outcomes include proportion of responders in the two groups at different time points; change in the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) total score; change in the NIH-CPSI subscales; change in the International Prostate Symptom Score; change in the Hospital Anxiety and Depression Scale; expectation
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A feasibility trial of a cognitive behavioural symptom management program for chronic pelvic pain for men with refractory chronic prostatitis/chronic pelvic pain syndrome

A feasibility trial of a cognitive behavioural symptom management program for chronic pelvic pain for men with refractory chronic prostatitis/chronic pelvic pain syndrome

no published reports examining risk factor reduction in CP/ CPPS. The Chronic Prostatitis psychosocial management program is the first comprehensive attempt to specifically target empirically supported psychosocial risk factors for change in CP/CPPS (i.e., catastrophizing, social support and depression). This study was designed to assess the feasibility of this management program and its short-term effectiveness in reducing psychosocial risk factors and symptoms and in improving QoL.

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A pilot study on acupuncture for lower urinary tract symptoms related to chronic prostatitis/chronic pelvic pain

A pilot study on acupuncture for lower urinary tract symptoms related to chronic prostatitis/chronic pelvic pain

In addition, acupuncture was tested in a group of refrac- tory patients. A recent study testing the use of cipro- floxacin, tamsulosin or both in refractory CP/CPPS men showed no clinical effect in any category, and concern regarding investigation of agents in previous treatment failures is notable [26]. Recently, the Chronic Prostatitis Collaborative Research Network [26] and Habmermacher et al. [27] have proposed a treatment algorithm for newly diagnosed CP/CPPS patients dependent on subjective symptoms and a few clinical trials. This algorithm sug- gests the application of first to third-line medications and therapies depending on most acute symptoms and histor- ical treatment outcomes for each related symptom [27]. Therefore, the study of acupuncture as a potential first- line therapy or as an adjuvant therapy depending on pri- mary patient who reported subjective symptoms may be of interest in our future studies. In addition, the complex- ity and controversy surrounding the design of an appro- priate placebo for acupuncture research need to be addressed. Taken together, these challenges facing both
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ACUTE AND CHRONIC PROSTATITIS

ACUTE AND CHRONIC PROSTATITIS

Empirical treatment can be implemented primary against Gram-negative bacteria and enterococci. The choice of antibiotics is conducted on the basis of in vi- tro assays for antimicrobial susceptibility testing (anti- biogram). Flouroquinolones act very well as initial the- rapy, as well as trimethoprim / sulfamethoxazole. The recommended duration of antibiotic therapy is betwe- en 4 and 6 weeks to prevent complications, as are pros- tate abscess and chronic prostatitis. The auxiliary ther- apy include antipyretics, analgesics, laxant agents, rehydration and rest. Patients with severe complicati- ons, such are: sepsis, immune deficiency and acute uri- nary retention, require hospitalization. Transurethral catheterization or other instrumentation is contraindi- cated during the acute infection. Acute urinary reten- tion should be eliminated by suprapubic drainage until the patient is able to empty the bladder independently.
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Efficacy and safety of Chinese herbal medicine for chronic prostatitis associated with damp-heat and blood-stasis syndromes: a meta-analysis and literature review

Efficacy and safety of Chinese herbal medicine for chronic prostatitis associated with damp-heat and blood-stasis syndromes: a meta-analysis and literature review

Abbreviations: CHM, Chinese herbal medicine; CIM, Chinese internal medicine; CPPA, chronic pelvic pain syndrome; CP, chronic prostatitis; HJS, Huang Jiasi surgery; IPSS, International Prostate Symptom Score; NIH-CPSI, National Institutes of Health chronic prostatitis symptom index; NR, not reported; SC, surgery of Chinese; WBC, white blood cell; bid, twice daily; CDT, criteria of diagnosis and therapeutic effect of diseases and syndromes in traditional Chinese medicine; CRG, clinical research guidelines of new CHM; USW, urological surgery written by Wu Jie-Ping; RCTs, randomized controlled trials.
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Psychosocial mechanisms of the pain and quality of life relationship for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS)

Psychosocial mechanisms of the pain and quality of life relationship for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS)

We included 175 men diagnosed with CP/CPPS by urologists at tertiary care clinical centres, specifically those who had symptoms of pain in the pelvic region for at least 3 of the last 6 months. The participants were all enrolled in the National Institutes of Health Chronic Prostatitis Cohort Study, which has been described previously. 17

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<p>Chronic prostatitis: current treatment options</p>

<p>Chronic prostatitis: current treatment options</p>

The term “ chronic prostatitis ” is used to de fi ne and include many different symp- tomatological patterns, and its understanding is still enigmatic for many physicians and patients. Overall, it is estimated that the prevalence of chronic prostatitis among the male population is about 4.5 – 9%, with recurrence rates increasing up to 50% with increasing age. 1–3 Therefore, it has a similar prevalence to that of ischemic heart disease and higher than diabetes. 4 Although idiopathic urogenital and anor- ectal pain syndromes are not uncommon, effective treatments remain elusive for this patient group. Pain and functional disorders in these parts of the body can be embarrassing, limiting the desire to discuss the symptoms with the physician; similarly, clinicians may not be familiar enough with these syndromes, leading to misdiagnosis. Moreover, most of the involved patients usually complain of many different symptoms, not limited to “ pure ” prostatodynia but also presenting with: lower urinary tract symptoms (LUTS) with pollakiuria, dysuria, nocturia, urinary dribbling, or weak urinary stream; symptoms related to the anorectal area, such as constipation, sensation of foreign body in the rectus, and rectal pain during and after defecation; symptoms related to the external genitalia, represented by genital pain or burning and premature ejaculation, spontaneous sexual stimulation, or alteration of orgasms; 5,6 patients can also refer to an associated low back pain, worsened in the sitting position. These symptoms can appear simultaneously or progressively, generating an increasing sensation of discomfort and anxiety for the
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Original Article A clinical observation of the combined treatment of Yishen decoction with antibacterial drugs for chronic prostatitis

Original Article A clinical observation of the combined treatment of Yishen decoction with antibacterial drugs for chronic prostatitis

the capsule of the prostate and be effective, but the majority of drugs can play a limited role [10, 11]. Chronic prostatitis is defined as “Jingzhuo” and “Linzhuo” in traditional Chinese medicine (TCM), and its pathogeneses are mostly kidney-Yang deficiency, bladder damp- ness-heat, and blood stasis, etc. And the symp- toms can be improved by TCM treatment, which has obvious advantages in the treatment of CP and improves its clinical cure rate [12]. In a pre- vious study, Luo proved that Yishen decoction had the effects of clearing heat and removing dampness, improving vital energy and blood and enhancing the body’s immunity [13]. On this basis, the therapeutic effect of Yishen decoction on chronic prostatitis was evaluated in this study, which had a good guiding signifi- cance for clinical use.
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Positioning, telling, and performing a male illness: Chronic prostatitis/chronic pelvic pain syndrome

Positioning, telling, and performing a male illness: Chronic prostatitis/chronic pelvic pain syndrome

Skeletal Pain and their four strand thematic structure has some overlap to CP/CPPS stories as well. Their initial theme of “Patients struggling with the fundamental relationship with their body, and a sense that it is no longer ‘the real me’ partially maps onto trying to cope and make sense of CP/CPPS. Their second theme of ‘A loss of certainty for the future, and being constantly aware of the restrictions of their body’ also maps onto the debilitating and elusive impact of CP/CPPS. ‘Feeling lost in the health care system and feeling as though there is no answer to their pain’ echoes the medical stories of CP/CPPS patients. Finally. ‘Finding it impossible to ‘prove’ their pain’ is also part of the CP/CPPS experience, where diagnosis is by exclusion and many of the symptoms, such as pain - as reported above - are ‘invisible’. It is apparent that other chronic illnesses of uncertain aetiology and prognosis may perhaps also share some of the narrative strategies of men with CP/CPPS.
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A survey of cannabis (marijuana) use and self reported benefit in men with chronic prostatitis/chronic pelvic pain syndrome

A survey of cannabis (marijuana) use and self reported benefit in men with chronic prostatitis/chronic pelvic pain syndrome

The online group reported greater distress and NIH-CPSI symptoms, but both groups showed trends where most reported improved symptoms like mood, pain, muscle spasms and sleep. However, no improvements were in weakness, fatigue, numbness, or ambulation. Improved symptoms for some patients might reflect the shared effects that pain/muscle spasm can have in regard to improving sleep and ultimately mood. Current research shows that unresolved chronic pain, continuing disease, obesity, and sleeping problems predict the persistence of pain, while issues like mood are weakly associated. 24 Of other note,
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Diagnostic considerations and interpretation of microbiological findings for evaluation of chronic prostatitis

Diagnostic considerations and interpretation of microbiological findings for evaluation of chronic prostatitis

The seven patients with chronic bacterial prostatitis caused by recognized uropathogens had a mean of 44 leukocytes per hpf of EPS, while the six patients with other bacteria localized i[r]

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