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He H, Luo H, Qian B, Xu H, Zhang G, Zou X, Zou J. Autonomic Nervous System Dysfunction Is Related to Chronic Prostatitis/Chronic Pelvic Pain Syndrome. World J Mens Health 2024; 42:1-28. [PMID: 37118962 PMCID: PMC10782122 DOI: 10.5534/wjmh.220248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 02/09/2023] [Accepted: 02/14/2023] [Indexed: 04/30/2023] Open
Abstract
Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common and non-lethal urological condition with painful symptoms. The complexity of CP/CPPS's pathogenesis and lack of efficient etiological diagnosis results in incomplete treatment and recurrent episodes, causing long-term mental and psychological suffering in patients. Recent findings indicate that the autonomic nervous system involves in CP/CPPS, including sensory, sympathetic, parasympathetic, and central nervous systems. Neuro-inflammation and sensitization of sensory nerves lead to persistent inflammation and pain. Sympathetic and parasympathetic alterations affect the cardiovascular and reproductive systems and the development of prostatitis. Central sensitization lowers pain thresholds and increases pelvic pain perception in chronic prostatitis. Therefore, this review summarized the detailed processes and mechanisms of the critical role of the autonomic nervous system in developing CP/CPPS. Furthermore, it describes the neurologically relevant substances and channels or receptors involved in this process, which provides new perspectives for new therapeutic approaches to CP/CPPS.
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Affiliation(s)
- Hailan He
- Department of Graduate, First Clinical Colledge, Gannan Medical University, Ganzhou, Jiangxi, China
- Department of Urology, the First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, China
| | - Hui Luo
- Department of Graduate, First Clinical Colledge, Gannan Medical University, Ganzhou, Jiangxi, China
- Department of Urology, the First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, China
| | - Biao Qian
- Department of Urology, the First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, China
- Institute of Urology, the First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, China
- Jiangxi Engineering Technology Research Center of Calculi Prevention, Ganzhou, Jiangxi, China
| | - Hui Xu
- Department of Urology, the First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, China
- Institute of Urology, the First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, China
- Jiangxi Engineering Technology Research Center of Calculi Prevention, Ganzhou, Jiangxi, China
| | - Guoxi Zhang
- Department of Urology, the First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, China
- Institute of Urology, the First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, China
- Jiangxi Engineering Technology Research Center of Calculi Prevention, Ganzhou, Jiangxi, China
| | - Xiaofeng Zou
- Department of Urology, the First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, China
- Institute of Urology, the First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, China
- Jiangxi Engineering Technology Research Center of Calculi Prevention, Ganzhou, Jiangxi, China
| | - Junrong Zou
- Department of Urology, the First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, China
- Institute of Urology, the First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, China
- Jiangxi Engineering Technology Research Center of Calculi Prevention, Ganzhou, Jiangxi, China.
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Rampazo ÉP, Rehder-Santos P, Catai AM, Liebano RE. Heart rate variability in adults with chronic musculoskeletal pain: A systematic review. Pain Pract 2024; 24:211-230. [PMID: 37661339 DOI: 10.1111/papr.13294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 08/14/2023] [Accepted: 08/21/2023] [Indexed: 09/05/2023]
Abstract
PURPOSE The aim of this review was to compare the heart rate variability (HRV) responses at rest of adults with chronic musculoskeletal pain against healthy controls. METHODS The PubMed, Scopus, Web of Science (Science and Social Science Citation Index), and CINAHL databases were searched, with no date restrictions. Two independent reviewers selected observational studies that characterized the HRV responses at rest in adults with chronic musculoskeletal pain compared with those of healthy controls. Methodological quality was assessed using the Downs and Black checklist. RESULTS This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. HRV in adults with chronic musculoskeletal pain was evaluated systematically. Of the 4893 studies screened, 20 of poor-to-moderate quality met the inclusion criteria. Most studies used electrocardiography and at least one time and/or frequency domain index. Studies were found that investigated HRV in adults with temporomandibular disorders, neck pain, whiplash, low back pain, and fibromyalgia. The heterogeneity of the studies in relation to painful conditions, parameters or position for HRV analysis precluded a meta-analysis. In general, these studies seem to show increased sympathetic and decreased parasympathetic modulation in adults with musculoskeletal pain when compared to controls. CONCLUSIONS Adults with musculoskeletal pain exhibited a decline in HRV compared to controls. However, definitive conclusions cannot be drawn since the evidence is heterogeneous and of moderate quality. Further high-quality research with standardized measurements is needed.
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Affiliation(s)
- Érika P Rampazo
- Physiotherapeutic Resources Research Laboratory, Department of Physical Therapy, Federal University of São Carlos (UFSCar), Rod Washington Luiz, km 235, São Carlos, 13565-905, São Paulo, Brazil
| | - Patrícia Rehder-Santos
- Cardiovascular Physiotherapy Laboratory, Department of Physical Therapy, Federal University of São Carlos (UFSCar), Rod Washington Luiz, km 235, São Carlos, 13565-905, São Paulo, Brazil
| | - Aparecida M Catai
- Cardiovascular Physiotherapy Laboratory, Department of Physical Therapy, Federal University of São Carlos (UFSCar), Rod Washington Luiz, km 235, São Carlos, 13565-905, São Paulo, Brazil
| | - Richard E Liebano
- Physiotherapeutic Resources Research Laboratory, Department of Physical Therapy, Federal University of São Carlos (UFSCar), Rod Washington Luiz, km 235, São Carlos, 13565-905, São Paulo, Brazil
- Department of Rehabilitation Sciences, University of Hartford, West Hartford, Connecticut, USA
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Wang J, Cao B, Lin S, Wang Y, Zhang Q, Jiang Y, Li W, Zhu Y. A Bibliometric Analysis of Urologic Chronic Pelvic Pain Syndrome From 2000 to 2022. J Pain Res 2023; 16:1225-1241. [PMID: 37064957 PMCID: PMC10103784 DOI: 10.2147/jpr.s396009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 03/21/2023] [Indexed: 04/18/2023] Open
Abstract
Purpose Urologic chronic pelvic pain syndrome has attracted a lot of attention in the new century, and an increasing number of relevant studies have been published. Therefore, we performed a bibliometric analysis of these publications, hoping to show the current research hotspots and future research trends. Methods The articles on were selected from the Web of Science Core Collection. Countries, authors, references and keywords in the field were visualized and analyzed using CiteSpace and VOSViewer software. Results A total of 1014 articles on urologic chronic pelvic pain syndrome were identified, with "chronic pelvic pain syndrome" being the most common keyword, with a strong association with "interstitial cystitis" and "chronic prostatitis". The hotspot of urologic chronic pelvic pain syndrome research has gradually shifted from chronic prostatitis / urologic chronic pelvic pain syndrome to cystitis/bladder pain syndrome over the past few years. Future research tends to focus on urologic chronic pelvic pain syndrome etiology, including oxidative stress and inflammation. Conclusion Research on urologic chronic pelvic pain syndrome is steadily growing. The United States has made the most prominent contribution in this area, and the share of China's contribution is expected to grow further. The etiology of urologic chronic pelvic pain syndrome, including inflammation and oxidative stress, have been the focus of current research and developmental trends in the future research.
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Affiliation(s)
- Jie Wang
- Department of Urology, Jiading Branch of Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 201803, People’s Republic of China
| | - Bin Cao
- Department of Urology, Jiading Branch of Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 201803, People’s Republic of China
| | - Sihao Lin
- Department of Urology, Jiading Branch of Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 201803, People’s Republic of China
| | - Yong Wang
- Department of Urology, Jiading Branch of Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 201803, People’s Republic of China
| | - Qifa Zhang
- Department of Urology, Jiading Branch of Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 201803, People’s Republic of China
| | - Yang Jiang
- Department of Urology, Jiading Branch of Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 201803, People’s Republic of China
| | - Wei Li
- Department of Urology, Jiading Branch of Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 201803, People’s Republic of China
| | - Yingjian Zhu
- Department of Urology, Jiading Branch of Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 201803, People’s Republic of China
- Correspondence: Yingjian Zhu; Wei Li, Department of Urology, Jiading Branch of Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, 800 Huangjiahuayuan Road, Shanghai, 201803, People’s Republic of China, Tel +8613764490868; +8618117094957, Email ;
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Yani MS, Eckel SP, Kirages DJ, Rodriguez LV, Corcos DM, Kutch JJ. Impaired Ability to Relax Pelvic Floor Muscles in Men With Chronic Prostatitis/Chronic Pelvic Pain Syndrome. Phys Ther 2022; 102:6585840. [PMID: 35576002 PMCID: PMC9618172 DOI: 10.1093/ptj/pzac059] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 02/08/2022] [Accepted: 03/21/2022] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Excessive pelvic floor muscle activity has been suggested as a source of pain in chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). Our objective was to determine whether men with CP/CPPS have changes in neural drive that impair their ability to relax pelvic floor muscles. METHODS We recruited 90 men (42 with CP/CPPS and 48 in the control group [without a history of pelvic pain]). All completed the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI). We quantified the ability to relax by comparing resting pelvic floor muscle activity under 2 conditions: a "rest-only" condition, in which participants were instructed to simply relax, and a "rest-between-contraction" condition, in which participants were instructed to rest for several seconds between voluntary pelvic floor muscle contractions. We used multivariate mixed-effects models to examine differences between the groups (men with CP/CPPS and men in the control group) as well as the effect of 6 symptoms captured by the NIH-CPSI: pain related to location (perineum, testicles, penis, suprapubic region) and activity (urination, ejaculation). RESULTS Men with CP/CPPS were significantly different from men in the control group; men with CP/CPPS had higher resting activity in the rest-between-contraction condition than in the rest-only condition, whereas men in the control group had similar resting activities in both conditions. This effect was strongest in men who reported ejaculation-related pain, which was 70% of the CP/CPPS group. CONCLUSION Men without a history of pelvic pain were able to relax their pelvic floor muscles back to baseline after performing voluntary pelvic floor muscle contractions. In contrast, men with CP/CPPS, particularly those with ejaculation-related pain, had an impaired ability to relax their pelvic floor muscles. IMPACT This study may support the investigation of more personalized physical therapist approaches for CP/CPPS that enhance the ability to relax pelvic floor muscles as a mechanism for pain reduction.
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Affiliation(s)
- Moheb S Yani
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, California, USA
| | - Sandrah P Eckel
- Division of Biostatistics, Department of Preventive Medicine, University of Southern California, Los Angeles, California, USA
| | - Daniel J Kirages
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, California, USA
| | - Larissa V Rodriguez
- Department of Urology, University of Southern California, Los Angeles, California, USA
| | - Daniel M Corcos
- Department of Physical Therapy & Human Movement Sciences, Northwestern University, Chicago, Illinois, USA
| | - Jason J Kutch
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, California, USA
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Hu H, Cui Y, Yang J, Cao Y. Loss of the Sympathetic Signal Produces Sterile Inflammation of the Prostate. Front Mol Neurosci 2022; 15:855376. [PMID: 35620446 PMCID: PMC9127543 DOI: 10.3389/fnmol.2022.855376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 04/20/2022] [Indexed: 11/13/2022] Open
Abstract
Neural innervations exert essential roles in the prostate. However, spatial distribution and regulatory function of such neural inputs are incompletely characterized. Here, we exploited the advanced whole-tissue immunolabeling and optical clearing technique to assess the 3D anatomy of autonomic innervations in the mouse and human prostate for the first time. We observed that sympathetic and parasympathetic inputs in the mouse prostate remained unaffected during castration-induced tissue regression. However, the pharmacologic destruction of sympathetic innervations in the mouse prostate led to sterile inflammation of the tissue, mimicking the disease condition of chronic non-bacterial prostatitis. Also, the genetic ablation of sympathetic inputs produced a similar inflammatory response. Furthermore, we showed that treatment of the specific β2-adrenergic receptor agonists could effectively mitigate the prostate inflammation caused by such sympathetic loss. Together, these results have elucidated the new immunomodulatory function of the sympathetic signal via the β2-adrenergic receptor in prostate inflammatory disease.
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Affiliation(s)
- Hao Hu
- Department of Urology, Peking University People’s Hospital, Beijing, China
| | - Yiwen Cui
- Peking University-Tsinghua University-National Institute of Biological Sciences Joint Graduate Program, Peking University, Beijing, China
- Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China
| | - Jing Yang
- Shenzhen Bay Laboratory, Shenzhen, China
| | - Ying Cao
- Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China
- Center for Life Sciences, Peking University, Beijing, China
- *Correspondence: Ying Cao,
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ButtÀ C, Tuttolomondo A, Casuccio A, DI Raimondo D, Miceli G, Cuttitta F, Zappulla V, Corpora F, Pinto A. Autonomic dysfunction in a group of lower extremities arterial disease outpatients. Minerva Cardiol Angiol 2020; 69:28-35. [PMID: 32643892 DOI: 10.23736/s2724-5683.20.05094-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND The understanding of the specific role of sympathetic neural control and dysregulation in lower extremities arterial disease (LEAD) is still very limited. Aim of our study was to investigate the autonomic profile in LEAD patients and to evaluate if the eventual autonomic alterations were more severe in patients with advanced disease. METHODS We enrolled all consecutive outpatients with LEAD referred to our Departments between July 2012 and September 2014. They were compared to a group of matched outpatients without LEAD. All patients underwent Holter ECG monitoring. Time-domain analysis of heart rate variability (HRV) was evaluated. RESULTS Compared to controls, patients with LEAD had a lower SDNN (P=0.007) and SDANN (P=0.003). Patients with clinically advanced LEAD had a lower SDNN (P=0.006) and SDANN (P=0.004) compared to LEAD patients with less severe disease and to those without disease. CONCLUSIONS LEAD patients had a reduced SDNN and SDANN than patients without LEAD. Autonomic dysfunction was more significant in clinically advanced stages of disease. This association did not relate to ABI value but to clinical stage of disease.
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Affiliation(s)
- Carmelo ButtÀ
- Unit of Cardiology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy -
| | - Antonino Tuttolomondo
- Unit of Internal Medicine and Stroke, Department of Health Promotion, Maternal and Child, Internal and Specialized Medicine, University of Palermo, Palermo, Italy
| | - Alessandra Casuccio
- Department of Health Promotion, Maternal and Child, Internal and Specialized Medicine, University of Palermo, Palermo, Italy
| | - Domenico DI Raimondo
- Unit of Internal Medicine and Stroke, Department of Health Promotion, Maternal and Child, Internal and Specialized Medicine, University of Palermo, Palermo, Italy
| | - Giuseppe Miceli
- Unit of Internal Medicine and Stroke, Department of Health Promotion, Maternal and Child, Internal and Specialized Medicine, University of Palermo, Palermo, Italy
| | - Francesco Cuttitta
- Unit of Internal Medicine and Stroke, Department of Health Promotion, Maternal and Child, Internal and Specialized Medicine, University of Palermo, Palermo, Italy
| | - Valentina Zappulla
- Unit of Internal Medicine and Stroke, Department of Health Promotion, Maternal and Child, Internal and Specialized Medicine, University of Palermo, Palermo, Italy
| | - Francesca Corpora
- Unit of Internal Medicine and Stroke, Department of Health Promotion, Maternal and Child, Internal and Specialized Medicine, University of Palermo, Palermo, Italy
| | - Antonio Pinto
- Unit of Internal Medicine and Stroke, Department of Health Promotion, Maternal and Child, Internal and Specialized Medicine, University of Palermo, Palermo, Italy
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Eslahi A, Farpour H, Hosseini A, Ahmed F, Chowdhury U, Nikbakht HA. Evaluation of the Sympathetic Skin Response in Men with Chronic Prostatitis: A Case-Control Study. Res Rep Urol 2020; 12:239-245. [PMID: 32754453 PMCID: PMC7358081 DOI: 10.2147/rru.s253101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 06/26/2020] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Etiological factors involved in chronic prostatitis (CP) type IIIb and chronic pelvic pain are not sufficiently understood; however, the nervous system has a significant role in the generation and maintenance of chronic pelvic pain. This study was designed to evaluate the sympathetic skin response (SSR) in men with CP type IIIb compared to normal population. PATIENTS AND METHODS For two years, about 14 patients suffering from CP type IIIb according to NIH-CPSI and 26 healthy control men were enrolled in this study. SSR was performed in all the subjects with a standard method. Bilateral palmar and plantar latency and amplitude of SSR were recorded in response to the median and tibial nerve electrical stimulations. SSR is considered abnormal when the latency is prolonged, and the amplitude reduced. RESULTS SSR latency in the left and right median nerve was significantly prolonged in the patient with CP type IIIb group compared to the control group (p=0.039 and 0.006, respectively). Additionally, the amplitude was reduced in patients with CP type IIIb group compared to the control group in the right tibial nerve (p=0.017). CONCLUSION Sympathetic skin response may be a helpful diagnostic test for men with chronic prostatitis type IIIb. However, this observation needs to be validated in a large sample cohort study with long-term follow-up.
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Affiliation(s)
- Ali Eslahi
- Department of Urology, Shiraz University of Medical Sciences, Shiraz, Iran
- Shiraz Geriatric Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hamidreza Farpour
- Shiraz Geriatric Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Physical Medicine and Rehabilitation Specialist, Bone and Joint Diseases Research Center, Department of Physical Medicine and Rehabilitation, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Azar Hosseini
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Faisal Ahmed
- Urology Research Center, Al-Thora General Hospital, Department of Urology, Ibb University of Medical Since, Ibb, Yemen
| | - Umayir Chowdhury
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hossein-Ali Nikbakht
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
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Appiya Santharam M, Khan FU, Naveed M, Ali U, Ahsan MZ, Khongorzul P, Shoaib RM, Ihsan AU. Interventions to chronic prostatitis/Chronic pelvic pain syndrome treatment. Where are we standing and what's next? Eur J Pharmacol 2019; 857:172429. [PMID: 31170381 DOI: 10.1016/j.ejphar.2019.172429] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 05/29/2019] [Accepted: 05/29/2019] [Indexed: 12/29/2022]
Abstract
Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a frustrating syndrome. The pathogenesis and state of the art treatment of CP/CPPS are not known. A wide variety of therapies including anti-inflammatories, antibiotics, alpha-blockers, neuropathic pain modulators, and 5α-reductase inhibitors are in practice. These treatment strategies focus on alleviating symptoms in specific domains without treating root-cause and therapeutic outcome is far from satisfactory. We review the literature on current pharmacological treatments for CP/CPPS in detail and suggest future perspectives to modify the treatment strategies. We suggest that introducing novel treatment strategies such as gene editing, and Tregs expressing chimeric receptors may improve the treatment outcomes by inducing immune tolerance and controlling expression of pro-inflammatory cytokines.
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Affiliation(s)
- Madanraj Appiya Santharam
- Department of Infection, Immunity and Inflammation, University of Leicester, Leicester LE1 9HN, United Kingdom
| | - Farhan Ullah Khan
- Department of Clinical Pharmacy, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Jiangsu Province, Nanjing, 211198, PR China; Shanghai Jiao Tong University, School of Pharmacy, 800 Dongchuan Road, Shanghai, 200240, China
| | - Muhammad Naveed
- Department of Clinical Pharmacology, School of Pharmacy, Nanjing Medical University, Jiangsu Province, Nanjing, 211166, PR China
| | - Usman Ali
- Shanghai Jiao Tong University, School of Pharmacy, 800 Dongchuan Road, Shanghai, 200240, China
| | - Muhammad Zaeem Ahsan
- Shanghai Jiao Tong University, School of Pharmacy, 800 Dongchuan Road, Shanghai, 200240, China
| | - Puregmaa Khongorzul
- State Key Laboratory of Natural Medicines, School of Life Science & Technology, China Pharmaceutical University, Nanjing, China
| | - Rana Muhammad Shoaib
- Shanghai Jiao Tong University, School of Pharmacy, 800 Dongchuan Road, Shanghai, 200240, China
| | - Awais Ullah Ihsan
- Department of Clinical Pharmacy, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Jiangsu Province, Nanjing, 211198, PR China.
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Abstract
BACKGROUND Chronic prostatitis (CP) is a prevalent genitourinary condition. Considering its safety profile, acupuncture can be an option treating CP symptoms. The aim of this review is to undertake a systematic review to estimate the effectiveness and safety of acupuncture on CP. METHODS We will search all randomized controlled trials for CP in August 2018 in the databases of MEDLINE, Cochrane Library, Web of Science, EMBASE, Springer, WHO International Clinical Trials Registry Platform (ICTRP), China National Knowledge Infrastructure (CNKI), Wan fang, Chinese Biomedical Literature Database (CBM), PsycInfo, Chinese Scientific Journal Database (VIP), and other available resources. Languages are limited as English and Chinese. Search terms used are will "acupuncture," and "chronic prostatitis," "non-bacterial prostatitis," "abacterial prostatitis." And duplicates will be screened. The primary outcomes consisted of improvement rate and pain relief evaluated by The National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) index. Secondary outcomes include the recurrence rate and side effects, such as pneumothorax, discomforts, and infection. RESULTS This study will demonstrate an evidence-based review of acupuncture for chronic prostatitis. CONCLUSION The study will provide clear evidence to assess the effectiveness and side effects of acupuncture for chronic prostatitis. ETHICS AND DISSEMINATION There is no requirement of ethical approval and it will be in print or disseminated by electronic copies. PROSPERO REGISTRATION NUMBER CRD42018088834.
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Affiliation(s)
- Tianzhong Peng
- Nanchang Hongdu Hospital of Traditional Chinese Medicine, Nanchang, Jiangxi Province
| | - Ying Cheng
- Yunnan University of Traditional Chinese Medicine, Kunming, Yunnan Province, China
| | - Yuhao Jin
- Nanchang Hongdu Hospital of Traditional Chinese Medicine, Nanchang, Jiangxi Province
| | - Na Xu
- Nanchang Hongdu Hospital of Traditional Chinese Medicine, Nanchang, Jiangxi Province
| | - Taipin Guo
- Yunnan University of Traditional Chinese Medicine, Kunming, Yunnan Province, China
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10
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Comprehensive overview of prostatitis. Biomed Pharmacother 2017; 94:1064-1076. [PMID: 28813783 DOI: 10.1016/j.biopha.2017.08.016] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2017] [Revised: 08/01/2017] [Accepted: 08/02/2017] [Indexed: 01/30/2023] Open
Abstract
Prostatitis is a common urinary tract syndrome that many doctors find problematic to treat effectively. It is the third most commonly found urinary tract disease in men after prostate cancer and Benign Prostate Hyperplasia (BPH). Prostatitis may account for 25% of all office visits made to the urological clinics complaining about the genital and urinary systems all over the world. In the present study, we classified prostatitis and comprehensively elaborated the etiology, pathogenesis, diagnosis, and treatment of acute bacterial prostatitis (category I), chronic bacterial prostatitis (category II), chronic pelvic pain syndrome (CPPS) (category III), and asymptomatic prostatitis (category IV). In addition, we also tried to get some insights about other types of prostatitis-like fungal, viral and gonococcal prostatitis. The aim of this review is to present the detail current perspective of prostatitis in a single review. To the best of our knowledge currently, there is not a single comprehensive review, which can completely elaborate this important topic in an effective way. Furthermore, this review will provide a solid platform to conduct future studies on different aspects such as risk factors, mechanism of pathogenesis, proper diagnosis, and rational treatment plans for fungal, viral, and gonococcal prostatitis.
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Braundmeier-Fleming A, Russell NT, Yang W, Nas MY, Yaggie RE, Berry M, Bachrach L, Flury SC, Marko DS, Bushell CB, Welge ME, White BA, Schaeffer AJ, Klumpp DJ. Stool-based biomarkers of interstitial cystitis/bladder pain syndrome. Sci Rep 2016; 6:26083. [PMID: 27188581 PMCID: PMC4870565 DOI: 10.1038/srep26083] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 04/27/2016] [Indexed: 12/14/2022] Open
Abstract
Interstitial cystitis/bladder pain syndrome (IC) is associated with significant morbidity, yet underlying mechanisms and diagnostic biomarkers remain unknown. Pelvic organs exhibit neural crosstalk by convergence of visceral sensory pathways, and rodent studies demonstrate distinct bacterial pain phenotypes, suggesting that the microbiome modulates pelvic pain in IC. Stool samples were obtained from female IC patients and healthy controls, and symptom severity was determined by questionnaire. Operational taxonomic units (OTUs) were identified by16S rDNA sequence analysis. Machine learning by Extended Random Forest (ERF) identified OTUs associated with symptom scores. Quantitative PCR of stool DNA with species-specific primer pairs demonstrated significantly reduced levels of E. sinensis, C. aerofaciens, F. prausnitzii, O. splanchnicus, and L. longoviformis in microbiota of IC patients. These species, deficient in IC pelvic pain (DIPP), were further evaluated by Receiver-operator characteristic (ROC) analyses, and DIPP species emerged as potential IC biomarkers. Stool metabolomic studies identified glyceraldehyde as significantly elevated in IC. Metabolomic pathway analysis identified lipid pathways, consistent with predicted metagenome functionality. Together, these findings suggest that DIPP species and metabolites may serve as candidates for novel IC biomarkers in stool. Functional changes in the IC microbiome may also serve as therapeutic targets for treating chronic pelvic pain.
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Affiliation(s)
- A Braundmeier-Fleming
- Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign, 1207 West Gregory Drive, Urbana, Illinois, USA
| | - Nathan T Russell
- Applied Research Institute at University of Illinois at Urbana-Champaign, 1205 West Clark Street, Urbana, IL, USA
| | - Wenbin Yang
- Department of Urology, Feinberg School of Medicine, Northwestern University, 303 East Chicago Avenue, Chicago, IL, USA
| | - Megan Y Nas
- Department of Microbiology-Immunology, Feinberg School of Medicine, Northwestern University, 303 East Chicago Avenue Chicago, IL, USA
| | - Ryan E Yaggie
- Department of Urology, Feinberg School of Medicine, Northwestern University, 303 East Chicago Avenue, Chicago, IL, USA
| | - Matthew Berry
- Applied Research Institute at University of Illinois at Urbana-Champaign, 1205 West Clark Street, Urbana, IL, USA
| | - Laurie Bachrach
- Department of Urology, Feinberg School of Medicine, Northwestern University, 303 East Chicago Avenue, Chicago, IL, USA
| | - Sarah C Flury
- Department of Urology, Feinberg School of Medicine, Northwestern University, 303 East Chicago Avenue, Chicago, IL, USA
| | - Darlene S Marko
- Department of Urology, Feinberg School of Medicine, Northwestern University, 303 East Chicago Avenue, Chicago, IL, USA
| | - Colleen B Bushell
- Applied Research Institute at University of Illinois at Urbana-Champaign, 1205 West Clark Street, Urbana, IL, USA
| | - Michael E Welge
- Applied Research Institute at University of Illinois at Urbana-Champaign, 1205 West Clark Street, Urbana, IL, USA
| | - Bryan A White
- Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign, 1207 West Gregory Drive, Urbana, Illinois, USA
| | - Anthony J Schaeffer
- Department of Urology, Feinberg School of Medicine, Northwestern University, 303 East Chicago Avenue, Chicago, IL, USA
| | - David J Klumpp
- Department of Urology, Feinberg School of Medicine, Northwestern University, 303 East Chicago Avenue, Chicago, IL, USA.,Department of Microbiology-Immunology, Feinberg School of Medicine, Northwestern University, 303 East Chicago Avenue Chicago, IL, USA
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12
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Kleinhans NM, Yang CC, Strachan ED, Buchwald DS, Maravilla KR. Alterations in Connectivity on Functional Magnetic Resonance Imaging with Provocation of Lower Urinary Tract Symptoms: A MAPP Research Network Feasibility Study of Urological Chronic Pelvic Pain Syndromes. J Urol 2016; 195:639-45. [PMID: 26497778 PMCID: PMC5035686 DOI: 10.1016/j.juro.2015.09.092] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2015] [Indexed: 01/23/2023]
Abstract
PURPOSE Urological chronic pelvic pain syndromes have refractory bladder or pelvic pain as the dominant symptom. This has been attributed to changes in the central nervous system caused by a chronic barrage of noxious stimuli. We developed what is to our knowledge a novel challenge protocol that induced bladder distention in study participants to reproduce pain and urinary symptoms. We tested to see whether it could discriminate between persons with urological chronic pelvic pain syndrome-like symptoms and asymptomatic controls. MATERIALS AND METHODS We recruited 10 female twin pairs who were discordant for urological chronic pelvic pain syndrome-like symptoms. Before scanning each twin urinated to completion and then consumed 500 cc water. Each twin was scanned with our resting state functional magnetic resonance imaging protocol immediately and approximately 50 minutes after consumption. Time series were extracted from the right and left periaqueductal gray, and the right and left amygdala subregions. We performed the repeated measures 2-sample t-test to assess differences in connectivity between symptomatic and asymptomatic twins before and after bladder distention. RESULTS Group by condition interaction effects were found from the periaqueductal gray to the right cerebellum VIIIa, the amygdala, the right premotor cortex/supplementary motor area and the insular cortex, and between the amygdala and the frontal pole/medial orbital frontal cortex, the hypothalamus, the insular cortex, the thalamus and the anterior cingulate cortex. CONCLUSIONS These findings demonstrate that our noninvasive bladder distention protocol can detect differences in the processing of urinary sensation between twins discordant for lower urinary tract pain.
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Affiliation(s)
- Natalia M Kleinhans
- Department of Radiology, University of Washington, Seattle, Washington; Department of Integrative Brain Imaging Center, University of Washington, Seattle, Washington
| | - Claire C Yang
- Department of Urology, University of Washington, Seattle, Washington.
| | - Eric D Strachan
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
| | - Dedra S Buchwald
- Department of Medicine, University of Washington, Seattle, Washington
| | - Kenneth R Maravilla
- Department of Radiology, University of Washington, Seattle, Washington; Diagnostic Imaging Sciences Center, University of Washington, Seattle, Washington
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Williams DP, Chelimsky G, McCabe NP, Koenig J, Singh P, Janata J, Thayer JF, Buffington CAT, Chelimsky T. Effects of Chronic Pelvic Pain on Heart Rate Variability in Women. J Urol 2015; 194:1289-94. [PMID: 25963185 PMCID: PMC8753597 DOI: 10.1016/j.juro.2015.04.101] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/30/2015] [Indexed: 01/06/2023]
Abstract
PURPOSE Interstitial cystitis/bladder pain syndrome and myofascial pelvic pain are frequently comorbid chronic pelvic pain disorders. Differences in bladder function between interstitial cystitis/bladder pain syndrome and myofascial pelvic pain suggest that efferent autonomic function may differentiate these syndromes. Heart rate variability, defined as the difference in duration of successive heartbeats, serves as an index of autonomic function by measuring its ability to modify heart rate in response to neurophysiological changes. High frequency heart rate variability was used as a reflection of more rapid vagally mediated (parasympathetic) changes. Low frequency heart rate variability signified slower fluctuations related to the baroreflex and sympathetic outflow. MATERIALS AND METHODS Heart rate variability was derived by autoregressive frequency analysis of the continuous electrocardiogram recording of heart rate with the subject supine for 10 minutes, tilted 70 degrees with the head up for 30 minutes and supine again for 10 minutes. This institutional review board approved study included 105 female subjects, including 32 who were healthy, and 26 with interstitial cystitis/bladder pain syndrome, 12 with myofascial pelvic pain and 35 with interstitial cystitis/bladder pain syndrome plus myofascial pelvic pain. RESULTS In all positions healthy controls had higher high frequency heart rate variability than women with interstitial cystitis/bladder pain syndrome and interstitial cystitis/bladder pain syndrome plus myofascial pelvic pain. Subjects with myofascial pelvic pain were similar to controls with greater high frequency heart rate variability at baseline (supine 1) and in upright positions than subjects with interstitial cystitis/bladder pain syndrome. Differences in low frequency heart rate variability were less evident while low-to-high frequency ratio differences appeared to be driven by the high frequency heart rate variability component. CONCLUSIONS Subjects with interstitial cystitis/bladder pain syndrome had diminished vagal activity and a shift toward sympathetic nervous system dominance. Overall these data support the hypothesis that changes in autonomic function occur in interstitial cystitis/bladder pain syndrome but not in myofascial pelvic pain. These changes may result from interstitial cystitis/bladder pain syndrome or contribute to its pathophysiology through abnormal self-regulatory function.
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Affiliation(s)
| | | | - N Patrick McCabe
- Case Western Reserve University School of Medicine, Cleveland, Ohio
| | | | - Partik Singh
- Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Jeffrey Janata
- Case Western Reserve University School of Medicine, Cleveland, Ohio
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14
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Zhang R, Sutcliffe S, Giovannucci E, Willett WC, Platz EA, Rosner BA, Dimitrakoff JD, Wu K. Lifestyle and Risk of Chronic Prostatitis/Chronic Pelvic Pain Syndrome in a Cohort of United States Male Health Professionals. J Urol 2015; 194:1295-300. [PMID: 26070893 PMCID: PMC4666310 DOI: 10.1016/j.juro.2015.05.100] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2015] [Indexed: 01/08/2023]
Abstract
PURPOSE Although chronic prostatitis/chronic pelvic pain syndrome is a prevalent urological disorder among men of all ages, its etiology remains unknown. Only a few previous studies have examined associations between lifestyle factors and chronic prostatitis/chronic pelvic pain syndrome, of which most were limited by the cross-sectional study design and lack of control for possible confounders. To address these limitations we performed a cohort study of major lifestyle factors (obesity, smoking and hypertension) and chronic prostatitis/chronic pelvic pain syndrome risk in the HPFS (Health Professionals Follow-up Study), a large ongoing cohort of United States based male health professionals. MATERIALS AND METHODS The HPFS includes 51,529 men who were 40 to 75 years old at baseline in 1986. At enrollment and every 2 years thereafter participants have completed questionnaires on lifestyle and health conditions. In 2008 participants completed an additional set of questions on recent chronic prostatitis/chronic pelvic pain syndrome pain symptoms modified from the NIH (National Institutes of Health)-CPSI (Chronic Prostatitis Symptom Index) as well as questions on approximate date of symptom onset. The 653 participants with NIH-CPSI pain scores 8 or greater who first experienced symptoms after 1986 were considered incident chronic prostatitis/chronic pelvic pain syndrome cases and the 19,138 who completed chronic prostatitis/chronic pelvic pain syndrome questions but did not report chronic prostatitis/chronic pelvic pain syndrome related pain were considered noncases. RESULTS No associations were observed for baseline body mass index, waist circumference, waist-to-hip ratio, cigarette smoking and hypertension with chronic prostatitis/chronic pelvic pain syndrome risk (each OR ≤1.34). CONCLUSIONS In this large cohort study none of the lifestyle factors examined was associated with chronic prostatitis/chronic pelvic pain syndrome risk. As the etiology of chronic prostatitis/chronic pelvic pain syndrome remains unknown, additional prospective studies are needed to elucidate modifiable risk factors for this common condition.
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Affiliation(s)
- Ran Zhang
- Departments of Nutrition (RZ, EG, WCW, KW), Epidemiology (RZ, EG, WCW) and Biostatistics (BAR), Harvard School of Public Health, Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School (EG, WCW, BAR) and Beth Israel Deaconess Medical Center, Massachusetts General Hospital and Harvard Medical School (JDD), Boston, Massachusetts, Division of Public Health Sciences and Alvin J. Siteman Cancer Center, Department of Surgery, Washington University School of Medicine (SS), St. Louis, Missouri, and Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, and Department of Urology and The James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine (EAP), Baltimore, Maryland
| | | | - Edward Giovannucci
- Departments of Nutrition (RZ, EG, WCW, KW), Epidemiology (RZ, EG, WCW) and Biostatistics (BAR), Harvard School of Public Health, Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School (EG, WCW, BAR) and Beth Israel Deaconess Medical Center, Massachusetts General Hospital and Harvard Medical School (JDD), Boston, Massachusetts, Division of Public Health Sciences and Alvin J. Siteman Cancer Center, Department of Surgery, Washington University School of Medicine (SS), St. Louis, Missouri, and Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, and Department of Urology and The James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine (EAP), Baltimore, Maryland
| | - Walter C. Willett
- Departments of Nutrition (RZ, EG, WCW, KW), Epidemiology (RZ, EG, WCW) and Biostatistics (BAR), Harvard School of Public Health, Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School (EG, WCW, BAR) and Beth Israel Deaconess Medical Center, Massachusetts General Hospital and Harvard Medical School (JDD), Boston, Massachusetts, Division of Public Health Sciences and Alvin J. Siteman Cancer Center, Department of Surgery, Washington University School of Medicine (SS), St. Louis, Missouri, and Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, and Department of Urology and The James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine (EAP), Baltimore, Maryland
| | - Elizabeth A. Platz
- Departments of Nutrition (RZ, EG, WCW, KW), Epidemiology (RZ, EG, WCW) and Biostatistics (BAR), Harvard School of Public Health, Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School (EG, WCW, BAR) and Beth Israel Deaconess Medical Center, Massachusetts General Hospital and Harvard Medical School (JDD), Boston, Massachusetts, Division of Public Health Sciences and Alvin J. Siteman Cancer Center, Department of Surgery, Washington University School of Medicine (SS), St. Louis, Missouri, and Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, and Department of Urology and The James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine (EAP), Baltimore, Maryland
| | - Bernard A. Rosner
- Departments of Nutrition (RZ, EG, WCW, KW), Epidemiology (RZ, EG, WCW) and Biostatistics (BAR), Harvard School of Public Health, Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School (EG, WCW, BAR) and Beth Israel Deaconess Medical Center, Massachusetts General Hospital and Harvard Medical School (JDD), Boston, Massachusetts, Division of Public Health Sciences and Alvin J. Siteman Cancer Center, Department of Surgery, Washington University School of Medicine (SS), St. Louis, Missouri, and Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, and Department of Urology and The James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine (EAP), Baltimore, Maryland
| | | | - Kana Wu
- Correspondence: Department of Nutrition, Harvard School of Public Health, 655 Huntington Ave., Building 2, Room 333, Boston, Massachusetts 02115 (telephone: 617-432-1842, )
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15
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Khan A, Murphy AB. Updates on therapies for chronic prostatitis/chronic pelvic pain syndrome. World J Pharmacol 2015; 4:1-16. [DOI: 10.5497/wjp.v4.i1.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Revised: 09/03/2014] [Accepted: 01/20/2015] [Indexed: 02/06/2023] Open
Abstract
Prostatitis comprises of a group of syndromes that affect almost 50% of men at least once in their lifetime and makeup the majority of visits to the Urology Clinics. After much debate, it has been divided into four distinct categories by National Institutes of Health namely (1) acute bacterial prostatitis; (2) chronic bacterial prostatitis; (3) chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) which is further divided into inflammatory and non-inflammatory CP/CPPS; and (4) asymptomatic inflammatory prostatitis. CP/CPPS has been a cause of great concern for both patients and physicians because of the lack of presence of thorough information about the etiological factors along with the difficult-to-treat nature of the syndrome. For the presented manuscript an extensive search on PubMed was conducted for CP/CPPS aimed to present an updated review on the evaluation and treatment options available for patients with CP/CPPS. Several diagnostic criteria’s have been established to diagnose CP/CPPS, with prostatic/pelvic pain for at least 3 mo being the major classifying symptom along with the presence of lower urinary tract symptoms and/or ejaculatory pain. Diagnostic tests can help differentiate CP/CPPS from other syndromes that come under the heading of prostatitis by ruling out active urinary tract infection and/or prostatic infection with uropathogen by performing urine cultures, Meares-Stamey Four Glass Test, Pre- and Post-Massage Two Glass Test. Asymptomatic inflammatory prostatitis is confirmed through prostate biopsy done for elevated serum prostate-specific antigen levels or abnormal digital rectal examination. Researchers have been unable to link a single etiological factor to the pathogenesis of CP/CPPS, instead a cluster of potential etiologies including atypical bacterial or nanobacterial infection, autoimmunity, neurological dysfunction and pelvic floor muscle dysfunction are most commonly implicated. Initially monotherapy with anti-biotics and alpha adrenergic-blockers can be tried, but its success has only been observed in treatment naïve population. Other pharmacotherapies including phytotherapy, neuromodulatory drugs and anti-inflammatories achieved limited success in trials. Complementary and interventional therapies including acupuncture, myofascial trigger point release and pelvic floor biofeedback have been employed. This review points towards the fact that treatment should be tailored individually for patients based on their symptoms. Patients can be stratified phenotypically based on the UPOINT system constituting of Urinary, Psychosocial, Organ-specific, Infectious, Neurologic/Systemic and symptoms of muscular Tenderness and the treatment algorithm should be proposed accordingly. Treatment of CP/CPPS should be aimed towards treating local as well as central factors causing the symptoms. Surgical intervention can cause significant morbidity and should only be reserved for treatment-refractory patients that have previously failed to respond to multiple drug therapies.
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Meerwijk EL, Chesla CA, Weiss SJ. Psychological pain and reduced resting-state heart rate variability in adults with a history of depression. Psychophysiology 2014; 51:247-56. [DOI: 10.1111/psyp.12175] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Accepted: 10/05/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Esther L. Meerwijk
- Department of Community Health Systems; University of California; San Francisco San Francisco California USA
| | - Catherine A. Chesla
- Department of Family Health Care Nursing; University of California; San Francisco San Francisco California USA
| | - Sandra J. Weiss
- Department of Community Health Systems; University of California; San Francisco San Francisco California USA
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17
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Biers S, Thiruchelvam N. Bladder pain syndrome: contemporary management and future strategies. JOURNAL OF CLINICAL UROLOGY 2014. [DOI: 10.1177/2051415813515810] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Suzanne Biers
- Department of Urology, Addenbrooke's Hospital, Cambridge
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18
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Wang YJ, Hsu CC, Yeh ML, Lin JG. Auricular acupressure to improve menstrual pain and menstrual distress and heart rate variability for primary dysmenorrhea in youth with stress. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2013; 2013:138537. [PMID: 24416063 PMCID: PMC3876699 DOI: 10.1155/2013/138537] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Revised: 11/20/2013] [Accepted: 11/20/2013] [Indexed: 12/21/2022]
Abstract
Background. Dysmenorrhea and accompanying symptoms can have a negative impact on academic achievement, physical activity and functioning, and quality of life. Unfortunately, stress increases the sensitivity and severity of pain, activating sympathetic responses while inhibiting parasympathetic responses. Objective. This study used objective, physiological measurements to evaluate the effects of auricular acupressure on menstrual pain and menstrual distress in young college students with primary dysmenorrhea across two menstrual cycles. The aim was to determine if significant differences could be detected between the intervention and follow-up phases after controlling life stress. Design. A one-group experimental research design was used, and repeated measurements and followups were done. Thirty-two women completed questionnaires and physiological parameters were measured. Results. Significant differences between the intervention and follow-up phases were found for high frequency (HF) and blood pressure on day 1 and no significant differences in menstrual pain and menstrual distress, heart rate variability, low frequency (LF), LF/HF ratio, or heart rate. Conclusion. Auricular acupressure effectively increases parasympathetic activity to maintain autonomic function homeostasis in young women with primary dysmenorrhea and may have a value in alleviating menstrual pain and menstrual distress in a high-stress life. Future studies should consider stress, stimulus dose of auricular acupressure, severity of menstrual pain, and a longitudinal research design.
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Affiliation(s)
- Yu-Jen Wang
- Department of Nursing, Chang Gung University of Sciences and Technology, Taoyuan, Taiwan
- School of Nursing, National Taipei University of Nursing and Health Sciences, B402, No. 365 Minde Road, Taipei 11219, Taiwan
| | - Chin-Che Hsu
- Department of Dermatology, Kaohsiung Medical College Hospital, Kaohsiung, Taiwan
| | - Mei-Ling Yeh
- School of Nursing, National Taipei University of Nursing and Health Sciences, B402, No. 365 Minde Road, Taipei 11219, Taiwan
| | - Jaung-Geng Lin
- School of Chinese Medicine-Acupuncture Science, China Medical University, 91 Hsueh-Shih Road, Taichung 40402, Taiwan
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19
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Cheng P, Shih W, Alberto M, Presson AP, Licudine A, Mayer EA, Naliboff BD, Chang L. Autonomic response to a visceral stressor is dysregulated in irritable bowel syndrome and correlates with duration of disease. Neurogastroenterol Motil 2013; 25:e650-9. [PMID: 23822743 PMCID: PMC3788031 DOI: 10.1111/nmo.12177] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Accepted: 06/03/2013] [Indexed: 12/14/2022]
Abstract
BACKGROUND Previous studies reported altered autonomic nervous system (ANS) responses in irritable bowel syndrome (IBS) at baseline and to colonic balloon distension. This study examined heart rate variability (HRV) and plasma catecholamines as an index of ANS responsiveness in IBS during flexible sigmoidoscopy (FS) and explored associations of HRV with clinical measures. METHODS Rome III-positive IBS patients and healthy controls completed questionnaires measuring gastrointestinal and psychological symptoms. Heart rate variability measures were calculated using electrocardiogram (ECG) data at rest and during FS. Plasma catecholamines were measured before and after the FS. Linear mixed effects models were used to compare HRV with IBS status and IBS duration across six time points. Significance was assessed at the 0.05 level. KEY RESULTS Thirty-six IBS patients (53% F, mean age 37.89) and 31 controls (58% F, mean age 37.26) participated. After adjusting for age, sex, body mass index, and current anxiety symptoms, IBS patients had a non-significant lower cardiovagal tone (P = 0.436) and higher cardiosympathetic balance (P = 0.316) at rest. During FS, controls showed a transient increase in cardiosympathetic balance and decrease in cardiovagal tone. However, IBS patients had significantly less cardiosympathetic and cardiovagal responsiveness both leading up to (P = 0.003, P = 0.005) and following (P = 0.001) this stimulus. Those with longer duration of disease had less cardiosympathetic (P = 0.014) and cardiovagal (P = 0.009) responsiveness than those with shorter duration. No differences in catecholamines between IBS and controls were found. CONCLUSIONS & INFERENCES Irritable bowel syndrome demonstrated dysregulated ANS responses to a visceral stressor which could be related to disease duration. Therefore, autonomic dysregulation is an objective physiologic correlate of IBS.
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Affiliation(s)
- Paul Cheng
- Gail and Gerald Oppenheimer Family Center for the Neurobiology of Stress, David Geffen School of Medicine, University of California, Los Angeles
| | - Wendy Shih
- Department of Biostatistics, David Geffen School of Medicine, University of California, Los Angeles
| | - Melissa Alberto
- Gail and Gerald Oppenheimer Family Center for the Neurobiology of Stress, David Geffen School of Medicine, University of California, Los Angeles
| | - Angela P. Presson
- Department of Biostatistics, David Geffen School of Medicine, University of California, Los Angeles,Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, UT
| | - Arlene Licudine
- Gail and Gerald Oppenheimer Family Center for the Neurobiology of Stress, David Geffen School of Medicine, University of California, Los Angeles
| | - Emeran A. Mayer
- Gail and Gerald Oppenheimer Family Center for the Neurobiology of Stress, David Geffen School of Medicine, University of California, Los Angeles
| | - Bruce D. Naliboff
- Gail and Gerald Oppenheimer Family Center for the Neurobiology of Stress, David Geffen School of Medicine, University of California, Los Angeles
| | - Lin Chang
- Gail and Gerald Oppenheimer Family Center for the Neurobiology of Stress, David Geffen School of Medicine, University of California, Los Angeles
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20
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Chin RPH, Ho CH, Cheung LPC. Scheduled analgesic regimen improves rehabilitation after hip fracture surgery. Clin Orthop Relat Res 2013; 471:2349-60. [PMID: 23543417 PMCID: PMC3676603 DOI: 10.1007/s11999-013-2927-5] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2012] [Accepted: 03/08/2013] [Indexed: 01/31/2023]
Abstract
BACKGROUND Postoperative pain often is the limiting factor in the rehabilitation of patients after hip fracture surgery. QUESTIONS/PURPOSES We compared an approach using scheduled analgesic dosing with as-needed analgesic dosing in patients after hip fracture surgery, to compare these approaches in terms of (1) resting and dynamic pain intensity, (2) postoperative patient mobility, and (3) functional end points. METHODS We conducted a prospective cohort study of 400 patients who underwent surgical treatment of hip fractures at our hospital. The groups were formed sequentially, such that the first 200 patients formed the intervention group (treated with scheduled analgesic intake for the first 3 weeks after surgery), and the next 200 patients were the control group (treated using a protocol of analgesic administration on request). Resting and dynamic pain intensity, mobility, and functional performance were compared between the two analgesic protocols. RESULTS As expected, analgesic consumption was lower in the control group (tramadol doses, 27 versus 63; paracetamol doses, 29 versus 63). Despite the large difference in the amounts of analgesics consumed, resting and dynamic pain intensity showed improvement in each group and there was no difference between groups in terms of postoperative pain. However, there was a positive correlation between functional outcomes and analgesic consumption in the control group. The intervention group achieved higher functional performance on discharge (elderly mobility scale, 11 versus 8; functional independence measure, 88 versus 79). On discharge, fewer patients in the intervention group were wheelchair ambulators (3 versus 32), meaning more patients in the intervention group were able to walk. CONCLUSIONS The study showed that a scheduled analgesic intake can improve the functional outcomes of patients with geriatric hip fractures after surgery. LEVEL OF EVIDENCE Level II, therapeutic study. See the guidelines for authors for a complete description of levels of evidence.
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Affiliation(s)
- Raymond Ping-Hong Chin
- Department of Orthopaedics and Traumatology, Queen Elizabeth Hospital, Hospital Authority, 3/Floor, M Block, 30 Gascoigne Road, Jordon, Kowloon, Hong Kong, China ,Orthopaedic Rehabilitation Centre, Kowloon Hospital, Hospital Authority, Hong Kong, China
| | - Chin-Hung Ho
- Department of Orthopaedics and Traumatology, Queen Elizabeth Hospital, Hospital Authority, 3/Floor, M Block, 30 Gascoigne Road, Jordon, Kowloon, Hong Kong, China ,Orthopaedic Rehabilitation Centre, Kowloon Hospital, Hospital Authority, Hong Kong, China
| | - Lydia Po-Chee Cheung
- Department of Orthopaedics and Traumatology, Queen Elizabeth Hospital, Hospital Authority, 3/Floor, M Block, 30 Gascoigne Road, Jordon, Kowloon, Hong Kong, China ,Orthopaedic Rehabilitation Centre, Kowloon Hospital, Hospital Authority, Hong Kong, China
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Etiology of chronic prostatitis/chronic pelvic pain syndrome: psychoimmunoneurendocrine dysfunction (PINE syndrome) or just a really bad infection? World J Urol 2013; 31:725-32. [PMID: 23579440 DOI: 10.1007/s00345-013-1061-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Accepted: 03/15/2013] [Indexed: 02/07/2023] Open
Abstract
PURPOSE To review the etiology and pathogenesis of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). METHODS A literature review for the years 1985-2012 was performed using the MEDLINE database of the United States National Library of Medicine. RESULTS The evidence for ongoing infection in men with CP/CPPS is lacking. However, men with CP/CPPS are twice as likely to have had a sexually transmitted disease (STD), and bacteria from men with CP/CPPS may be phenotypically different from those that cause cystitis or acute prostatitis. Evidence continues to support an alteration in both the afferent and efferent autonomic nervous systems. Functional brain imaging suggests changes in the gray matter as well as the importance of the anterior insula and anterior cingulated gyrus in pain processing. Neural function can be modulated by immune and endocrine factors. Alterations in cytokine function and autoimmunity appear to play a role in the immune dysfunction. Alterations in the hypothalamic-pituitary-adrenal axis can mediate the endocrine effects, similar to many other chronic pain conditions. Genetics may play a role in who may develop chronic pain after an initial insult. Finally, any biological changes must then be processed through the psychosocial environment, including the tendency to catastrophize, and degree of spousal support, to produce a given individual patient's pain experience. CONCLUSIONS Infection with atypical bacteria or sequelae of an STD may lead to CP/CPPS in some men. Such a biological insult in the context of alterations in psychoimmunoneurendocrine factors produces the chronic pain experience.
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Abstract
BACKGROUND Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a condition that is detrimental to the quality of life of men. Evidence suggests that it may have a neuropathic origin and therefore medications such as pregabalin might have a role in the controlling of symptoms. OBJECTIVES The primary objective was to compare pregabalin to other modalities of pain relief to alleviate men's symptoms of CP/CPPS.The secondary objective was to assess the safety and effectiveness of pregabalin to improve various individual symptoms consistent with CP/CPPS. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (1966 to May 2012), EMBASE (1980 to May 2012), CINAHL, clinicaltrials.gov, Google Scholar, and reference lists of articles and abstracts from conference proceedings, without language restriction for pregabalin treatment of Class III prostatitis and CP/CPPS. SELECTION CRITERIA Randomized controlled trials (RCTs) comparing pregabalin to placebo or other types of analgesics for the management of patients with CP/CPPS were included. Patients with known causes of pain/discomfort were excluded. DATA COLLECTION AND ANALYSIS Only one RCT was included. The trial compared pregabalin to placebo for patients who had CP/CPPS. MAIN RESULTS For men who responded clinically (≥ 6-point improvement), there was no difference between the pregabalin (103/218; 47.2%) and placebo (38/106; 35.8%) arms (risk ratio (RR) 1.32; 95% CI 0.99 to 1.76). There was less pain with a higher point improvement in the pregabalin group compared to the placebo group (4.2 points versus 1.7 points, respectively; mean difference (MD) -2.3 points; 95% CI -4.0 to -0.7 points).Though 59% (191/324) of the patients developed side effects, no serious effects were experienced. There were significantly more neurologic side effects in the pregabalin group compared to the placebo group (38.5% (84/218) versus 22.6% (24/106), respectively; RR 1.7; 95% CI 1.15 to 2.51), and less pain in the pregabalin group than in the placebo group (17.4% (38/218) versus 33.3% (35/106), respectively; RR 0.53; 95% CI 0.36 to 0.78). However, no significant differences were seen between the pregabalin and placebo groups with regards to gastrointestinal disturbances (18.3% (40/218) versus 18.9% (20/106), respectively; RR 0.97; 95% CI 0.60 to 1.58), ocular/visual symptoms (6.9% (15/218) versus 2.8% (3/106), respectively; RR 2.43; 95% CI 0.72 to 8.22), and renal/genitourinary symptoms (5.5% (12/218) versus 1.9% (2/106), respectively; RR 3.03; 95% CI 0.67 to 13.79). AUTHORS' CONCLUSIONS There is evidence from one RCT that pregabalin does not improve CP/CPPS symptoms and causes adverse effects in a large percentage of men. However, research is required to assess further whether pregabalin has a role in patients with CP/CPPS for symptom control.
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Lee KS, Choi JD. Chronic prostatitis: approaches for best management. Korean J Urol 2012; 53:69-77. [PMID: 22379583 PMCID: PMC3285711 DOI: 10.4111/kju.2012.53.2.69] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2012] [Accepted: 02/02/2012] [Indexed: 12/14/2022] Open
Abstract
Prostatitis is a prevalent condition that encompasses a large array of clinical symptoms with significant impacts on men's life. The diagnosis and treatment of this disorder presents numerous challenges for urologists, most notably, a lack of specific and effective diagnostic methods. Chronic bacterial prostatitis is successfully treated with appropriate antibiotics that penetrate the prostate and kill the causative organisms. Prostatitis category III (chronic pelvic pain syndrome) is common, very bothersome, and enigmatic. Symptoms are usually prolonged and, generally speaking, treatment results are unsatisfactory. During the last decade, research has focused on the distress caused by the condition, but although our knowledge has certainly increased, there have been no real breakthroughs; controversies and many unanswered questions remain. Furthermore, the optimal management of category III prostatitis is not known. Conventional prolonged courses of antibiotic therapy have not proven to be efficacious. Novel therapies providing some evidence for efficacy include alpha-blocker, anti-inflammatory phytotherapy, physiotherapy, neuroleptics, and others, each offering therapeutic mechanisms. A stepwise approach involving multimodal therapy is often successful for treating patients. The UPOINT technique has been used to clinically phenotype these patients and drive the appropriate selection of multimodal therapy.
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Affiliation(s)
- Kyung Seop Lee
- Department of Urology, Dongguk University School of Medicine, Gyeongju, Korea
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Cho DS, Choi JB, Kim YS, Joo KJ, Kim SH, Kim JC, Kim HW. Heart rate variability in assessment of autonomic dysfunction in patients with chronic prostatitis/chronic pelvic pain syndrome. Urology 2011; 78:1369-72. [PMID: 21996103 DOI: 10.1016/j.urology.2011.07.1379] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2011] [Revised: 06/23/2011] [Accepted: 07/09/2011] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To determine and compare autonomic dysfunction in patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). METHODS The subjects were 30-60 years old and had no known systemic disease. Electrocardiographic signals in the patients in the resting state were obtained from 59 patients with CP/CPPS (age 46.5 ± 7.02 years) and 94 healthy subjects (age 48.4 ± 5.96 years), and heart rate variability parameters were compared. RESULTS The standard deviation of the N-N interval (P < .001), square root of the mean squared differences of the successive N-N intervals (P = .004), total power (P = .004), very low frequency (P = .012), and high frequency (P < .001) were lower in the patients with CP/CPPS. However, no significant differences were found in the low frequency and low frequency/high frequency ratios. CONCLUSION Patients with CP/CPPS exhibited lower heart rate variability parameters compared with normal controls, with the exception of low frequency and low frequency/high frequency ratios. Possible differences in autonomic nervous system between those with CP/CPPS and normal healthy subjects could exist and autonomic dysfunction might be 1 of the causes that aggravates CP/CPPS.
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Affiliation(s)
- Dae Sung Cho
- Department of Urology, Ajou University School of Medicine, Suwon, Korea
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Zhang J, Enix D, Snyder B, Giggey K, Tepe R. Effects of Biofreeze and chiropractic adjustments on acute low back pain: a pilot study. J Chiropr Med 2011; 7:59-65. [PMID: 19674721 DOI: 10.1016/j.jcme.2008.02.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2007] [Revised: 02/20/2008] [Accepted: 02/24/2008] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE This randomized controlled study was designed to determine the pain-relieving effect of Biofreeze (Performance Health Inc., Export, PA) body surface application and chiropractic adjustments on subjects with acute low back pain (LBP). METHODS The data were collected at the baseline, 2 weeks after treatment, and 4 weeks after treatment for final analyses. Diversified manual adjustments were provided by licensed chiropractors twice a week for 4 weeks to both control and experimental groups. Biofreeze was applied to the lower back area 3 times a day for 4 weeks in the experimental group. Outcome assessments included visual analog scale, Roland Morris Disability Questionnaire, heart rate variability for stress, and electromyography for low back muscle activity. RESULTS A total of 36 subjects were recruited in the study (25 male). The average age was 34 years. Significant pain reduction was found after each week of treatment in the experimental group (P < .05). The Roland Morris Disability Questionnaire did not show significant changes in both groups. There were no significant differences for pain reduction in the control group. Heart rate variability analysis showed no significant change (P > .05) in the experimental group after 4 weeks of Biofreeze and chiropractic adjustments. There were no statistically significant changes in the electromyography readings between the 2 groups. CONCLUSION Biofreeze combined with chiropractic adjustment showed significant reduction in LBP.
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Affiliation(s)
- John Zhang
- Associate Director of Research, Logan College of Chiropractic, Chesterfield, MO 63017
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Pontari MA, Krieger JN, Litwin MS, White PC, Anderson RU, McNaughton-Collins M, Nickel JC, Shoskes DA, Alexander RB, O'Leary M, Zeitlin S, Chuai S, Landis JR, Cen L, Propert KJ, Kusek JW, Nyberg LM, Schaeffer AJ. Pregabalin for the treatment of men with chronic prostatitis/chronic pelvic pain syndrome: a randomized controlled trial. ACTA ACUST UNITED AC 2010; 170:1586-93. [PMID: 20876412 DOI: 10.1001/archinternmed.2010.319] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Evidence suggests that the urogenital pain of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) may be neuropathic. METHODS This randomized, double-blind, placebo-controlled trial was conducted across 10 tertiary care centers in North America to determine whether pregabalin, which has been proved effective in other chronic pain syndromes, is effective in reducing CP/CPPS symptoms. In 2006-2007, 324 men with pelvic pain for at least 3 of the previous 6 months were enrolled in this study. Men were randomly assigned to receive pregabalin or placebo in a 2:1 ratio and were treated for 6 weeks. Pregabalin dosage was increased from 150 to 600 mg/d during the first 4 weeks. The primary outcome was a 6-point decrease in the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) total score. Multiple secondary outcomes were assessed. RESULTS Of 218 men assigned to receive pregabalin, 103 (47.2%) reported at least a 6-point decrease in the NIH-CPSI total score at 6 weeks compared with 35.8% (38 of 106 men) assigned to receive placebo (P = .07, exact Mantel-Haenszel test, adjusting for clinical sites). Compared with the placebo group, men assigned to receive pregabalin experienced reductions in the NIH-CPSI total score and subscores (P < .05), a higher Global Response Assessment response rate (31.2% and 18.9%; P = .02), and improvement in total McGill Pain Questionnaire score (P = .01). Results for the other outcomes did not differ between groups. CONCLUSION Pregabalin therapy for 6 weeks was not superior to placebo use in the rate of a 6-point decrease (improvement) in the NIH-CPSI total score in men with CP/CPPS. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00371033.
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Affiliation(s)
- Michel A Pontari
- Department of Urology, Temple University School of Medicine, Philadelphia, Pennsylvania 19140, USA.
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Gottsch HP, Yang CC, Berger RE. A review of botulinum toxin use for chronic pelvic pain syndrome. Curr Urol Rep 2010; 11:265-70. [PMID: 20446070 DOI: 10.1007/s11934-010-0118-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The inability of urologists to consistently and effectively treat men with chronic pelvic pain syndrome (CPPS), also known as chronic abacterial prostatitis, is a source of great frustration. Botulinum toxin (BTX), a potent neurotoxin, can act on most of the peripheral nerves of the pelvis through a variety of mechanisms. BTX injection therapy for CPPS treatment has shown modest improvements. BTX is ideal for integration into a multimodal treatment plan, which may help achieve pain relief in men with chronic pelvic pain.
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Affiliation(s)
- Henry P Gottsch
- Department of Urology, University of Washington, BB-Wing, Floor 11, 1959 NE Pacific Street, Box 356510, Seattle, WA 98195-6510, USA.
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Gottsch HP, Miller JL, Yang CC, Berger RE. A pilot study of botulinum toxin for interstitial cystitis/painful bladder syndrome. Neurourol Urodyn 2010; 30:93-6. [PMID: 20589903 DOI: 10.1002/nau.20946] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2010] [Accepted: 04/27/2010] [Indexed: 12/30/2022]
Affiliation(s)
- Henry P Gottsch
- Department of Urology, University of Washington, Seattle, Washington 98195-6510, USA
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Aberrant temporal and spatial brain activity during rest in patients with chronic pain. Proc Natl Acad Sci U S A 2010; 107:6493-7. [PMID: 20308545 DOI: 10.1073/pnas.1001504107] [Citation(s) in RCA: 149] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
In the absence of external stimuli, human hemodynamic brain activity displays slow intrinsic variations. To find out whether such fluctuations would be altered by persistent pain, we asked 10 patients with unrelenting chronic pain of different etiologies and 10 sex- and age-matched control subjects to rest with eyes open during 3-T functional MRI. Independent component analysis was used to identify functionally coupled brain networks. Time courses of an independent component comprising the insular cortices of both hemispheres showed stronger spectral power at 0.12 to 0.25 Hz in patients than in control subjects, with the largest difference at 0.16 Hz. A similar but weaker effect was seen in the anterior cingulate cortex, whereas activity of the precuneus and early visual cortex, used as a control site, did not differ between the groups. In the patient group, seed point-based correlation analysis revealed altered spatial connectivity between insulae and anterior cingulate cortex. The results imply both temporally and spatially aberrant activity of the affective pain-processing areas in patients suffering from chronic pain. The accentuated 0.12- to 0.25-Hz fluctuations in the patient group might be related to altered activity of the autonomic nervous system.
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Yilmaz U, Ciol MA, Berger RE, Yang CC. Sensory perception thresholds in men with chronic pelvic pain syndrome. Urology 2009; 75:34-7. [PMID: 19854487 DOI: 10.1016/j.urology.2009.08.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2009] [Revised: 06/21/2009] [Accepted: 08/06/2009] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To compare sensory thresholds in different nerve-fiber types in men with chronic pelvic pain syndrome (CPPS) and healthy controls, using thermal sensory testing and measuring current perception thresholds (CPT). METHODS We enrolled 22 men with CPPS and 20 healthy control participants. We determined the thermal sensory perception thresholds of C and Adelta nerve fibers on the perineum and left posterior thigh. To test CPT, we used sine wave electrical stimulation at 5, 250, and 2000 Hz, resulting in the selective depolarization of small unmyelinated C fibers, small myelinated Adelta, and large myelinated Abeta fibers, respectively. We bilaterally tested the hypothenar surface of the palms, medial parts of soles, midshaft of penis, and 1 site in the midperineum, for a total of 7 sites. RESULTS The mean age of men with CPPS was similar to that of controls [42.8 (standard deviation, 9.4) and 40.4 (standard deviation, 13.2) years, respectively, P = .548]. There was no significant difference between the 2 groups for thermal perception thresholds in both the perineum and left thigh (P >.05). There was also no difference between the 2 groups for CPT values of all 3 frequencies of stimuli in each area tested (P >.05 for all comparisons). CONCLUSIONS The absence of sensory threshold differences between men with CPPS and controls, with either thermal stimulation of C and Adelta fiber afferents or electrical stimulation of C, Adelta, and Abeta fiber afferents, discounts the existence of a peripheral neuropathy as a cause for pain in men with CPPS.
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Affiliation(s)
- Ugur Yilmaz
- Department of Urology, University of Washington, Seattle, Washington, USA
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Hedelin H, Fall M. Controversies in chronic abacterial prostatitis/pelvic pain syndrome. ACTA ACUST UNITED AC 2009; 42:198-204. [DOI: 10.1080/00365590701777749] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Hans Hedelin
- Department of Urology and Centre for Research and Development, Kärnsjukhuset, Skövde, Sweden
| | - Magnus Fall
- Department of Urology, Sahlgrenska Sjukhuset, Göteborg, Sweden
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Affiliation(s)
- Michel Pontari
- Department of Urology, Temple University School of Medicine, Philadelphia, Pennsylvania
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Heart Rate Variability Modulation After Manipulation in Pain-Free Patients vs Patients in Pain. J Manipulative Physiol Ther 2009; 32:277-86. [DOI: 10.1016/j.jmpt.2009.03.003] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2008] [Revised: 01/13/2009] [Accepted: 01/26/2009] [Indexed: 11/19/2022]
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Pérez-Martínez C, Puigvert Martínez A, Vargas Díaz IB, Guadalupe Gallegos Ávila M, Luis Arrondo J, Ortiz C. Estudio caso-control de electromiografía del piso pélvico en pacientes con síndrome doloroso pélvico crónico. Rev Int Androl 2008. [DOI: 10.1016/s1698-031x(08)72565-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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