1
|
Chen J, Ma W, Yue S, Li D, Chen L, Zhang C, Guan Y, Li C, Jiang C, Liao G, Liang C, Wang H, Tai S. Dual deficiency of melatonin and dihydrotestosterone promotes stromal cell damage and mediates prostatitis via the cGAS-STING pathway in sleep-deprived mice. Cell Commun Signal 2024; 22:183. [PMID: 38491517 PMCID: PMC10941623 DOI: 10.1186/s12964-024-01554-5] [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: 12/10/2023] [Accepted: 03/02/2024] [Indexed: 03/18/2024] Open
Abstract
PURPOSE Prostatitis is a highly prevalent condition that seriously affects men's physical and mental health. Although epidemiological investigations have provided evidence of a correlation between insufficient sleep and prostatitis, the pathogenesis of prostatitis remains unclear. We sought to identify the underlying mechanism involved and identify a promising therapeutic target. METHODS Sleep deprivation (SD) was utilized to establish a mouse model of insufficient sleep in a special device. Prostatitis was observed at different time points post-SD. The degree of prostatitis was evaluated by pathological section and behavioural tests. Using immunofluorescence, western blot, and proteomic analyses, the underlying mechanism of SD-related prostatitis was investigated, and the development and therapeutic target of prostatitis were elucidated. RESULTS SD, as an initial pathological trigger, resulted in a reduction in dihydrotestosterone and melatonin levels. Proteomic analysis revealed that the cGAS-STING pathway may play a significant role in inducing prostatitis. The subsequent results illustrated that the dual reduction in dihydrotestosterone and melatonin led to an accumulation of reactive oxygen species and the release of mitochondrial DNA (mt-DNA). The accumulation of mt-DNA activated the cGAS-STING pathway, which recruited inflammatory cells into the prostatic stroma through the secretion of interferon-β. Consequently, an inflammatory microenvironment was formed, ultimately promoting the development of prostatitis. Notably, mice with SD-induced prostatitis gradually recovered to a normal state within 7 days of recovery sleep. However, after being subjected to SD again, these mice tended to have a more pronounced manifestation of prostatitis within a shorter timeframe, which suggested that prostatitis is prone to relapse. CONCLUSIONS The cGAS-STING pathway activated by dual deficiency of dihydrotestosterone and melatonin plays a comprehensive inflammatory role in SD-related prostatitis. This research provides valuable insights into the pathogenesis, therapeutic targets, and prevention strategies of prostatitis.
Collapse
Affiliation(s)
- Jia Chen
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Institute of Urology, Anhui Medical University, Anhui Province Key Laboratory of Genitourinary Diseases, Hefei, 230022, P.R. China
| | - Wenming Ma
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Institute of Urology, Anhui Medical University, Anhui Province Key Laboratory of Genitourinary Diseases, Hefei, 230022, P.R. China
| | - Shaoyu Yue
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Institute of Urology, Anhui Medical University, Anhui Province Key Laboratory of Genitourinary Diseases, Hefei, 230022, P.R. China
| | - Dongsheng Li
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Institute of Urology, Anhui Medical University, Anhui Province Key Laboratory of Genitourinary Diseases, Hefei, 230022, P.R. China
| | - Lei Chen
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Institute of Urology, Anhui Medical University, Anhui Province Key Laboratory of Genitourinary Diseases, Hefei, 230022, P.R. China
| | - Cheng Zhang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Institute of Urology, Anhui Medical University, Anhui Province Key Laboratory of Genitourinary Diseases, Hefei, 230022, P.R. China
| | - Yu Guan
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Institute of Urology, Anhui Medical University, Anhui Province Key Laboratory of Genitourinary Diseases, Hefei, 230022, P.R. China
| | - Chun Li
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Institute of Urology, Anhui Medical University, Anhui Province Key Laboratory of Genitourinary Diseases, Hefei, 230022, P.R. China
| | - Changqin Jiang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Institute of Urology, Anhui Medical University, Anhui Province Key Laboratory of Genitourinary Diseases, Hefei, 230022, P.R. China
| | - Guiyi Liao
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Institute of Urology, Anhui Medical University, Anhui Province Key Laboratory of Genitourinary Diseases, Hefei, 230022, P.R. China
| | - Chaozhao Liang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Institute of Urology, Anhui Medical University, Anhui Province Key Laboratory of Genitourinary Diseases, Hefei, 230022, P.R. China.
| | - Hui Wang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Institute of Urology, Anhui Medical University, Anhui Province Key Laboratory of Genitourinary Diseases, Hefei, 230022, P.R. China.
| | - Sheng Tai
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Institute of Urology, Anhui Medical University, Anhui Province Key Laboratory of Genitourinary Diseases, Hefei, 230022, P.R. China.
| |
Collapse
|
2
|
Conic RRZ, Vasilopoulos T, Devulapally K, Przkora R, Dubin A, Sibille KT, Mickle AD. Hypertension and urologic chronic pelvic pain syndrome: An analysis of MAPP-I data. BMC Urol 2024; 24:21. [PMID: 38281923 PMCID: PMC10822153 DOI: 10.1186/s12894-024-01407-w] [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: 08/10/2023] [Accepted: 01/15/2024] [Indexed: 01/30/2024] Open
Abstract
BACKGROUND Urologic chronic pelvic pain syndrome (UCPPS), which includes interstitial cystitis/bladder pain syndrome (IC/BPS) and chronic prostatitis (CP/CPPS), is associated with increased voiding frequency, nocturia, and chronic pelvic pain. The cause of these diseases is unknown and likely involves many different mechanisms. Dysregulated renin-angiotensin-aldosterone-system (RAAS) signaling is a potential pathologic mechanism for IC/BPS and CP/CPPS. Many angiotensin receptor downstream signaling factors, including oxidative stress, fibrosis, mast cell recruitment, and increased inflammatory mediators, are present in the bladders of IC/BPS patients and prostates of CP/CPPS patients. Therefore, we aimed to test the hypothesis that UCPPS patients have dysregulated angiotensin signaling, resulting in increased hypertension compared to controls. Secondly, we evaluated symptom severity in patients with and without hypertension and antihypertensive medication use. METHODS Data from UCPPS patients (n = 424), fibromyalgia or irritable bowel syndrome (positive controls, n = 200), and healthy controls (n = 415) were obtained from the NIDDK Multidisciplinary Approach to the Study of Chronic Pelvic Pain I (MAPP-I). Diagnosis of hypertension, current antihypertensive medications, pain severity, and urinary symptom severity were analyzed using chi-square test and t-test. RESULTS The combination of diagnosis and antihypertensive medications use was highest in the UCPPS group (n = 74, 18%), followed by positive (n = 34, 17%) and healthy controls (n = 48, 12%, p = 0.04). There were no differences in symptom severity based on hypertension in UCPPS and CP/CPPS; however, IC/BPS had worse ICSI (p = 0.031), AUA-SI (p = 0.04), and BPI pain severity (0.02). Patients (n = 7) with a hypertension diagnosis not on antihypertensive medications reported the greatest severity of pain and urinary symptoms. CONCLUSION This pattern of findings suggests that there may be a relationship between hypertension and UCPPS. Treating hypertension among these patients may result in reduced pain and symptom severity. Further investigation on the relationship between hypertension, antihypertensive medication use, and UCPPS and the role of angiotensin signaling in UCPPS conditions is needed.
Collapse
Affiliation(s)
- Rosalynn R Z Conic
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Terrie Vasilopoulos
- Department of Orthopaedic Surgery and Sports Medicine, University of Florida, Gainesville, FL, USA
- Department of Anesthesiology, Division of Pain Medicine, University of Florida, Gainesville, FL, USA
| | - Karthik Devulapally
- Department of Physiological Sciences, College of Veterinary Medicine, University of Florida, PO Box 100144, Gainesville, FL, 32610, USA
| | - Rene Przkora
- Department of Anesthesiology, Division of Pain Medicine, University of Florida, Gainesville, FL, USA
| | - Andrew Dubin
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Kimberly T Sibille
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Florida, Gainesville, FL, USA
- Department of Anesthesiology, Division of Pain Medicine, University of Florida, Gainesville, FL, USA
| | - Aaron D Mickle
- Department of Physiological Sciences, College of Veterinary Medicine, University of Florida, PO Box 100144, Gainesville, FL, 32610, USA.
- Department of Biomedical Engineering, College of Engineering, University of Florida, Gainesville, FL, USA.
- Department of Neuroscience, College of Medicine, University of Florida, Gainesville, FL, USA.
| |
Collapse
|
3
|
Hameed F, Anwaar A. The three-glass test yields excellent results for diagnosis of chronic bacterial prostatitis: Study from a Pakistani tertiary care hospital. JOURNAL OF CLINICAL UROLOGY 2023. [DOI: 10.1177/20514158231155046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
Background: Prostatitis is a common disorder affecting 10–14% of men. Chronic prostatitis is a bothersome disease affecting young, middle-aged and elderly men. Routine cultures often fail to localise the source of infection. Although the four-glass test is considered for evaluating chronic prostatitis, the three-glass urine test can also be performed. This test yields excellent results. Methods: Overall, 144 cases of Pakistani origin were enrolled. A three-glass test was performed, and the samples were labelled as VB1, VB2 and VB3+ expressed prostatic secretions (EPS). Qualitative culture and drug sensitivity test were performed for 16 antimicrobials. Results: Samples from 127 patients ( Mage = 37 years) were analysed. Chronic bacterial prostatitis was identified in 81 (63.77%) patients. Conclusion: In more than half of the cases examined in this study, the bacteria were localised to the prostate. Level of evidence: IIIb
Collapse
Affiliation(s)
| | - Adeel Anwaar
- Department of Urology, Shalamar Hospital, Pakistan
| |
Collapse
|
4
|
Quallich SA, Quentin Clemens J, Ronstrom C, James AS, Kreder KJ, Henry Lai H, Naliboff BD, Rodriguez LV, Berry SH, Sutcliffe S. Flares and their impact among male urologic chronic pelvic pain syndrome patients: An in-depth qualitative analysis in the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network. Neurourol Urodyn 2022; 41:1468-1481. [PMID: 35686553 PMCID: PMC11033701 DOI: 10.1002/nau.24983] [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: 11/14/2021] [Revised: 03/09/2022] [Accepted: 04/21/2022] [Indexed: 11/09/2022]
Abstract
INTRODUCTION There has been a sparse exploration of the lived experience of men with urologic chronic pelvic pain syndrome (UCPPS), and none with the goal of Investigating the experience of "flares" as part of this chronic pain syndrome in men. METHODS We conducted three focus groups of male UCPPS patients at two sites of the MAPP Research Network (n = 16 total participants) to explore the full spectrum of flares and their impact on men's lives. RESULTS Flare experiences were common and specific symptom components varied widely. Men reported nonpelvic symptoms (e.g., diarrhea), and variability in symptom intensity (mild to severe), duration (minutes to days), and frequency of flares. Flares episodes, and the threat of flares, were disruptive to their lives, social roles, and relationships. Distinct long-term impacts were reported, such as decreased sexual activity, decreased travel, and potential loss of employment or career. The themes included social isolation and the need for a sense of control and understanding over their unpredictable symptoms. CONCLUSIONS Given their negative impact, future research with men and UCPPS should focus on approaches to prevent flares, and should consider a multimodal approach to reducing the frequency, severity, and/or duration. Quality of life may be improved by providing men with a sense of control over their symptoms and offering them multimodal treatment options, consistent with the recommendations for further research for women with UCPPS.
Collapse
Affiliation(s)
- Susanne A Quallich
- Department of Urology, Division of Andrology, General and Community Health, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - J Quentin Clemens
- Department of Urology, Division of Neurology and Pelvic Reconstructive Surgery, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Carrie Ronstrom
- Department of Surgery, Division of Urologic Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Aimee S James
- Department of Surgery, Division of Public Health Sciences and the Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Karl J Kreder
- Department of Urology, College of Medicine, University of Iowa, Iowa City, Iowa, USA
| | - H Henry Lai
- Department of Surgery, Division of Urologic Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Bruce D Naliboff
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Larissa V Rodriguez
- Departments of Urology and Obstetrics and Gynecology, University of Southern California, Los Angeles, California, USA
| | | | - Siobhan Sutcliffe
- Department of Surgery, Division of Public Health Sciences and the Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, Missouri, USA
| |
Collapse
|
5
|
Zhang M, Jin C, Kong X, Meng J, Fan S, Ding Y, Fang Q, Dong T, Zhang H, Ni J, Liu Y, Wang H, Chen X, Hao Z, Peng B, Zhang L, Wang Z, Liang C. Identification of novel susceptibility factors related to CP/CPPS-like symptoms: Evidence from a multicenter case-control study. Prostate 2022; 82:772-782. [PMID: 35188987 DOI: 10.1002/pros.24319] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 01/28/2022] [Accepted: 02/07/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND We aimed to systematically identify novel susceptible factors related to the occurrence and development of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS)-like symptoms that were not limited to lifestyles or dietary habits in Chinese population. METHODS We recruited participants from three centers (Shanghai [northeast], Hefei [east], and Lanzhou [northwest]) from August 2020 to June 2021. Demographics, lifestyles, dietary habits, past medical history, and national institutes of health-chronic prostatitis symptom index (NIH-CPSI) were collected from the individuals via optimized questionnaires. Logistic regression analysis and multivariate adjustment models were used to calculate the odds ratio (OR) and 95% confidence interval (95% CI) to assess the association between these variables and CP/CPPS-like symptoms. RESULTS A total of 1851 participants were enrolled in this study (764 cases and 1087 controls). Age distributions differed between groups (median, range: 32, 18-74 vs. 29, 18-70, p < 0.001). After adjustment, physicochemical occupational hazards were identified significantly related to CP/CPPS-like symptom occurrence and development (ORoccurrence : 1.389, 95% CI: 1.031-1.870, p < 0.001; ORdevelopment : 2.222, 95% CI: 1.464-3.372, p < 0.001); besides, greater than or equal to four ejaculations per week significantly increased the likelihood of CP/CPPS-like symptoms compared with one ejaculation per week (ORoccurrence : 3.051, 95% CI: 1.598-5.827, p = 0.001). For these patients, who were easily felt gastrointestinal discomfort caused by spicy food intake, they had a higher incidence to affect with CP/CPPS-like symptoms (ORoccurrence : 2.258, 95% CI: 1.858-2.745, p < 0.001). In addition, history of drug allergy and genitourinary infections were identified as independent susceptible factors for the occurrence of CP/CPPS-like symptoms (ORoccurrence : 1.689, 95% CI: 1.007-2.834, p = 0.047; ORoccurrence : 3.442, 95% CI: 2.202-5.382, p < 0.001, respectively), while the history of rheumatic immune diseases was found tightly associated with the development of CP/CPPS-like symptoms (ORdevelopment : 2.002, 95% CI: 1.008-4.058, p = 0.048). CONCLUSION Infection/inflammatory/immune-related disorders, novel dietary habits, and lifestyles associated with the susceptibility of CP/CPPS-like symptoms' occurrence and development are identified. Altering these irregular conditions serves as potential strategies for the treatment of patients with CP/CPPS-like symptoms.
Collapse
Affiliation(s)
- Meng Zhang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Institute of Urology & Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, Anhui, PR China
- Shenzhen Luohu Hospital Group, Institute of Urology of Shenzhen University, The Third Affiliated Hospital of Shenzhen University, Shenzhen, PR China
| | - Chen Jin
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Institute of Urology & Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, Anhui, PR China
| | - Xiangbin Kong
- Department of Urology, Lanzhou University Second Hospital, Lanzhou, Gansu, PR China
| | - Jialin Meng
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Institute of Urology & Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, Anhui, PR China
| | - Song Fan
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Institute of Urology & Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, Anhui, PR China
| | - Yang Ding
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Institute of Urology & Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, Anhui, PR China
| | - Qiaozhou Fang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Institute of Urology & Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, Anhui, PR China
| | - Ting Dong
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Institute of Urology & Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, Anhui, PR China
| | - Houliang Zhang
- Department of Urology, Shanghai Tenth People's Hospital, Tongji University, Shanghai, PR China
| | - Jinliang Ni
- Department of Urology, Shanghai Tenth People's Hospital, Tongji University, Shanghai, PR China
| | - Yi Liu
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Institute of Urology & Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, Anhui, PR China
| | - Hua Wang
- Department of Toxicology, School of Public Health, Anhui Medical University, Hefei, Anhui, PR China
| | - Xianguo Chen
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Institute of Urology & Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, Anhui, PR China
| | - Zongyao Hao
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Institute of Urology & Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, Anhui, PR China
| | - Bo Peng
- Department of Urology, Shanghai Tenth People's Hospital, Tongji University, Shanghai, PR China
| | - Li Zhang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Institute of Urology & Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, Anhui, PR China
| | - Zhiping Wang
- Department of Urology, Lanzhou University Second Hospital, Lanzhou, Gansu, PR China
| | - Chaozhao Liang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Institute of Urology & Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, Anhui, PR China
| |
Collapse
|
6
|
Low quality of life in men with chronic prostatitis-like symptoms. Prostate Cancer Prostatic Dis 2022; 25:785-790. [PMID: 35752656 PMCID: PMC9705241 DOI: 10.1038/s41391-022-00559-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 05/10/2022] [Accepted: 05/30/2022] [Indexed: 01/14/2023]
Abstract
BACKGROUND Chronic prostatitis (CP) can impair health-related quality of life (QOL), but the full impact of CP, including the impact of CP-like symptoms in men who have no CP diagnosis (CPS), is unknown. We estimated the impact of diagnosed CP (DCP) and CPS on Health-related QOL. METHODS From a representative nationwide survey of men aged 20-84 in Japan, we determined the prevalence of DCP and also of CPS. For CPS, we used Nickel's criteria, which were used previously to estimate the prevalence of CP and are based on the NIH Chronic Prostatitis Symptom Index. To test the robustness of Nickel's criteria, we used two other definitions of CPS (two sensitivity analyses). We measured QOL with the Short-Form 12-Item Health Survey. We compared the participants' QOL scores with the national-norm scores, and with the scores of men who had benign prostatic hyperplasia (BPH). RESULTS Among the 5 010 participants, 1.4% had DCP and 3.7% had CPS. The sensitivity analyses resulted in CPS prevalence estimates of 3.1% and 4.5%. CPS was particularly common in younger participants (5.7% of those in their 30 s had CPS). QOL was very low among men with CP: In most areas (domains) of QOL, their scores were more than 0.5 standard deviation below the national-norm mean. Their mental-health scores were lower than those of men with BPH. The lowest scores among all 8 QOL domains were in role-functioning. CONCLUSIONS CP is common, but it is underdiagnosed, particularly in younger men. Whether diagnosed or only suspected, CP's impact on QOL is large. Because CP is common, and because it substantially impairs individuals' QOL and can also reduce societal productivity, it requires more attention. Specifically, needed now is a simple tool for urologists and for primary care providers, to identify men, particularly young men, whose QOL is impaired by CP.
Collapse
|
7
|
Tiwari P, Choudhary A. Does the four-glass test still have a place in microbiological evaluation of chronic prostatitis? Findings from an Indian tertiary care centre. JOURNAL OF CLINICAL UROLOGY 2021. [DOI: 10.1177/2051415820957887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Background: Chronic prostatitis (CP) is a bothersome disease affecting young and middle-aged men. Routine cultures often fail to localize the source of infection. Although the four-glass test is considered the gold-standard test for evaluating CP, it has found less favour in clinical practice. We re-inspected its utility in patients suffering from CP. Methods: Seventy cases of CP of Indian origin were enrolled. The four-glass test was conducted, and the samples were labelled as VB1, VB2, VB3 and EPS. A quantitative culture and drug sensitivity test for 16 antimicrobials was performed. Results: Samples from 61 patients ( Mage=36 years) were analysed. Chronic bacterial prostatitis was identified in 29 (47.5%) cases. Enterococcus spp. were the most common isolate, followed by Escherichia coli. A wide variability in positivity pattern was noted in the four-glass test. The most common pattern was for only the EPS sample to be positive (nine cases; 16.1%), followed by all four samples to be positive (seven cases; 12.5%). High susceptibility was found (94–100%) against third-generation cephalosporins, meropenem, amikacin, gentamicin and nitrofurantoin. Conclusions: The four-glass test is still important in the evaluation of CP. In about half of the cases examined in this study, bacterial localization could be made to the prostate. Level of evidence: Level IIIb.
Collapse
Affiliation(s)
- Punit Tiwari
- Consultant Urologist, MKM Stone and Urology Hospital, India
| | - Arpan Choudhary
- Department of Urology, Super Specialty Hospital, NSCB Medical College, India
| |
Collapse
|
8
|
Kim JK, Lee YG, Han K, Han JH. Obesity, metabolic health, and urological disorders in adults: a nationwide population-based study. Sci Rep 2021; 11:8687. [PMID: 33888807 PMCID: PMC8062508 DOI: 10.1038/s41598-021-88165-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 03/30/2021] [Indexed: 12/25/2022] Open
Abstract
We evaluate the risks of various urological disorders that require treatments according to obesity and metabolic health status using a nationwide dataset of the Korean population. 3,969,788 patients who had undergone health examinations were enrolled. Participants were classified as “obese” (O) or “non-obese” (NO) using a BMI cut-off of 25 kg/m2. People who developed ≥ 1 metabolic disease component in the index year were considered “metabolically unhealthy” (MU), while those with none were considered “metabolically healthy” (MH). There were classified into the MHNO, MUNO, MHO, and MUO group. In BPH, chronic renal disease, neurogenic bladder, any medication related to voiding dysfunction, alpha-blocker, and antidiuretics, age and gender-adjusted hazard ratio (HR) was highest in MUO, but higher in MUNO than in MHO. In stress incontinence, prostate surgery, and 5alpha-reductase, HR increased in the order of MUNO, MHO, and MUO. In prostatitis, anti-incontinence surgery, and cystocele repair, HR was higher in MHO than MUNO and MUO. In cystitis, cystostomy, and anticholinergics, HR was higher in MUNO and MUO than MHO. In conclusion, obesity and metabolic health were individually or collaboratively involved in urological disorders related to voiding dysfunction. Metabolic healthy obesity needs to be distinguished in the diagnosis and treatment of urological disorders.
Collapse
Affiliation(s)
- Jong Keun Kim
- Department of Urology, Hallym University Dongtan Sacred Heart Hospital, 7, Keunjaebong-gil, Hwaseong-si, Gyeonggi-do, 18450, Republic of Korea
| | - Young Goo Lee
- Department of Urology, Hallym University Kangnam Sacred Heart Hospital, 1, Singil-ro, Yeongdeungpo-gu, Seoul, 07441, Republic of Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, 369, Sangdo-Ro, Dongjak-gu, Seoul, 06978, Republic of Korea
| | - Jun Hyun Han
- Department of Urology, Hallym University Dongtan Sacred Heart Hospital, 7, Keunjaebong-gil, Hwaseong-si, Gyeonggi-do, 18450, Republic of Korea.
| |
Collapse
|
9
|
Zhang J, Liang C, Shang X, Li H. Chronic Prostatitis/Chronic Pelvic Pain Syndrome: A Disease or Symptom? Current Perspectives on Diagnosis, Treatment, and Prognosis. Am J Mens Health 2021; 14:1557988320903200. [PMID: 32005088 PMCID: PMC7256330 DOI: 10.1177/1557988320903200] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Definitive diagnosis and selection of effective treatment for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) are frustrations encountered frequently by urology care providers in their practice. Knowledge of etiology and pathophysiology is not sufficient and therapeutic guidelines have not yielded acceptable outcomes and prognoses for both patients and care providers. The authors present updated perspectives on CP/CPPS, including definition, diagnosis, treatment, and prognosis, based on literature review and clinical experience. A key point is to shift the diagnostic and therapeutic focus from a single entity of disease toward associated symptoms of CP/CPPS. An individualized multimodal treatment approach to cope with the course of the disorder is proposed. Communications and personal/family/community supports are emphasized as an important component in the therapeutic regime and rehabilitation of patients with CP/CPPS. The purpose is to improve comprehension on CP/CPPS and to help care providers and patients to achieve the goal of medical intervention-relieving associated symptoms of CP/CPPS and improving the quality of life.
Collapse
Affiliation(s)
- Jianzhong Zhang
- Department of Urology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - ChaoZhao Liang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Xuejun Shang
- Reproductive and Genetic Laboratory, Jinling Affiliated Hospital of Nanjing University School of Medicine, Nanjing, Jiangsu, China
| | - Hongjun Li
- Department of Urology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| |
Collapse
|
10
|
Li G, Chang D, Chen D, Zhang P, You Y, Huang X, Cai J, Yang X. Efficacy of radial extracorporeal shock wave therapy for chronic prostatitis/chronic pelvic pain syndrome: A protocol for systematic review. Medicine (Baltimore) 2020; 99:e22981. [PMID: 33126371 PMCID: PMC7598797 DOI: 10.1097/md.0000000000022981] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Prostatitis is a common urogenital system disease in men which affects 5% to 9% of adult men worldwide and accounts for approximately 8% of visits to urologists. In the past years, its pathogenesis is complicated and the classification of it is not clear, so the effect of treatment measures is not significant. Recently, the treatment of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) includes nonsteroidal anti-inflammatory drugs, phytotherapy, hormonal therapy, alpha-blockers, anti-anxiolytic, and acupuncture, which provide more choice for the urologist. But there still are some limitations. scholars. Many studies suggest radial extracorporeal shock wave therapy may be the better option in the treatment of CP/CPPS. However, the efficacy and safety of it still lack solid evidence. METHODS AND ANALYSIS The electronic databases of MEDLINE, PubMed, Web of Science, EMBASE, Cochrane Library, Clinicaltrials.org, China National Knowledge Infrastructure Database, Wan fang Database, China Biology Medicine Database, VIP Science Technology Periodical Database, Chinese Clinical Trial Registry will be retrieved. All the randomized controlled trials of radial extracorporeal shock wave therapy (rESWT) for patients with CP/CPPS will be included. We will evaluate the outcomes including National Institutes of Health Chronic Prostatitis Symptom Index, visual analog scale, international prostate symptom score, international index of erectile function-5, and conduct this study strictly according to the Cochrane Handbook for Systematic Reviews of Interventions. RESULTS The current study is a protocol for systematic review and meta-analysis without results, and data analysis will be carried out after the protocol. We will share our findings on October 31st of 2021. CONCLUSION rESWT as a noninvasive treatment with no pain, which will be accepted more easily. Although some studies have suggested that rESWT can relieve the symptoms of patients, the efficacy and safety of it still lack solid evidence. To address this limitation scientifically and systematically, this study will inspect the efficacy and safety of the rESWT treatment in patients with CP/CPPS by integrating various studies. ETHICS AND DISSEMINATION Formal ethical approval is not required in this protocol. We will collect and analyze data based on published studies, and since there are no patients involved in this study, individual privacy will not be under concerns. The results of this review will be disseminated to peer-reviewed journals or submit to related conferences. PROTOCOL REGISTRATION NUMBER INPLASY202090076.
Collapse
|
11
|
Chen J, Zhang H, Niu D, Li H, Wei K, Zhang L, Yin S, Liu L, Zhang X, Zhang M, Liang C. The risk factors related to the severity of pain in patients with Chronic Prostatitis/Chronic Pelvic Pain Syndrome. BMC Urol 2020; 20:154. [PMID: 33028277 PMCID: PMC7542966 DOI: 10.1186/s12894-020-00729-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 09/24/2020] [Indexed: 01/22/2023] Open
Abstract
Background Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) is a disease with diverse clinical manifestations, such as pelvic pain or perineal pain. Although recent studies found several risk factors related to the pain severity of CP/CPPS patients, results were inconsistent. Here, we aimed to identify novel risk factors that are closely related to the severity of pain in patients with CP/CPPS. Methods We retrospectively collected the clinical records from patients with CP/CPPS from March 2019 to October 2019. The questionnaire was used to obtain related parameters, such as demographics, lifestyle, medical history, etc. To identify potential risk factors related to pain severity, we used the methods of univariate and multivariate logistic regression analyses. Further, to confirm the relationship between these confirmed risk factors and CP/CPPS, we randomly divided CP/CPPS patients into the training and the validation cohorts with a ratio of 7:3. According to the co-efficient result of each risk factor calculated by multivariate logistic regression analysis, a predicting model of pain severity was established. The receiver operating characteristic curve (ROC), discrimination plot, calibration plot, and decision curve analyses (DCA) were used to evaluate the clinical usage of the current model in both the training and validation cohorts. Results A total of 272 eligible patients were enrolled. The univariate and multivariate logistic regression analysis found that age [odds ratio (OR): 2.828, 95% confidence intervals (CI): 1.239–6.648, P = 0.004], holding back urine (OR: 2.413, 95% CI: 1.213–4.915, P = 0.005), anxiety or irritability (OR: 3.511, 95% CI: 2.034–6.186, P < 0.001), contraception (OR: 2.136, 95% CI:1.161–3.014, P = 0.029), and smoking status (OR: 1.453, 95% CI: 1.313–5.127, P = 0.013) were the risk factors of pain severity. We then established a nomogram model, to test whether these factors could be used to predict the pain severity of CP/CPPS patients in turn. Finally, ROC, DCA, and calibration analyses proved the significance and stability of this nomogram, further confirmed that these factors were closely related to the pain severity of CP/CPPS patients. Conclusions We identify age, holding back urine, anxiety or irritability, contraception, and smoking are risk factors closely related to the pain severity in patients with CP/CPPS. Our results provide novel inspirations for clinicians to design the personalized treatment plan for individual CP/CPPS patient who has suffered different encounters.
Collapse
Affiliation(s)
- Jing Chen
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China.,The Institute of Urology, Anhui Medical University, Hefei, People's Republic of China
| | - Haomin Zhang
- The Second Clinical College of Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Di Niu
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China.,The Institute of Urology, Anhui Medical University, Hefei, People's Republic of China
| | - Hu Li
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China.,The Institute of Urology, Anhui Medical University, Hefei, People's Republic of China
| | - Kun Wei
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China.,The Institute of Urology, Anhui Medical University, Hefei, People's Republic of China
| | - Li Zhang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China.,The Institute of Urology, Anhui Medical University, Hefei, People's Republic of China
| | - Shuiping Yin
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China.,The Institute of Urology, Anhui Medical University, Hefei, People's Republic of China
| | - Longfei Liu
- Department of Urology, b Reproductive Medicine Center, Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Xiansheng Zhang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China.,The Institute of Urology, Anhui Medical University, Hefei, People's Republic of China.,Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, People's Republic of China
| | - Meng Zhang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China. .,The Institute of Urology, Anhui Medical University, Hefei, People's Republic of China. .,Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, People's Republic of China. .,Institute of Urology of Shenzhen University, The Third Affiliated Hospital of Shenzhen University, Shenzhen Luohu Hospital Group, Shenzhen, People's Republic of China.
| | - Chaozhao Liang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China. .,The Institute of Urology, Anhui Medical University, Hefei, People's Republic of China. .,Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, People's Republic of China.
| |
Collapse
|
12
|
Borzunova YM, Alentev AM, Borzunov IV. [Use of Nordic walking in the complex treatment of lower urinary tract symptoms in chronic prostatitis]. VOPROSY KURORTOLOGII, FIZIOTERAPII, I LECHEBNOĬ FIZICHESKOĬ KULTURY 2020; 97:45-51. [PMID: 32356634 DOI: 10.17116/kurort20209702145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Lower urinary tract symptoms (LUTS) caused by chronic prostatitis (CP) are a common condition. Standard antibiotic therapy is often not justified, since bacterial prostatitis is presented in up to 10% of the cases, while there is no effect on the risk factors for the development and relapse of the disease. This study is aimed at one of the main risk factors for LUTS - a sedentary lifestyle. AIM To increase the effectiveness of treatment for LUTS in men using the Nordic Walking technique. MATERIAL AND METHODS 84 patients with CP were examined, which were divided into 3 groups. The 1st group (control) included 32 patients who received standard antibacterial therapy. In the 2nd group (primary) - 32 patients who received complex therapy (antibiotic therapy + 4-week course of Nordic walking). The third group (comparison) included 20 patients who were prescribed monotherapy - Nordic walking for 4 weeks. The dynamics of clinical manifestations was assessed using CP Symptom Scale (NIH-CPSI) and the international symptom index for diseases of the prostate IPSS; the volume of residual urine, uroflowmetric data, and the level of leukocytes in the secretion of the prostate gland were estimated. RESULTS Laboratory studies showed a significantly faster decrease in the number of leukocytes in the secretion of the prostate gland on the 7th and 14th day in the primary (2nd) group (p<0.001). Clinical symptoms according to the NIH-CPSI and IPSS scales significantly regressed in the primary group on the 14th and 28th days of therapy. Uroflowmetric data and the volume of residual urine improved more significantly in the primary group by the 14th and 28th days. CONCLUSION Patients receiving combined therapy showed significantly better treatment results in the form of faster normalization of prostate secretion, regression of clinical symptoms, improved urine flow rate and a decrease in residual urine volume after 4 weeks of therapy. When choosing management algorithm for patients with LUTS, it is advisable to use an integrated approach: in addition to antibiotic therapy, Nordic walking is recommended 3 times a week for at least 4 weeks.
Collapse
Affiliation(s)
| | - A M Alentev
- Ural State Medical University, Ekaterinburg, Russia
| | - I V Borzunov
- Ural State Medical University, Ekaterinburg, Russia
| |
Collapse
|
13
|
Baker TA, Vásquez E, Minahan JA. Variability of Pain Outcomes and Physical Activity Among a Diverse Sample of Older Men: Is It More Than Just Race? Gerontol Geriatr Med 2019; 5:2333721419878587. [PMID: 31633001 PMCID: PMC6767716 DOI: 10.1177/2333721419878587] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 08/31/2019] [Accepted: 09/04/2019] [Indexed: 11/24/2022] Open
Abstract
There is a compendium of data documenting the increasing number of older adults.
This suggests the continued need to understand identified health outcomes across
domains of pain and physical activity, particularly among older men. Therefore,
the aim of this study was to evaluate race similarities and/or differences in
pain and rates of physical activity among White, Black, and Hispanic men 60+
years of age. Data were taken from the Health and Retirement Study, a
longitudinal panel study surveying a representative sample of people in the
United States. Logistic regression analysis was used to examine associations
between race and pain and the odds of regular physical activity. Results showed
that Black men were less likely to participate in light or moderate/vigorous
physical activity. Similarly, pain increased the odds of physical activity among
Hispanics, but decreased the odds of physical activity among White men. Findings
may reflect a number of factors that impact the well-being of what it means to
experience pain and physical functioning, while also assuming a masculine
identity. This perspective may allow for a better understanding of short- and
long-term implications of the pain experience and the pain and physical
functioning dyad among this group of men.
Collapse
|
14
|
Zhu GQ, Jeon SH, Lee KW, Tian WJ, Cho HJ, Ha US, Hong SH, Lee JY, Moon MK, Moon SH, Kim SW, Bae WJ. Electric Stimulation Hyperthermia Relieves Inflammation via the Suppressor of Cytokine Signaling 3-Toll Like Receptor 4 Pathway in a Prostatitis Rat Model. World J Mens Health 2019; 38:359-369. [PMID: 31385476 PMCID: PMC7308236 DOI: 10.5534/wjmh.190078] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 06/24/2019] [Indexed: 12/15/2022] Open
Abstract
Purpose Chronic prostatitis (CP), including chronic pelvic pain syndrome (CPPS), is the most commonly encountered manifestation of prostatitis. The aim of this study was to evaluate the effect of electric stimulation hyperthermia treatment (ESHT) on CP/CPPS and to explore the underlying mechanism. Materials and Methods RWPE-2 cells with lipopolysaccharide-induced inflammation and a prostatitis rat model induced by 17β-estradiol and dihydrotestosterone underwent sham, electric stimulation, or ESHT treatment. Four weeks later, cells, supernatants, and rat prostates were collected for analysis using immunohistochemistry, Western blots, and enzyme-linked immunosorbent assays. Results We found that ESHT improved prostatitis in vivo and attenuated inflammation in vitro. ESHT significantly induced suppressor of cytokine signaling 3 (SOCS3) expression and subsequently promoted HSP70. It attenuated inflammation through decreased expression of toll-like receptor 4 (TLR4), nuclear factor kappa B, and subsequent inflammatory cytokines. ESHT also inhibited apoptosis and released growth factor in tissue affected by prostatitis. Conclusions ESHT improved CP/CPPS and reversed pathologic changes of prostatitis by inhibiting the SOCS3-TLR4 pathway.
Collapse
Affiliation(s)
- Guan Qun Zhu
- Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea.,Catholic Integrative Medicine Research Institute, The Catholic University of Korea, Seoul, Korea
| | - Seung Hwan Jeon
- Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea.,Catholic Integrative Medicine Research Institute, The Catholic University of Korea, Seoul, Korea
| | - Kyu Won Lee
- Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea.,Catholic Integrative Medicine Research Institute, The Catholic University of Korea, Seoul, Korea
| | - Wen Jie Tian
- Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea.,Catholic Integrative Medicine Research Institute, The Catholic University of Korea, Seoul, Korea
| | - Hyuk Jin Cho
- Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - U Syn Ha
- Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sung Hoo Hong
- Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ji Youl Lee
- Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | | | | | - Sae Woong Kim
- Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea.,Catholic Integrative Medicine Research Institute, The Catholic University of Korea, Seoul, Korea.
| | - Woong Jin Bae
- Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea.,Catholic Integrative Medicine Research Institute, The Catholic University of Korea, Seoul, Korea.
| |
Collapse
|
15
|
Gasperi M, Krieger JN, Panizzon MS, Goldberg J, Buchwald D, Afari N. Genetic and Environmental Influences on Urinary Conditions in Men: A Classical Twin Study. Urology 2019; 129:54-59. [PMID: 30986484 DOI: 10.1016/j.urology.2019.04.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 03/31/2019] [Accepted: 04/02/2019] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To evaluate the genetic and environmental relationship among prostatitis and other urological conditions, including benign prostatic hyperplasia (BPH) and prostate cancer (CaP), a classical twin design and biometric modeling was used. While prostatitis-characterized by pain and voiding symptoms, no clear etiology, and functional and quality of life impairments-co-occurs with other urinary conditions, the degree of shared overlapping etiologic processes among them remains unclear. We examined the contribution of genetic and environmental factors to these conditions and the etiology of their associations at the level of genetic and environmental influences. METHODS 4380 monozygotic and dizygotic male twin pairs from the Vietnam Era Twin Registry reported lifetime physician-diagnosed prostatitis (combined acute and chronic), bladder problems, enlarged prostate/BPH, and CaP. Multivariate biometrical modeling estimated the magnitude of genetic and environmental influences for each condition, as well as their genetic and environmental covariance. The common pathway model tested the assumption that covariation among these urinary conditions is determined by a single latent factor. RESULTS Overall prevalence of prostatitis was 2.7%. Heritability estimates ranged from 19% for bladder problems to 42% for CaP. Significant shared environmental influences were present for CaP (12%), enlarged prostate/BPH (10%) but were smaller than genetic influences. A reduced one factor common pathway model provided the best fit, suggesting that covariation among the conditions is determined by a shared latent factor. CONCLUSION We identified a common, genetically-influenced factor that accounts for much of the comorbidity among these 4 disease conditions. Nonshared environmental factors also make a significant contribution.
Collapse
Affiliation(s)
- Marianna Gasperi
- University of California, San Diego, CA; VA Center of Excellence for Stress and Mental Health, San Diego, CA
| | | | - Matthew S Panizzon
- Center for Behavior Genetics of Aging, University of California, San Diego, CA
| | - Jack Goldberg
- University of Washington, Seattle, WA; Vietnam Era Twin Registry, Seattle, WA
| | - Dedra Buchwald
- Elson S Floyd College of Medicine, Washington State University, Spokane, WA
| | - Niloofar Afari
- University of California, San Diego, CA; VA Center of Excellence for Stress and Mental Health, San Diego, CA.
| |
Collapse
|
16
|
Hervás-Pérez JP, Jiménez Díaz-Benito V, Guodemar-Pérez J, Ruiz-López M, García-Fernández P, Rodríguez-López ES, Pérez-Manchón D. [The influence of physical activity as an alternative treatment to chronic prostatitis: A meta-analysis]. Rev Int Androl 2019; 18:107-116. [PMID: 30871896 DOI: 10.1016/j.androl.2018.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 11/12/2018] [Accepted: 12/02/2018] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Chronic prostatitis is one of the most common diagnoses in outpatient clinics in Urology. It is presented as a heterogeneous group of diseases, whose etiology is often unknown, showing as a common denominator a set of painful, irritative and obstructive symptoms of the genitourinary tract and perineum. OBJECTIVES A systematic review and updated meta-analysis of this pathology was performed in relation to the damages or benefits that physical activity could have in chronic prostatitis or chronic pelvic pain. METHODS The Scopus, PubMed, ScienceDirect, PEDro, The Cochrane Library, Dialnet and SciELO databases were consulted until June 2018 (the last paper used in this meta-analysis was published in March 2018). RESULTS The research team reviewed a total of 93 studies, of which 10 were selected, with a subsequent examination of their methodological quality using the PEDro scale. The comparison of the body mass index, the quality of life related to the body mass index and the correlation of the urinary incontinence were made. The overall analysis of the interventions within the urinary incontinence was significant (effect size: 0.11; 95% CI 0.038 to 0.43; P=.024). CONCLUSIONS The variability associated with experimental designs represents a heterogeneity in the effects of different programs or physical activity interventions for the treatment of chronic prostatitis. The effect sizes obtained suggest that the effectiveness of alternative treatment programs, using vehicular physical activity, may be related to the type of intervention performed.
Collapse
Affiliation(s)
- Juan Pablo Hervás-Pérez
- Departamento de Fisioterapia, Facultad de Educación y Salud, Universidad Camilo José Cela, Villanueva de la Cañada, Madrid, España.
| | - Victor Jiménez Díaz-Benito
- Facultad de Ciencias de la Actividad Física y del Deporte, Universidad Politécnica de Madrid, Madrid, España
| | - Jesús Guodemar-Pérez
- Departamento de Fisioterapia, Facultad de Educación y Salud, Universidad Camilo José Cela, Villanueva de la Cañada, Madrid, España
| | - Montserrat Ruiz-López
- Departamento de Enfermería, Facultad de Educación y Salud, Universidad Camilo José Cela, Villanueva de la Cañada, Madrid, España
| | - Pablo García-Fernández
- Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Universidad Alfonso X, Villanueva de la Cañada, Madrid, España
| | - Elena Sonsoles Rodríguez-López
- Departamento de Fisioterapia, Facultad de Educación y Salud, Universidad Camilo José Cela, Villanueva de la Cañada, Madrid, España
| | - David Pérez-Manchón
- Departamento de Enfermería, Facultad de Educación y Salud, Universidad Camilo José Cela, Villanueva de la Cañada, Madrid, España
| |
Collapse
|
17
|
|
18
|
Wang J, Liang K, Sun H, Li L, Wang H, Cao J. Psychotherapy combined with drug therapy in patients with category III chronic prostatitis/chronic pelvic pain syndrome: A randomized controlled trial. Int J Urol 2018; 25:710-715. [PMID: 29862568 DOI: 10.1111/iju.13706] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Accepted: 04/24/2018] [Indexed: 11/26/2022]
Affiliation(s)
- Jianxin Wang
- Department of Urology; Taizhou First People's Hospital; Taizhou China
- Department of Urology; Binzhou Medical University Hospital; Binzhou China
| | - Kuixiang Liang
- Department of Obstetrics; Binzhou Medical University Hospital; Binzhou China
| | - Huijing Sun
- Department of Nursing; Binzhou Polytechnical College; Binzhou China
| | - Lianpeng Li
- Department of Urology; Binzhou Central Hospital; Binzhou China
| | - Hongcai Wang
- Department of Neurology; Binzhou Medical University Hospital; Binzhou China
| | - Jingyuan Cao
- Department of Urology; Taizhou First People's Hospital; Taizhou China
| |
Collapse
|
19
|
Spar M. Chronic Prostatitis/Chronic Pelvic Pain Syndrome. Integr Med (Encinitas) 2018. [DOI: 10.1016/b978-0-323-35868-2.00062-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
20
|
The Anti-Inflammatory Effects of a Yin Zhi Huang Soup in an Experimental Autoimmune Prostatitis Rat Model. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2017; 2017:7312938. [PMID: 29430255 PMCID: PMC5752995 DOI: 10.1155/2017/7312938] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Revised: 10/24/2017] [Accepted: 11/22/2017] [Indexed: 11/17/2022]
Abstract
The present study aimed to investigate the therapeutic effects of the Chinese herbal medicine Yin Zhi Huang soup (YZS) in an experimental autoimmune prostatitis (EAP) rat model. In total, 48 rats were randomly divided into the following four groups (n = 12/group): saline group, pathological model group, Qianlietai group, and YZS group. We determined the average wet weight of the prostate tissue, the ratio of the wet weight of the prostate tissue to body weight, tumor necrosis factor-alpha (TNF-α) levels in the blood serum, the expression of inducible nitric oxide synthase (iNOS) in the rats' prostate tissues, and the pathological changes in the prostate tissue using light microscopy. YZS reduced the rats' prostate wet weight, the ratio of the prostate wet weight to body weight, and TNF-α levels in the blood serum and inhibited the expression of iNOS in the rats' prostate tissues (P < 0.05). Following YZS treatment, the pathological changes in the rats' prostates were improved compared with those in the model group (P < 0.05). Furthermore, YZS treatment reduced inflammatory changes in the prostate tissue. It also significantly suppressed proinflammatory cytokines, such as TNF-α, and chemokines, such as iNOS, in the rat model of EAP.
Collapse
|
21
|
Guu SJ, Geng JH, Chao IT, Lin HT, Lee YC, Juan YS, Liu CC, Wang CJ, Tsai CC. Efficacy of Low-Intensity Extracorporeal Shock Wave Therapy on Men With Chronic Pelvic Pain Syndrome Refractory to 3-As Therapy. Am J Mens Health 2017; 12:441-452. [PMID: 29072124 PMCID: PMC5818120 DOI: 10.1177/1557988317736585] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Managing patients with chronic pelvic pain syndrome (CPPS) refractory to the traditional 3-As therapy (antibiotics, alpha-blockers, and anti-inflammatories) is a challenging task. Low-intensity extracorporeal shock wave therapy (LI-ESWT) was recently reported to be able to improve pain, urinary symptoms, and even sexual function by inducing neovascularization and anti-inflammation, reducing muscle tone, and influencing nerve impulses. This study evaluates whether combined treatment with LI-ESWT can restore clinical ability and quality of life (QoL) in patients refractory to 3-As therapy. This was an open-label, single-arm prospective study. Patients with CPPS without more than a 6-point decrease in the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) total score under the maximal dosage of 3-As therapy were enrolled. LI-ESWT treatment consisted of 3,000 shock waves administered once weekly for 4 weeks. The NIH-CPSI, visual analog scale (VAS) score, International Prostate Symptom Score (IPSS), and the five-item version of the International Index of Erectile Function (IIEF-5) were used to evaluate efficacy at 1, 4, and 12 weeks after LI-ESWT. Thirty-three patients were enrolled in this study. After LI-ESWT treatment, 27 of the 33 patients (81.82%) had a successful response to LI-ESWT, with a decrease of 3.29 and 5.97 in the VAS score and total IPSS at the 3-month follow-up. Waist circumference was the only significant predictor of a successful response to LI-ESWT. LI-ESWT can serve as a salvage therapy for patients with CPPS refractory to traditional 3-As therapy. Further studies are needed to determine an adequate therapeutic protocol and important predictors in patients with different CPPS etiologies.
Collapse
Affiliation(s)
- Shiao-Jin Guu
- 1 Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Jiun-Hung Geng
- 1 Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,2 Department of Urology, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan
| | - I-Ting Chao
- 3 Teaching and Research Center, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan
| | - Hui-Tzu Lin
- 3 Teaching and Research Center, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan
| | - Yung-Chin Lee
- 1 Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,2 Department of Urology, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan.,4 Department of Urology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yung-Shun Juan
- 1 Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,4 Department of Urology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,5 Department of Urology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan
| | - Chia-Chu Liu
- 1 Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,4 Department of Urology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chii-Jye Wang
- 1 Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,4 Department of Urology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chia-Chun Tsai
- 1 Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,5 Department of Urology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan
| |
Collapse
|
22
|
Funahashi Y, Majima T, Matsukawa Y, Yamamoto T, Yoshida M, Gotoh M. Intraprostatic Reflux of Urine Induces Inflammation in a Rat. Prostate 2017; 77:164-172. [PMID: 27683251 DOI: 10.1002/pros.23257] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Accepted: 08/31/2016] [Indexed: 12/22/2022]
Abstract
BACKGROUND We examined whether urine reflux into the prostate can induce prostatic inflammation in a rat and evaluated the effect of α1-adrenoreceptor antagonist. METHODS Experiment 1: Male Sprague-Dawley rats were injected with 500 µl of Evans Blue through the urethral orifice. Intravesical pressure was measured, and the prostate was excised to evaluate urine reflux. Experiment 2: Rats were injected with 500 µl urine or saline (control) from the urethral orifice. Silodosin (200 µg/kg/day) was administered to the silodosin group. We evaluated histopathology, the expression of proinflammatory cytokines and oxidative stress markers of the prostate on day 7, after assessing the prostatic microcirculation and cystometrogram. RESULTS Experiment 1: The histopathology showed that Evans Blue instilled through the urethral orifice entered the prostatic ducts. Intravesical pressure during Evans Blue instillation was 47.7 ± 1.6 cmH2 O (mean ± standard error). Experiment 2: On day 7 after urine instillation through the urethral orifice, histopathology showed infiltrated inflammatory cells in the peri-glandular stroma. Inflammation-associated proteins (IL-1α, IL-1β, IL-6, and TNFα) were upregulated in the urine-instilled rats but not in the silodosin group. Erythrocyte speed on the prostatic surface, immunostaining for hypoxyprobe, and quantification of oxidative stress markers (MDA and HIF-1α) demonstrated prostatic hypoxia in the urine-instilled rats, which was ameliorated in the silodosin group. Cystometrogram revealed a shorter intercontraction interval in the urine-instilled rats, which was prolonged in the silodosin group. CONCLUSIONS Urine reflux into the prostatic duct induces abacterial prostatitis. Silodosin relieved prostatic inflammation and bladder overactivity by increasing microcirculation in the prostate. Prostate 77:164-172, 2017. © 2016 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Yasuhito Funahashi
- Department of Urology, Nagoya University Graduate School of Medicine, Showa-ku, Nagoya, Japan
| | - Tsuyoshi Majima
- Department of Urology, Nagoya University Graduate School of Medicine, Showa-ku, Nagoya, Japan
| | - Yoshihisa Matsukawa
- Department of Urology, Nagoya University Graduate School of Medicine, Showa-ku, Nagoya, Japan
| | - Tokunori Yamamoto
- Department of Urology, Nagoya University Graduate School of Medicine, Showa-ku, Nagoya, Japan
| | - Masaki Yoshida
- Department of Urology, National Center for Geriatrics and Gerontology, Morioka-cho, Ohbu, Japan
| | - Momokazu Gotoh
- Department of Urology, Nagoya University Graduate School of Medicine, Showa-ku, Nagoya, Japan
| |
Collapse
|
23
|
New Independent Thermobalancing Treatment with Therapeutic Device for Chronic Prostatitis/Chronic Pelvic Pain Syndrome. Nephrourol Mon 2017. [DOI: 10.5812/numonthly.44694] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
|
24
|
Xue Y, Lameijer EW, Ye K, Zhang K, Chang S, Wang X, Wu J, Gao G, Zhao F, Li J, Han C, Xu S, Xiao J, Yang X, Ying X, Zhang X, Chen WH, Liu Y, Zhang Z, Huang K, Yu J. Precision Medicine: What Challenges Are We Facing? GENOMICS PROTEOMICS & BIOINFORMATICS 2016; 14:253-261. [PMID: 27744061 PMCID: PMC5093857 DOI: 10.1016/j.gpb.2016.10.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2016] [Revised: 09/30/2016] [Accepted: 10/01/2016] [Indexed: 11/19/2022]
Affiliation(s)
- Yu Xue
- MOE Key Laboratory of Molecular Biophysics, College of Life Science and Technology and the Collaborative Innovation Center for Brain Science, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Eric-Wubbo Lameijer
- School of Electronic and Information Engineering, Xi'an Jiaotong University, Xi'an 710049, China
| | - Kai Ye
- School of Electronic and Information Engineering, Xi'an Jiaotong University, Xi'an 710049, China
| | - Kunlin Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China
| | - Suhua Chang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China
| | - Xiaoyue Wang
- State Key Laboratory of Medical Molecular Biology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China
| | - Jianmin Wu
- MOE/Beijing Key Laboratory of Carcinogenesis and Translational Research, Center for Cancer Bioinformatics, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Ge Gao
- Center for Bioinformatics, State Key Laboratory of Protein and Plant Gene Research, School of Life Sciences, Peking University, Beijing 100871, China
| | - Fangqing Zhao
- Beijing Institutes of Life Science, Chinese Academy of Sciences, Beijing 100101, China
| | - Jian Li
- MOE Key Laboratory of Developmental Genes and Human Disease, Institute of Life Sciences, Southeast University, Nanjing 210096, China
| | - Chunsheng Han
- State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China
| | - Shuhua Xu
- Max Planck Independent Research Group on Population Genomics, CAS-MPG Partner Institute for Computational Biology (PICB), Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai 200031, China
| | - Jingfa Xiao
- CAS Key Laboratory of Genome Sciences and Information, Chinese Academy of Sciences, Beijing 100101, China
| | - Xuerui Yang
- MOE Key Laboratory of Bioinformatics, School of Life Sciences, Center for Synthetic and Systems Biology, Tsinghua University, Beijing 100084, China
| | - Xiaomin Ying
- Computational Omics Laboratory, Center of Computational Biology, Beijing Institute of Basic Medical Sciences, Beijing 100850, China
| | - Xuegong Zhang
- Bioinformatics Division, TNLIST and MOE Key Laboratory for Bioinformatics, Department of Automation, Tsinghua University, Beijing 100084, China
| | - Wei-Hua Chen
- Department of Bioinformatics and Systems Biology, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Yun Liu
- MOE Key Laboratory of Metabolism and Molecular Medicine, Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, Shanghai 200032, China
| | - Zhang Zhang
- BIG Data Center and CAS Key Laboratory of Genome Sciences & Information, Beijing Institute of Genomics, Chinese Academy of Sciences, Beijing 100101, China
| | - Kun Huang
- Department of Biomedical Informatics, The Ohio State University, Columbus, OH 43017, USA
| | - Jun Yu
- CAS Key Laboratory of Genome Sciences and Information, Chinese Academy of Sciences, Beijing 100101, China.
| |
Collapse
|
25
|
Association of diet and lifestyle with chronic prostatitis/chronic pelvic pain syndrome and pain severity: a case-control study. Prostate Cancer Prostatic Dis 2015; 19:92-9. [PMID: 26666410 DOI: 10.1038/pcan.2015.57] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Revised: 10/06/2015] [Accepted: 10/20/2015] [Indexed: 11/08/2022]
Abstract
BACKGROUND Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common problem with unclear etiology. Some diet and lifestyle factors were thought to correlate with CP/CPPS, but studies comprehensively investigate this correlation are rarely available. The current study was conducted to determine the potential lifestyle-related risk factors of CP/CPPS and its pain severity in Chinese population. METHODS Participants were recruited from seven hospitals in Shanghai from July 2012 to August 2013. Demographics, medical history, diet and lifestyle information, and CP/CPPS symptoms were obtained from each participant using a questionnaire. Univariate and multivariate logistic regression analyses were used to identify potential lifestyle-related risk factors for CP/CPPS and its pain severity. RESULTS A total of 784 men with CP/CPPS and 785 controls were enrolled in this study. Multivariate regression model indicated that age, nightshift work, stress, smoking status, alcohol consumption, less water intake, imbalanced diet, frequent sexual activity, delaying ejaculation and holding urine were identified as potential risk factors for CP/CPPS, whereas sedentary lifestyle, caffeinated drinks and less water intake were associated with severe pain in CP/CPPS patients. CONCLUSIONS Several diet and lifestyle factors associated with CP/CPPS and pain severity were determined in this study. These modifiable conditions are potential targets for treatment of CP/CPPS. However, further studies are necessary to determine their role in the pathogenesis of CP/CPPS.
Collapse
|
26
|
Smith JA. This Month in Adult Urology. J Urol 2015. [DOI: 10.1016/j.juro.2015.07.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|