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Lin W, Wang Y, Chen Y. Efficacy Analysis of Physical Therapy in Treating Chronic Prostatitis: Unblocking Obstructed Glandular Ducts Could Be a Novel Treatment Strategy. Res Rep Urol 2023; 15:553-561. [PMID: 38145159 PMCID: PMC10742744 DOI: 10.2147/rru.s442844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 11/28/2023] [Indexed: 12/26/2023] Open
Abstract
Objective This study investigates the efficacy of physical therapy in treating chronic prostatitis grounded on the glandular duct blockage theory. Methods The study includes patients who were diagnosed and treated for chronic prostatitis between November 2022 and July 2023 at Renhui clinic in Jiangmen, Guangdong and Renhui frontline clinic in Shenzhen Guangdong. The recorded data includes the frequency of physical therapies including prostate massages, rectal probe high-frequency vibration treatment, and low-intensity extracorporeal shockwave therapy (Li-ESWT). Post-treatment urine sediment was collected for microscopic examination, and the scores of each patient on the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) and the Premature Ejaculation Diagnostic Tool (PEDT) were recorded pre- and post-treatment in order to calculate the effectiveness rate. Results The study involved a total of 48 patients, of which 26 were diagnosed with premature ejaculation. On average, each patient received 2.1 prostate massages, underwent 4.1 rectal probe high-frequency vibration treatments, and 8.3 Li-ESWT sessions. Following treatment, the initial microscopic examination of the urine sediment revealed aged white blood cell clusters, prostate calculi clusters, and inactive sperm clusters, all appearing in the shape of glandular tubes. The mean NIH-CPSI scores pre- and post-treatment were 27.2±6.9 and 18.0±6.6, respectively, indicating an effectiveness rate of 81.3%. The average PEDT scores pre- and post-treatment were 14.5±3.5 and 10.5±4.2, respectively, with an effectiveness rate of 53.8%. Conclusion Unblocking obstructed glandular ducts might provide a novel therapeutic strategy for treating chronic prostatitis.
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Affiliation(s)
- Weiguang Lin
- Department of Urology, Renhui Clinic, Jiangmen, 529099, People’s Republic of China
- Department of Urology, Renhui Frontline Clinic, Shenzhen, 518038, People’s Republic of China
| | - Yunlong Wang
- Department of Urology, Renhui Clinic, Jiangmen, 529099, People’s Republic of China
- Department of Urology, Renhui Frontline Clinic, Shenzhen, 518038, People’s Republic of China
| | - Yanxiong Chen
- Department of Urology, Renhui Clinic, Jiangmen, 529099, People’s Republic of China
- Department of Urology, Renhui Frontline Clinic, Shenzhen, 518038, People’s Republic of China
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Abstract
PURPOSE OF REVIEW Pathologies of the prostate in men are one of the most prevalent clinical conditions today [1]. Specifically, pelvic inflammatory disease such as prostatitis can cause symptoms and syndromes different from urological ones, such as bowel or nervous system manifestations. This has a largely negative impact on the quality of life of patients. Therefore, it is convenient to know and update the information about the therapeutic approach to prostatitis, which is a challenge that involves different medical specialties. The aim of this article is to provide summarized and focused evidence to help in the therapeutic approach of patients with prostatitis. A computer-based search of the PubMed and Cochrane Library databases was used to perform a comprehensive literature review on prostatitis, with special interest in recent findings and latest therapeutic guideline recommendations. RECENT FINDINGS Recent discoveries about the epidemiology and clinical classifications of prostatitis seem to incur in an increasingly individualized and directed management, with the aim of covering all the confluent factors in prostatic inflammatory pathology. In addition, the role of new drugs and combination with phytotherapy open up a range of new treatment possibilities, although future randomized studies will be necessary to better understand how to use all treatment modalities. Despite all the knowledge acquired about the pathophysiology of prostate diseases, and due to their interrelation with other pelvic systems and organs, there are still gaps that make it difficult for us to provide an optimal and standardized treatment in many of our patients. Being aware of the influence of all the factors potentially involved in prostate symptoms is crucial for a correct diagnosis and establishing an effective treatment plan.
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Yuan P, Sun T, Han Z, Chen Y, Meng Q. Uncovering the genetic links of diabetic erectile dysfunction and chronic prostatitis/chronic pelvic pain syndrome. Front Physiol 2023; 14:1096677. [PMID: 36846330 PMCID: PMC9946966 DOI: 10.3389/fphys.2023.1096677] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 01/31/2023] [Indexed: 02/11/2023] Open
Abstract
Background: Clinical associations between erectile dysfunction and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) have been noticed, but the common pathogenic mechanisms between them remain elusive. The aim of the study was to mine shared genetic alterations between ED and chronic prostatitis/chronic pelvic pain syndrome. Method: Transcriptome data of ED and chronic prostatitis/chronic pelvic pain syndrome-related genes (CPRGs) were retrieved from relevant databases and differentially expressed analysis was used to obtain significant CPRGs. Then function enrichment and interaction analyses were performed to show shared transcriptional signature, including gene ontology and pathway enrichment, the construction of protein-protein interaction (PPI) network, cluster analysis, and co-expression analysis. Hub CPRGs and key cross-link were selected by validating these genes in clinical samples, chronic prostatitis/chronic pelvic pain syndrome and ED-related datasets. Then the miRNA-OSRGs co-regulatory network was predicted and validated. Subpopulation distribution and disease association of hub CPRGs were further identified. Result: Differentially expressed analysis revealed 363 significant CPRGs between ED and chronic prostatitis/chronic pelvic pain syndrome, functioning in inflammatory reaction, oxidative stress, apoptosis, smooth muscle cell proliferation, and extracellular matrix organization. A PPI network containing 245 nodes and 504 interactions was constructed. Module analysis depicted that multicellular organismal process and immune metabolic process were enriched. 17 genes were screened in PPI via topological algorithms, and reactive oxygen species as well as interleukin-1 metabolism were regarded as the bridging interactive mechanism. After screening and validation, a hub-CPRG signature consisting of COL1A1, MAPK6, LPL, NFE2L2 and NQO1 were identified and associated miRNA were verified. These miRNAs played an important role in immune and inflammatory response likewise. Finally, NQO1 was identified as a key genetic link between ED and chronic prostatitis/chronic pelvic pain syndrome. It was predominately enriched in corpus cavernosum endothelial cell, and correlated with other male urogenital and immune system diseases tightly. Conclusion: We identified the genetic profiles as well as corresponding regulatory network underlying interaction between ED and chronic prostatitis/chronic pelvic pain syndrome via multi-omics analysis. These findings expanded a new understanding for the molecular mechanism of ED with chronic prostatitis/chronic pelvic pain syndrome.
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Affiliation(s)
- Penghui Yuan
- Department of Urology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China,*Correspondence: Penghui Yuan, ; Yinwei Chen, ; Qingjun Meng,
| | - Taotao Sun
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Zhengyang Han
- Department of Ultrasound, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Yinwei Chen
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China,*Correspondence: Penghui Yuan, ; Yinwei Chen, ; Qingjun Meng,
| | - Qingjun Meng
- Department of Urology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China,*Correspondence: Penghui Yuan, ; Yinwei Chen, ; Qingjun Meng,
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Bai J, Gu L, Chen Y, Liu X, Yang J, Li M, Dong X, Yang S, Huang B, Wang T, Jin L, Liu J, Wang S. Evaluation of psychological stress, cortisol awakening response, and heart rate variability in patients with chronic prostatitis/chronic pelvic pain syndrome complicated by lower urinary tract symptoms and erectile dysfunction. Front Psychol 2022; 13:903250. [PMID: 36405196 PMCID: PMC9674019 DOI: 10.3389/fpsyg.2022.903250] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 09/28/2022] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Mental stress and imbalance of its two neural stress systems, the autonomic nervous system (ANS) and the hypothalamic-pituitary-adrenal (HPA) axis, are associated with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and erectile dysfunction (ED). However, the comprehensive analyses of psychological stress and stress systems are under-investigated, particularly in CP/CPPS patients complicated by lower urinary tract symptoms (LUTS) and ED. MATERIALS AND METHODS Participants were 95 patients in CP/CPPS+ED group, 290 patients in CP/CPPS group, 124 patients in ED group and 52 healthy men in control group. The National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI), the International Index of Erectile Function-5 (IIEF-5) and the International Prostate Symptom Score (IPSS) were used for assessing the disease severity of CP/CPPS, LUTS and ED. Psychometric self-report questionnaires including the Beck Anxiety Inventory (BAI), Perceived Stress Scale (PSS), Type A Personality Test (TAPT) and Symptom Checklist 90 (SCL-90) were completed for distress from physical symptoms. Twenty-five subjects per group were randomly selected for further investigating the changes of the HPA axis and ANS. Saliva samples were taken on 3 consecutive days at 8 specific times with strict reference to time of morning awakening for evaluation of free cortisol. Heart rate variability (HRV) as marker of the ANS was measured using 24 h electrocardiography, and time-and frequency-domain variables were analyzed. RESULTS The BAI and SCL-90 scores were significantly higher in the CP/CPPS+ED, CP/CPPS and ED groups compared with the control group (p < 0.01). The PSS scores of both groups with ED were significantly higher than the control group (p < 0.01). Compared with the CP/CPPS group, the differences of PSS, SCL-90 and TAPT scores were statistically significant in CP/CPPS+ED patients (p < 0.01). The IPSS scores were shown to have significantly positive correlations with BAI (r = 0.32, p < 0.0001), PSS (r = 0.18, p < 0.01) and SCL-90 (r = 0.19, p < 0.01) in the CP/CPPS patients. However, in all subjects, the IIEF-5 scores were shown to have significantly negative correlations with BAI (r = -0.17,p < 0.001), PSS (r = -0.25,p < 0.0001), SCL-90 (r = -0.20,p < 0.001) and quality of life score in NIH-CPSI (r = -0.14,p = 0.0075). Cortisol awakening response (CAR) parameters and diurnal cortisol levels did not significantly vary between the four groups. Time-dependent parameters of HRV also did not differ significantly across groups. In the frequency domain analysis, low frequency (LF) was significantly lower in ED patients when compared with CP/CPPS+ED patients (p = 0.044) and healthy controls (p = 0.005), high frequency (HF) power was significantly higher in healthy controls compared to patients with ED (p < 0.001), CP/CPPS (p < 0.001) and CP/CPPS+ED (p < 0.001), and the CP/CPPS+ED group had significantly higher LF/HF ratio than the control group (p = 0.001). CONCLUSION CP/CPPS and ED patients score exceedingly high on most psychosocial variables. The symptom scores of LUTS and ED positively correlate with the severity of psychological stress. Our findings also suggest that the ANS sympathovagal imbalance is associated with ED and LUTS in CP/CPPS, whereas HPA axis activity is not.
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Affiliation(s)
- Jian Bai
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Longjie Gu
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yinwei Chen
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaming Liu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jun Yang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Mingchao Li
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiyuan Dong
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shulin Yang
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Bo Huang
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tao Wang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lei Jin
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jihong Liu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shaogang Wang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Tawfik AM, Radwan MH, Abdulmonem M, Abo-Elenen M, Elgamal SA, Aboufarha MO. Tadalafil monotherapy in management of chronic prostatitis/chronic pelvic pain syndrome: a randomized double-blind placebo controlled clinical trial. World J Urol 2022; 40:2505-2511. [PMID: 35802142 PMCID: PMC9512753 DOI: 10.1007/s00345-022-04074-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 06/07/2022] [Indexed: 11/29/2022] Open
Abstract
Purpose In this placebo-controlled trial, we aimed to evaluate the clinical results of using PDE-5 inhibitor, tadalafil 5 mg OD, for management of CP/CPPS. Patients and methods 140 patients ≤ 45 years old with moderate/severe CP/CPPS associated with ED (IIEF-5 < 22) were randomly divided and received either tadalafil 5 mg OD (tadalafil-group) or placebo (control-group) for 6 weeks. Post-treatment CPSI scores were compared to baseline and to placebo. Clinically significant responders (≥ 25% reduction from baseline score) were calculated. Tadalafil-induced changes in IIE-5 were evaluated in correlation to that of CPSI scores. Results By the 6th week, 59 and 56 patients were available in both groups respectively. Compared to baseline, tadalafil-group patients showed significant improvement in total, pain, urinary and Qol domains of CPSI (19.1 ± 5.26, 10.42 ± 3.55, 4.2 ± 1.72 and 4.47 ± 1.64 vs. 24.21 ± 5.05, 12.14 ± 3.57, 6.08 ± 1.53 and 6.22 ± 1.76), p < 0.5. When compared to placebo, all 6th week CPSI domains scores, except for pain, were significantly better in tadalafil-group (p < 0.05). Post-treatment pain score didn't significantly differ between both groups (10.42 ± 3.55, vs. 11.71 ± 3.9, p > 0.05). Clinically significant responders were 30 patients (50.8%) in tadalafil-group vs. 3 patients (5.4%) in control. Tadalafil-induced changes in IIEF-5 score had weak but significant correlation to Qol domain (r = − 0.28, p < 0.05). Conclusion Tadalafil 5 mg OD can significantly improve all CPSI domains as compared to baseline. Post-treatment CPSI scores, except for pain, were better than placebo. About 50.8% of patients can develop ≥ 25% reduction in their total CPSI scores after treatment. Apart from Qol domain, these changes are not significantly correlated to tadalafil-induced IIEF-5 scores changes.
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Affiliation(s)
- Ahmed M Tawfik
- Urology Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
| | - Mohammed H Radwan
- Urology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | | | | | - Samir A Elgamal
- Urology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
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Application Analysis of UPOINT System in Chinese Type III Prostatitis Patients: A Single Center Experience. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:9227032. [PMID: 35547566 PMCID: PMC9085319 DOI: 10.1155/2022/9227032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 03/12/2022] [Accepted: 04/15/2022] [Indexed: 12/03/2022]
Abstract
Objective UPOINT clinical phenotype system was used to estimate the type III prostatitis patients. Put in the erectile dysfunction (ED) domain and analysis the ED domain's effect towards the UPOINT system. Methods A total of 126 patients with type III prostatitis were prospectively collected and classified in each domain of the UPOINT system, including urinary, psychosocial, organ-specific, infection, neurological/systemic, and tenderness. Symptom severity was measured using the national institutes of health chronic prostatitis symptom index (NIH-CPSI) and the international prostate symptom score (IPSS). The erectile function was evaluated using the international index of erectile function (IIEF-5). Mental state was evaluated using the Symptom Checklist 90 (SCL-90). The quality of life of patients was assessed by the Quality of Life scale (QoL). Results The percentage of patients positive for each domain was 60.32%, 43.65%, 53.17%, 11.11%, 42.06%, and 33.33% for the urinary, psychosocial, organ-specific, infection, neurological/systemic, and tenderness, respectively. There were significant correlations between the number of positive UPOINT domains and total NIH-CPSI (r = 0.630, P < 0.001) and IPSS (r = 0.429, P < 0.001). Symptom duration was associated with a number of positive domains (r = 0.194, P < 0.05). After adding an ED domain to establish a modified UPOINT system, the correlation between the number of positive domains and symptom severity was not improved (0.630 to 0.590, P < 0.001). The percentage of the patients who suffered psychosocial problems was 43.65%. Conclusions In our cohort, the number of positive domains was correlated with symptom severity. Inclusion of the ED phenotype in the UPOINT phenotype classification system did not significantly enhance the association of positive presentation with symptom severity. Our findings presented do not support the utility of using ED as a stand-alone item in the UPOINT domain. Psychological problems should be considered when treating type III prostatitis patients.
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Lee JH, Yoo TK, Kang JY, Cho JM, Park YW, Lee SW, Choi JD. Relationship between erectile dysfunction and moderate to severe prostatitis-like symptoms in middle-aged men: a propensity score-matched analysis. Int Urol Nephrol 2021; 53:2261-2266. [PMID: 34546557 DOI: 10.1007/s11255-021-02991-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 09/06/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE We assessed the relationship between chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and erectile dysfunction (ED) using propensity score matching. METHODS Data from 8727 middle-aged men who had undergone health checkups were analyzed. The National Institutes of Health Chronic Prostatitis Symptoms Index (NIH-CPSI), the International Index of Erectile Function-5 (IIEF), the Premature Ejaculation Diagnostic Tool (PEDT), testosterone measurement, basic blood chemistry, and metabolic syndrome (MetS) assessment were performed in this study. Of the 8727 men considered, 7181 formed the cohort for propensity score matching, including 597 men with moderate to severe prostatitis-like symptoms (case) and 6584 men with no prostatitis-like symptoms (control); ultimately, however, members of the case and control groups were matched at a 1:1 ratio by propensity score. RESULTS After matching, the variables of age, testosterone, PEDT and MetS were evenly distributed between the groups. After matching, the mean IIEF score of the case group was significantly lower than that of the control group (17.2 ± 5.5 vs. 14.7 ± 5.3; P < 0.001). Additionally, the severity of ED was significantly greater in the case group (no, mild, mild to moderate, moderate, and severe, respectively: 27.5%, 30.2%, 24.6%, 13.1%, and 4.7% in the control group; 10.7%, 27.0%, 33.0%, 18.9%, and 10.4% in the case group; P < 0.001). Finally, the rate of moderate to severe ED was significantly higher in the case group than in the control group (17.8% vs. 29.3%; P < 0.001). CONCLUSION Moderate to severe prostatitis-like symptoms were significantly and independently correlated with ED in middle-aged men.
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Affiliation(s)
- Jun Ho Lee
- Department of Urology, Nowon Eulji Medical Center, Eulji University School of Medicine, 327, Gongneung-ro, Nowon-gu, Seoul, 01830, Republic of Korea
| | - Tag Keun Yoo
- Department of Urology, Nowon Eulji Medical Center, Eulji University School of Medicine, 327, Gongneung-ro, Nowon-gu, Seoul, 01830, Republic of Korea
| | - Jung Yoon Kang
- Department of Urology, Nowon Eulji Medical Center, Eulji University School of Medicine, 327, Gongneung-ro, Nowon-gu, Seoul, 01830, Republic of Korea
| | - Jeong Man Cho
- Uijeongbu Eulji Medical Center, Eulji University, Uijeongbu-si, Republic of Korea
| | - Yeon Won Park
- Department of Urology, National Police Hospital, Seoul, South Korea
| | - Sin Woo Lee
- Department of Urology, Nowon Eulji Medical Center, Eulji University School of Medicine, 327, Gongneung-ro, Nowon-gu, Seoul, 01830, Republic of Korea
| | - Jae Duck Choi
- Department of Urology, Nowon Eulji Medical Center, Eulji University School of Medicine, 327, Gongneung-ro, Nowon-gu, Seoul, 01830, Republic of Korea.
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Zhang Y, Ma H, Nan T, Li Y, Zheng W, Zhou Z, Gong X. Comparative Efficacy of Oral Chinese Patent Medicine for Chronic Prostatitis/Chronic Pelvic Pain Syndrome With Sexual Dysfunction: A Bayesian Network Meta-Analysis of Randomized Controlled Trials. Front Pharmacol 2021; 12:649470. [PMID: 34040523 PMCID: PMC8143435 DOI: 10.3389/fphar.2021.649470] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 04/22/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Oral Chinese patent medicine (OCPM) combined with western medicine (WM) are believed to be effective for the therapy of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) with sexual dysfunction (SD). These western medicines mainly involve antibiotics, phosphodiesterase type-5 inhibitor (PDE-5i), α-blockers. But there is no randomized controlled trial (RCT) that directly compares the efficacy of different OCPM. Hence, we operated a network meta-analysis (NMA) to contrast the efficacy of different OCPM for CP/CPPS with SD. Methods: Relevant studies were searched in PubMed, Cochrane Library, Web of Science, Embase, China National Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP), and Wanfang database. All of the RCTs concentrated on the use of OCPM to cure CP/CPPS with SD from the inception of the databases to November 2020. We appraised the risk of bias under the Cochrane Handbook and CONSORT statement. The data were statistically analyzed via STATA 13.0 and WinBUGS 1.4.3 instrument. Results: Altogether, 30 pieces of literature with 2,996 participants containing 11 oral Chinese patent medicine and 11 interventions were included in the NMA. In terms of The National Institutes of Health chronic prostatitis symptom index (NIH-CPSI), Qianlie Shutong Capsules (QLSTC) + WM had the most possible of being the optimal treatment. In the light of the International Index of Erectile Function (IIEF-5), Congrong Yishen Granules (CRYSG) + WM had the most possible of being the optimal treatment. Shugan Yiyang Capsules (SGYYC) + WM performed the highest likelihood efficacy under cluster rank graph combined NIH-CPSI and IIEF-5. Liuwei Dihuang Pills/Yougui capsules (LWDHP/YGC) + WM had highly possible to be the optimal treatment not only for the clinical effective rate of CP/CPPS but also for the clinical effective rate of SD. Considering four outcomes, QLSTC, CRYSG, SGYYC, LWDHP/YGC, Qianlie Beixi Capsules (QLBXC) plus WM were the best therapy approach for CP/CPPS with SD, especially LWDHP/YGC + WM and QLBXC + WM. Conclusion: Based on the NMA, QLSTC, CRYSG, SGYYC, LWDHP/YGC, QLBXC plus WM demonstrated the maximum probability of being the optimal therapies. Owing to the limitations of this research, these results should be confirmed by elaborate RCTs. Systematic Review Registration: [https://www.crd.york.ac.uk/prospero/], identifier [CRD42021224060].
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Affiliation(s)
- Yang Zhang
- Shaanxi University of Chinese Medicine, Xianyang, China
| | - Hongzhao Ma
- The Second Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, China
| | - Tao Nan
- The Second Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, China
| | - Yongqiang Li
- The Second Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, China
| | - Wei Zheng
- The Second Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, China
| | - Zhihui Zhou
- The Second Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, China
| | - Xiaoyong Gong
- The Second Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, China
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Mykoniatis I, Pyrgidis N, Sokolakis I, Sountoulides P, Hatzichristodoulou G, Apostolidis A, Hatzichristou D. Low‐intensity shockwave therapy for the management of chronic prostatitis/chronic pelvic pain syndrome: a systematic review and meta‐analysis. BJU Int 2021; 128:144-152. [DOI: 10.1111/bju.15335] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Ioannis Mykoniatis
- Department of Urology School of Health Sciences Faculty of Medicine Aristotle University of Thessaloniki Thessaloniki Greece
| | - Nikolaos Pyrgidis
- Department of Urology School of Health Sciences Faculty of Medicine Aristotle University of Thessaloniki Thessaloniki Greece
- Department of Urology ‘Martha‐Maria’ Hospital Nuremberg Nuremberg Germany
| | - Ioannis Sokolakis
- Department of Urology ‘Martha‐Maria’ Hospital Nuremberg Nuremberg Germany
| | - Petros Sountoulides
- Department of Urology School of Health Sciences Faculty of Medicine Aristotle University of Thessaloniki Thessaloniki Greece
| | | | - Apostolos Apostolidis
- Department of Urology School of Health Sciences Faculty of Medicine Aristotle University of Thessaloniki Thessaloniki Greece
| | - Dimitrios Hatzichristou
- Department of Urology School of Health Sciences Faculty of Medicine Aristotle University of Thessaloniki Thessaloniki Greece
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Wang H, Ma M, Qin F, Yuan J. The influence of prostatic calculi on lower urinary tract symptoms and sexual dysfunction: a narrative review. Transl Androl Urol 2021; 10:929-938. [PMID: 33718093 PMCID: PMC7947430 DOI: 10.21037/tau-20-1046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Prostatic calculi (PC) are commonly found in patients who present for urologic consultation. However, the effect of PC on urinary symptoms remains controversial. In this study, we searched the Embase and PubMed databases for literature related to the following keywords: “prostatic calculi”, “prostatic stone”, “prostatic lithiasis” and “prostatic calcification”, along with the limits, “lower urinary tract symptoms”, “sexual dysfunction”, “erectile dysfunction”, “erectile function”, and “premature ejaculation”. According to the literature, there are various subtypes of PC based on X-ray or ultrasound findings, including type I/II, type A/B, and endogenous PC/extrinsic PC. Furthermore, the formation of PC remains unclear, and more importantly, the ability of PC to cause lower urinary tract symptoms (LUTS) and sexual dysfunction (SD) is worth exploring. We retrospectively reviewed all available literature and found that most studies agreed that PC are associated with LUTS. The factors which may play an important role in the pathogenesis of LUTS include the size and location of PC, induced inflammation, and the blood flow of the prostate. Similarly, SD was also examined in the patients with PC, and psychological factors cannot be ignored in this regard. However, more in-depth study of the molecular mechanisms, including prospective, controlled, longitudinal, and large- sample studies, are needed in the future.
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Affiliation(s)
- Hao Wang
- Andrology Laboratory, West China Hospital, Sichuan University, Chengdu, China.,Department of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Ming Ma
- Andrology Laboratory, West China Hospital, Sichuan University, Chengdu, China.,Department of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Feng Qin
- Andrology Laboratory, West China Hospital, Sichuan University, Chengdu, China
| | - Jiuhong Yuan
- Andrology Laboratory, West China Hospital, Sichuan University, Chengdu, China.,Department of Urology, West China Hospital, Sichuan University, Chengdu, China
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11
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Li XC, Zhang XB, Liao ZC, Tang ZY, Li DJ. Is mild erectile dysfunction associated with severe psychological symptoms in Chinese patients with moderate-to-severe chronic prostatitis/chronic pelvic pain syndrome? Asian J Androl 2021; 23:319-324. [PMID: 33208565 PMCID: PMC8152419 DOI: 10.4103/aja.aja_71_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
This study aimed to assess the association between psychological disorders and erectile dysfunction (ED) in patients with different degrees of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). This was a retrospective study conducted from June 2017 to October 2019 and included 182 outpatients. Patients were interviewed using the Structured Interview on Erectile Dysfunction (SIEDY) for pathogenic quantification. The National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) and the International Index of Erectile Function-5 (IIEF-5) were used for the evaluation of CP/CPPS and ED. The Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) were used to assess anxiety symptoms and depressive symptoms. The number of patients with mild CP/CPPS and mild ED, mild CP/CPPS and moderate-to-severe ED, moderate-to-severe CP/CPPS and mild ED, and moderate-to-severe CP/CPPS and moderate-to-severe ED was 69 (37.9%), 36 (19.8%), 35 (19.2%), and 42 (23.1%), respectively. The corresponding PHQ-9 scores of the four groups were 6.22, 7.19, 10.69, and 7.71, respectively. The corresponding GAD-7 scores of the four groups were 5.26, 6.31, 8.77, and 6.36, respectively. Among patients with moderate-to-severe CP/CPPS, the PHQ-9 and GAD-7 scores of the moderate-to-severe ED group were significantly lower than those of the mild ED group (P = 0.007 and P = 0.010, respectively). The prevalence of ED and premature ejaculation (PE) in patients with moderate-to-severe CP/CPPS was significantly higher than that in patients with mild CP/CPPS (P = 0.001 and P = 0.024, respectively). Our findings proved that the severity of ED was negatively associated with psychological symptoms in outpatients with moderate-to-severe CP/CPPS.
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Affiliation(s)
- Xiu-Cheng Li
- Department of Urology, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Xiao-Bo Zhang
- Xiangya International Medical Center, Department of Geriatric Urology, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Zhang-Cheng Liao
- Department of Urology, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Zheng-Yan Tang
- Department of Urology, Xiangya Hospital, Central South University, Changsha 410008, China.,Provincial Laboratory for Diagnosis and Treatment of Genitourinary System Disease, Changsha 410008, China
| | - Dong-Jie Li
- Xiangya International Medical Center, Department of Geriatric Urology, Xiangya Hospital, Central South University, Changsha 410008, China.,Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha 410008, China.,Hunan Key Laboratory of Pharmacogenetics, Institute of Clinical Pharmacology, Central South University, Changsha 410078, China.,National Clinical Research Center for Geriatric Disorders, Changsha 410008, China
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12
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Padoa A, McLean L, Morin M, Vandyken C. "The Overactive Pelvic Floor (OPF) and Sexual Dysfunction" Part 1: Pathophysiology of OPF and Its Impact on the Sexual Response. Sex Med Rev 2020; 9:64-75. [PMID: 32238325 DOI: 10.1016/j.sxmr.2020.02.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 11/30/2019] [Accepted: 02/02/2020] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Overactive pelvic floor (OPF) muscles are defined as muscles that do not relax, or may even contract, when relaxation is needed, for example, during micturition or defecation. Conditions associated with OPF are multifactorial and include multiple possible etiologies and symptom complexes. The complex interplay between biological and psychosocial elements can lead to the persistence of OPF symptoms along with psychological and emotional distress. OBJECTIVES (1) To review and contextualize, from a pathophysiologic perspective, the evidence for OPF, (2) to provide an overview of common clinical presentations and comorbidities of OPF, and (3) to discuss the effect of OPF on sexual function in men and women. METHODS Review of the updated literature on the pathophysiology of OPF was carried out. OPF-associated conditions were overviewed, with special emphasis on the impact on sexual function in men and women. RESULTS Individuals with suspected OPF often present with a combination of gastrointestinal, gynecological, musculoskeletal, sexual, and urological comorbidities, mostly accompanied by psychoemotional distress. In both women and men, sexual function is significantly impaired by OPF and genitopelvic pain penetration disorders are often the primary manifestation of this condition. Women with OPF report less sexual desire, arousal, and satisfaction; more difficulty reaching orgasm; lower frequencies of intercourse; more negative attitudes toward sexuality; and more sexual distress than women without sexual pain. The most frequently reported sexual dysfunctions in men with OPF include erectile dysfunction, premature ejaculation, and ejaculatory pain. CONCLUSION The complex pathophysiology of OPF involving multisystemic comorbidities and psychosocial factors emphasize the importance of a biopsychosocial assessment for guiding effective and personalized management. Padoa A, McLean L, Morin M, et al. "The Overactive Pelvic Floor (OPF) and Sexual Dysfunction" Part 1: Pathophysiology of OPF and Its Impact on the Sexual Response. Sex Med 2021;9:64-75.
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Affiliation(s)
- Anna Padoa
- Department of Obstetrics and Gynecology, Yitzhak Shamir (formerly Assaf Harofe) Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Linda McLean
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Melanie Morin
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke and Research Center of the Centre hospitalier de l'Université de Sherbrooke (CHUS), Sherbrooke, QC, Canada
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13
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Corpus cavernosum smooth muscle cell dysfunction and phenotype transformation are related to erectile dysfunction in prostatitis rats with chronic prostatitis/chronic pelvic pain syndrome. JOURNAL OF INFLAMMATION-LONDON 2020; 17:2. [PMID: 31911760 PMCID: PMC6945598 DOI: 10.1186/s12950-019-0233-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 12/29/2019] [Indexed: 01/09/2023]
Abstract
Background The relationship between chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and erectile dysfunction (ED) has been shown in many studies. However, the specific mechanism remains unclear. This study was to investigate the corpus cavernosum smooth muscle cell function and phenotype transformation in Experimental autoimmune prostatitis (EAP) rats. Methods EAP was induced in rats by using prostate protein supplemented with immuneadjuvant extraction, and the max-ICP and MAP were measured. IHC and Masson staining were done to assess inflammatory infiltration and collagen deposition in the corpus cavernosum, respectively. Subsequently, normal rat and EAP rat CCSMCs were purified by tissue block implantation and differential adherence method. The oxidative stress, smooth muscle phenotype transformation, cell cycle and intracellular calcium ion transport were also evaluated. Results The ratio of max ICP/MAP in EAP rats significantly reduced, and the TNF-α content and collagen deposition in the corpus cavernosum markedly increased as compared to healthy rats. High-purity rat CCSMCs were obtained. Oxidative stress was evident and the cGMP content decreased in the EAP rat CCSMCs. The expression of Cav1.2, IP3R1 and RyR2 increased, but the SERCA2 expression decreased in EAP rat CCSMCs, which was accompanied by increased intracellular calcium. Increased expression of OPN, collagen and KCa3.1, decreased Calponin expression and increased proportion of cells in the S phase were also observed in the EAP rat CCSMCs. Conclusion CP causes oxidative stress and imbalance of intracellular calcium in CCSMCs and promotes CCSMCs transformation from contractile to synthetic state, which may be involved in the pathogenesis of ED.
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14
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ASSOCIATION OF ERECTILE DYSFUNCTION AND PREMATURE EJACULATION IN MEN WITH CHRONIC PROSTATITIS. JOURNAL OF MEN'S HEALTH 2020. [DOI: 10.15586/jomh.v16isp1.185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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15
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Salehi B, Butnariu M, Corneanu M, Sarac I, Vlaisavljevic S, Kitic D, Rahavian A, Abedi A, Karkan MF, Bhatt ID, Jantwal A, Sharifi-Rad J, Rodrigues CF, Martorell M, Martins N. Chronic pelvic pain syndrome: Highlighting medicinal plants toward biomolecules discovery for upcoming drugs formulation. Phytother Res 2019; 34:769-787. [PMID: 31799719 DOI: 10.1002/ptr.6576] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 10/18/2019] [Accepted: 11/14/2019] [Indexed: 12/27/2022]
Abstract
Chronic pelvic pain syndrome (CPPS) can be triggered by a various types of gynecological, gastrointestinal, urological, and musculoskeletal disorders. Recently, the role of the central nervous system has proven to be an integral part on the development of any chronic pain syndrome, including CPPS. However, owing to the complex and heterogeneous etiology and pathophysiology of CPPS, the establishment of effective therapeutic interventions remains challenging for both physicians and patients. Nonetheless, recent studies have pointed that medicinal plants and their secondary metabolites can be effectively used in CPPS therapy, besides contributing to restore the patients' quality of life and potentiate the conventional CPPS management. In this sense, this review aims to provide a careful overview on the biomedical data for the use of medicinal plants use and their secondary metabolites on CPPS management.
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Affiliation(s)
- Bahare Salehi
- Student Research Committee, School of Medicine, Bam University of Medical Sciences, Bam, Iran
| | - Monica Butnariu
- Banat's University of Agricultural Sciences and Veterinary Medicine "King Michael I of Romania" from Timisoara, University of Timişoara, Timişoara, Romania
| | - Mihaela Corneanu
- Banat's University of Agricultural Sciences and Veterinary Medicine "King Michael I of Romania" from Timisoara, University of Timişoara, Timişoara, Romania
| | - Ioan Sarac
- Banat's University of Agricultural Sciences and Veterinary Medicine "King Michael I of Romania" from Timisoara, University of Timişoara, Timişoara, Romania
| | - Sanja Vlaisavljevic
- Department of Chemistry, Biochemistry and Environmental Protection, Faculty of Sciences, University of Novi Sad, Novi Sad, Serbia
| | - Dusanka Kitic
- Faculty of Medicine, Department of Pharmacy, University of Niš, Bul. Zorana Djindjica 81, Serbia
| | - Amirhossein Rahavian
- Department of Urology, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amirreza Abedi
- Department of Urology, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Morteza F Karkan
- Department of Urology, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Indra D Bhatt
- G.B. Pant National Institute of Himalayan Environment and Sustainable Development, Kosi Katarmal, Almora, India
| | - Arvind Jantwal
- Department of Pharmaceutical Sciences, Bhimtal Campus, Kumaun University, Nainital, India
| | - Javad Sharifi-Rad
- Zabol Medicinal Plants Research Center, Zabol University of Medical Sciences, Zabol, Iran
| | - Célia F Rodrigues
- LEPABE, Department of Chemical Engineering, Faculty of Engineering, University of Porto, Porto, Portugal
| | - Miquel Martorell
- Department of Nutrition and Dietetics, Faculty of Pharmacy, University of Concepcion, Concepcion, Chile.,Universidad de Concepción, Unidad de Desarrollo Tecnológico, Concepcion, Chile
| | - Natália Martins
- Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, Porto, Portugal.,Institute for Research and Innovation in Health (i3S), University of Porto, Portugal
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16
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Huang T, Wang G, Hu Y, Shi H, Wang K, Yin L, Peng B. Structural and functional abnormalities of penile cavernous endothelial cells result in erectile dysfunction at experimental autoimmune prostatitis rat. JOURNAL OF INFLAMMATION-LONDON 2019; 16:20. [PMID: 31372097 PMCID: PMC6659287 DOI: 10.1186/s12950-019-0224-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 07/02/2019] [Indexed: 01/08/2023]
Abstract
Background There is growing recognition of the association of CP/CPPS accompany with ED. However, the specific mechanism of action remains unclear. The aim of this study was to investigate structural and functional abnormalities of cavernous endothelial cells in EAP rat, which may result in the ED. Methods we use rat prostate protein extract supplemented with immunoadjuvant to induce EAP rat, ICP and MAP were measured and inflammatory factor infiltration, Akt, eNOS, AR, nNOS and iNOS in the corpus cavernosum were tested. Subsequently, the normal rat and EAP rat cavernosum endothelial cells were purified by MACS, and the metabolism, oxidative stress, MMP, Akt, eNOS, AR and iNOS were evaluated. Results The EAP rat model was successfully constructed. The ratio of max ICP/MAP in EAP rat was significantly lower and TNF-α infiltration in corpus cavernosum was significantly higher than normal rats. Besides, Akt, eNOS and AR were decreased, iNOS was significantly increased. The growth and metabolism of endothelial cells in the EAP rats corpus cavernosum decreased and inflammatory factor mRNA was increased and intracellular oxidative stress was also increased significantly. The MMP of EAP rats cavernosum endothelial cells decreased and the expression of Akt, eNOS and AR were also significantly decreased, iNOS was significantly increased. Conclusion The prostate suffer local inflammatory infiltrate and promotes cytokines infiltrated into corpus cavernosum caused the oxidative stress increases and the metabolism or MMP decreases. In addition, AR, Akt and eNOS expression and phosphorylation are also reduced, thereby inhibiting the diastolic function of the corpus cavernosum, resulting in decreased erectile function.
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Affiliation(s)
- Tianrun Huang
- Department of Urology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, NO 301 Yanchang Road, Shanghai, 200072 People's Republic of China
| | - Guangchun Wang
- Department of Urology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, NO 301 Yanchang Road, Shanghai, 200072 People's Republic of China
| | - Yangyang Hu
- Department of Urology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, NO 301 Yanchang Road, Shanghai, 200072 People's Republic of China
| | - Heng Shi
- Department of Urology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, NO 301 Yanchang Road, Shanghai, 200072 People's Republic of China
| | - Keyi Wang
- Department of Urology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, NO 301 Yanchang Road, Shanghai, 200072 People's Republic of China
| | - Lei Yin
- Department of Urology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, NO 301 Yanchang Road, Shanghai, 200072 People's Republic of China
| | - Bo Peng
- Department of Urology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, NO 301 Yanchang Road, Shanghai, 200072 People's Republic of China
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17
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Qin Z, Liu Y, Zhou K, Wu J, Pang R, Li N, Xu C, Kwong JSW, Liu Z. Acupuncture for chronic prostatitis/chronic pelvic pain syndrome: study protocol for a randomized controlled trial. Trials 2017; 18:616. [PMID: 29273095 PMCID: PMC5741861 DOI: 10.1186/s13063-017-2383-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 12/05/2017] [Indexed: 02/05/2023] Open
Abstract
Background Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common condition affecting men of all ages. Acupuncture may be an effective treatment option for CP/CPPS, but evidence is limited. We propose to evaluate the effectiveness of acupuncture in a rigorously conducted trial. Methods Ten hospitals will recruit 440 participants with CP/CPPS in China from October 2017 to December 2019. Participants will be randomly allocated to acupuncture or sham acupuncture with a 1:1 ratio using computerized simple random sampling. The whole study consists of 2-week baseline, 8-week treatment, and 24-week follow up. Twenty 30-mintute sessions of acupuncture or sham acupuncture treatment will be provided between week 1 and 8. The two co-primary outcomes are the proportion of responders at week 8 and week 32. Secondary outcomes include proportion of responders in the two groups at different time points; change in the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) total score; change in the NIH-CPSI subscales; change in the International Prostate Symptom Score; change in the Hospital Anxiety and Depression Scale; expectation assessments; proportions of participants in each response category of the Global Response Assessment; change in the International Index of Erectile Function 5; change in the five-level EuroQol five-dimensional questionnaire and a visual analogue scale; and changes in peak and average urinary flow rate. Discussion This study will provide robust evidence on whether acupuncture is effective for relieving symptoms of CP/CPPS. Trials registration ClinicalTrials.gov, NCT03213938. Registered on 5 July 2017. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-2383-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Zongshi Qin
- Department of Acupuncture and Neurology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.,School of Life Sciences, Beijing University of Chinese Medicine, Beijing, China
| | - Yan Liu
- Data Centre of Traditional Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Kehua Zhou
- Catholic Health System Internal Medicine Training Program, Sisters of Charity Hospital, University at Buffalo, Buffalo, NY, USA
| | - Jiani Wu
- Department of Acupuncture and Neurology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Ran Pang
- Department of Urology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Ning Li
- West China Hospital, Sichuan University, Chengdu, China
| | - Chang Xu
- Chinese Evidence-Based Medicine Center and Chinese Cochrane Center, West China Hospital, Sichuan University, Chengdu, China
| | - Joey S W Kwong
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Zhishun Liu
- Department of Acupuncture and Neurology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
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18
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Cao JJ, Huang W, Wu HS, Cao M, Zhang Y, Jin XD. Prostatic Calculi: Do They Matter? Sex Med Rev 2017; 6:482-491. [PMID: 29157875 DOI: 10.1016/j.sxmr.2017.10.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2017] [Revised: 10/09/2017] [Accepted: 10/12/2017] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Prostatic calculi (PC) are frequently detected at computed tomography or ultrasound in men attending the health center or the urology outpatient department. PC have attracted more attention from urologists, but the clinical significance of PC is unknown. AIM To review the available literature on the effects of PC on prostatic diseases and sexual function in men. METHODS Relevant clinical trials were identified by searching the PubMed, Embase, and Cochrane Library databases. Results were classified, summarized, and analyzed. MAIN OUTCOME MEASURES Transabdominal and rectal ultrasonography; urodynamics analysis; International Prostate Symptom Score; pathologic examination of prostatic tissue; prostate-specific antigen; and expressed prostatic secretion. RESULTS PC can not only prolong the duration of bothersome symptoms but also decrease the cure rate of antibacterial therapy in patients with chronic prostatitis. Patients with PC usually have more severe lower urinary tract symptoms (LUTS), and some studies reported that moderate to marked PC are a predisposing factor for moderate to severe LUTS. Studies also reported that the serum level prostate-specific antigen is not influenced by PC. In addition, the presence of PC is not associated with an increased risk of prostate cancer. However, the correlation between PC in the peripheral zone and prostate cancer is statistically significant. In addition, the association between PC and Gleason scores is controversial. Some novel studies suggested that PC might play an important role in sexual impairment in middle-age men or men with chronic pelvic pain syndrome or chronic prostatitis. Recently, PC were found to increase the incidence of severe LUTS, urinary retention, and hematospermia after transrectal ultrasound-guided prostate biopsy. CONCLUSION PC can aggravate LUTS, chronic prostatitis, and sexual dysfunction in men, but the association between PC and prostate cancer is still controversial. Cao J-J, Huang W, Wu H-S, et al. Prostatic Calculi: Do They Matter? Sex Med Rev 2018;6:482-491.
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Affiliation(s)
- Jun-Jie Cao
- Department of Urology, The First Affiliated Hospital, Zhejiang University, School of Medicine, Hangzhou, Zhejiang, China
| | - Wei Huang
- Department of Urology, The First Affiliated Hospital, Zhejiang University, School of Medicine, Hangzhou, Zhejiang, China
| | - Hong-Shen Wu
- Department of Urology, The First Affiliated Hospital, Zhejiang University, School of Medicine, Hangzhou, Zhejiang, China
| | - Min Cao
- Department of Urology, The First Affiliated Hospital, Zhejiang University, School of Medicine, Hangzhou, Zhejiang, China
| | - Yan Zhang
- Department of Urology, The First Affiliated Hospital, Zhejiang University, School of Medicine, Hangzhou, Zhejiang, China
| | - Xiao-Dong Jin
- Department of Urology, The First Affiliated Hospital, Zhejiang University, School of Medicine, Hangzhou, Zhejiang, China.
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19
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Prospective Study on Association of Prostatic Calcifications with Clinical Symptoms and Results of Treatment in Men with type III prostatitis. Sci Rep 2017; 7:5234. [PMID: 28701725 PMCID: PMC5507924 DOI: 10.1038/s41598-017-05550-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 05/31/2017] [Indexed: 12/21/2022] Open
Abstract
The purpose is to investigate the clinical significance of prostatic calculi in patients with chronic prostatitis and to discuss the possible treatment.The data from 277 young males with CP/CPPS were analyzed prospectively. Symptom severity was measured using the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) and the International Prostatic Symptoms Score (IPSS). Sexual function was assessed by the International Index of Erectile Function (IIEF-5) questionnaire. After four weeks of therapy, the NIH-CPSI, IPSS, and IIEF-5 tests were repeated. The variables were compared between patients with and without prostatic calcifications using the Students t-test or chi-square test. No significant differences were found between CP/CPPS patients with and without prostatic calcifications regarding age, body mass index, prostate volume, CPSI, IPSS and IIEF-5. Men with calcifications endured symptoms significantly longer (37.9 ± 25.2 versus 19.0 ± 16.4 months, P < 0.01), and had significantly higher white blood cell counts per high power field in expressed prostatic secretions (7.7 ± 12.8 versus 3.9 ± 4.7; P < 0.01), than patients without prostatic calcifications, who responded better to medication compared with patients with prostatic calcifications. In conclusion, patients with calcifications were more likely to have category IIIA disease and they required a longer medication period.
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20
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Lin WY, Chang YH, Lin CL, Kao CH, Wu HC. Erectile dysfunction and the risk of prostate cancer. Oncotarget 2017; 8:52690-52698. [PMID: 28881762 PMCID: PMC5581061 DOI: 10.18632/oncotarget.17082] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 03/21/2017] [Indexed: 12/22/2022] Open
Abstract
Background Prostate cancer (PCa) is the most commonly diagnosed malignancy and the third leading cause of cancer death among men in developed countries. Because some risk factors are common between erectile dysfunction (ED) and PCa, we investigated the association between ED and subsequent PCa. Methods This nationwide population-based cohort study used data from the Taiwan National Health Insurance Research Database for the period 2000–2010. We identified patients newly diagnosed with ED by using codes from the International Classification of Diseases, Ninth Revision, Clinical Modification. Results In total, 5858 and 23432 patients were enrolled in the ED and non-ED cohorts, respectively. After adjustment for age, sex, and comorbidities, the overall incidence densities of PCa were significantly higher in the ED cohort than in the non-ED cohort, with an adjusted hazard ratio (aHR) of 1.19. The age-specific relative risk of PCa was significantly higher for all age groups in the ED cohort than in the non-ED cohort. Compared with patients without ED, those with organic ED had a 1.27-fold higher risk of PCa. Conclusion ED is a harbinger of PCa in some men. Physicians should consider the possibility of occult PCa in patients with ED regardless of age and comorbidities.
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Affiliation(s)
- Wei-Yu Lin
- Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Gia-Yi, Taiwan.,Chang Gung University of Science and Technology, Chia-Yi, Taiwan.,Department of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ying-Hsu Chang
- Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, LinKo, Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.,School of Medicine, China Medical University, Taichung, Taiwan
| | - Chia-Hung Kao
- Graduate Institute of Clinical Medical Science, College of Medicine, China Medical University, Taichung, Taiwan.,Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan.,Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan
| | - Hsi-Chin Wu
- Department of Urology, China Medical University Hospital, Taichung, Taiwan.,Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
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21
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Zhang Z, Li Z, Yu Q, Wu C, Lu Z, Zhu F, Zhang H, Liao M, Li T, Chen W, Xian X, Tan A, Mo Z. The prevalence of and risk factors for prostatitis-like symptoms and its relation to erectile dysfunction in Chinese men. Andrology 2016; 3:1119-24. [PMID: 26769668 DOI: 10.1111/andr.12104] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 07/14/2015] [Accepted: 08/12/2015] [Indexed: 11/29/2022]
Abstract
The aim of this study was to describe the prevalence of and risk factors for prostatitis-like symptoms and its relation to erectile dysfunction (ED) among southern Chinese men. Data were collected from 2790 men attending the Fangchenggang Area Male Healthy and Examination Survey from September 2009 to December 2009. The prostatitis-like symptoms were assessed by the NIH Chronic Prostatitis Symptom Index and ED was assessed using the 5-item International Index of Erectile Function. Lifestyle and demographic characteristics were obtained through a questionnaire. Prevalence of prostatitis-like symptoms was 12.4% among 2790 Chinese men aged 20-84 years. In smokers who smoked ≥20 cigarettes per day (age-adjusted OR = 1.29; 95% CI = 1.00-1.66; p = 0.04), physical inactivity (age-adjusted OR = 1.31; 95% CI = 1.03-1.66; p = 0.02) was a significant risk factor for prostatitis-like symptoms. Alcohol consumption (daily drinking) also was a risk factor for prostatitis-like symptoms, although the differences were not statistically significant (age-adjusted OR = 1.36; 95% CI = 0.96-1.92; p = 0.07). Those with diabetes may also be at higher risk for prostatitis-like symptoms (age-adjusted OR = 1.37; 95% CI = 0.85-2.21; p = 0.19). In addition, men with ED were more likely to have had prostatitis-like symptoms (age-adjusted OR = 1.86; 95% CI = 0.47-2.36; p < 0.0001), and the ORs increased with increasing severity of ED status (mild ED, mild to moderate ED, and moderate to severe ED were 1.57, 2.62, and 3.24, respectively. Test for trend, p = 0.0001). Our results show that prostatitis-like symptoms are prevalent in Southern China affecting men of all ages. Smoking, drinking, lack of physical activity, and elevated plasma glucose level were associated with an increased risk of prostatitis-like symptoms. In addition, our results reveal that ED accounted for a large proportion (61.5%) among men with prostatitis-like symptoms; we also confirm the magnitude of ED associated with prostatitis-like symptoms. Thus, interventions to evaluate and improve ED might help ameliorate prostatitis-like symptoms and vice versa.
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Affiliation(s)
- Z Zhang
- Urology Department, Minzu Hospital of Guangxi Zhuang Autonomous Region, Affiliated Minzu Hospital of Guangxi Medical University, Nanning, China.,Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, China
| | - Z Li
- Urology Department, The Armed Police Corps Hospital of Guangdong Provence, Guangzhou, China
| | - Q Yu
- Urology Department, First Affiliated Hospital of Xinxiang Medical College, Xinxiang, China
| | - C Wu
- Urology Department, First Affiliated Hospital of Xinxiang Medical College, Xinxiang, China
| | - Z Lu
- Institute of Urology and Nephrology, First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - F Zhu
- Urology Department, First Affiliated Hospital of Xinxiang Medical College, Xinxiang, China
| | - H Zhang
- Urology Department, First Affiliated Hospital of Xinxiang Medical College, Xinxiang, China
| | - M Liao
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, China.,Institute of Urology and Nephrology, First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - T Li
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, China.,Institute of Urology and Nephrology, First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - W Chen
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, China.,Institute of Urology and Nephrology, First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - X Xian
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, China.,Institute of Urology and Nephrology, First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - A Tan
- Institute of Urology and Nephrology, First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Z Mo
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, China.,Institute of Urology and Nephrology, First Affiliated Hospital of Guangxi Medical University, Nanning, China
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Pereira R, Margarida Oliveira C, Nobre P. Sexual Functioning and Cognitions During Sexual Activity in Men With Genital Pain: A Comparative Study. JOURNAL OF SEX & MARITAL THERAPY 2016; 42:602-615. [PMID: 26548315 DOI: 10.1080/0092623x.2015.1113582] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Male genital pain is frequently associated with sexual dysfunction, and some studies suggest it is influenced by cognitive factors. However, there is little evidence on how these factors discriminate male genital pain from other sexual problems. This study intends to explore differences on sexual functioning and self-reported cognitions during sexual activity between men with genital pain, men with sexual dysfunction, and sexually healthy men. A total of 134 men divided in three groups based on their clinical condition (i.e., genital pain, sexual dysfunction, or no sexual/pain complaints) and matched for demographic variables completed measures of sexual functioning (IIEF) and thoughts during sexual activity (SMQ). Findings showed that men with genital pain and men with sexual dysfunctions reported significantly lower levels of overall satisfaction with sexual life, compared to men without sexual problems. Additionally, men with genital pain and men with sexual dysfunctions presented significantly more failure anticipation thoughts in comparison to sexually healthy men. Overall, findings emphasize the role of negative cognitions as a common factor associated with male genital pain and sexual dysfunctions, suggesting that genital pain should be regarded as a sexual problem and that clinical interventions should include sex therapy techniques as well as cognitive-behavioral procedures.
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Affiliation(s)
- Raquel Pereira
- a University of Porto, Faculty of Psychology and Educational Sciences , Porto , Portugal
| | | | - Pedro Nobre
- a University of Porto, Faculty of Psychology and Educational Sciences , Porto , Portugal
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Hu Y, Niu X, Wang G, Huang J, Liu M, Peng B. Chronic prostatitis/chronic pelvic pain syndrome impairs erectile function through increased endothelial dysfunction, oxidative stress, apoptosis, and corporal fibrosis in a rat model. Andrology 2016; 4:1209-1216. [PMID: 27565759 DOI: 10.1111/andr.12273] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Revised: 06/29/2016] [Accepted: 07/19/2016] [Indexed: 12/22/2022]
Affiliation(s)
- Y. Hu
- Department of Urology; Shanghai Tenth People's Hospital Affiliated to the Tongji University; Shanghai China
| | - X. Niu
- Department of Urology; Shanghai Tenth People's Hospital Affiliated to the Tongji University; Shanghai China
| | - G. Wang
- Department of Urology; Shanghai Tenth People's Hospital Affiliated to the Tongji University; Shanghai China
| | - J. Huang
- Department of Urology; Shanghai Tenth People's Hospital Affiliated to the Tongji University; Shanghai China
| | - M. Liu
- Department of Urology; Shanghai Tenth People's Hospital Affiliated to the Tongji University; Shanghai China
| | - B. Peng
- Department of Urology; Shanghai Tenth People's Hospital Affiliated to the Tongji University; Shanghai China
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Takayanagi A, Kobayashi K, Fukuta F, Matsuki M, Matsuda Y, Mori M, Masumori N. Changes of sexual function and perception in Japanese men: A 15-year cross-sectional community-based study. Int J Urol 2016; 23:941-945. [PMID: 27520708 DOI: 10.1111/iju.13184] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 07/13/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To investigate the longitudinal changes of sexual function of Japanese men. METHODS From 1992 to 1993, we carried out a cross-sectional community-based study on sexual function in Japanese men aged 40-79 years. After 15 years, a follow-up study was carried out to determine longitudinal changes of their sexual function. Of the 319 participants in the initial study, 135 participated again in the follow-up study. Sexual function was assessed using the same validated questionnaire in the two studies. RESULTS Erectile rigidity declined in men of each age decade at baseline (40s, 50s, 60s and 70s) of the initial study (P < 0.01, <0.01, <0.01 and <0.05). The frequency of sexual drive was significantly decreased in men aged in their 40s, 50s and 60s (P < 0.05, <0.01 and <0.01). Men aged in their 40s were dissatisfied with their decreased sexual function (P < 0.05). In contrast, men aged in their 70s were satisfied with their sexual life (P < 0.01). CONCLUSIONS Over a 15-year period, the sexual function of Japanese men declined in each age decade. However, the perception of this decline differed among different age group. Most elderly Japanese men did not worry about their impaired sexual function.
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Affiliation(s)
- Akio Takayanagi
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan.
| | - Ko Kobayashi
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
| | - Fumimasa Fukuta
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
| | - Masahiro Matsuki
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
| | - Yohei Matsuda
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
| | - Mitsuru Mori
- Department of Public Health, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
| | - Naoya Masumori
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
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Li HJ, Kang DY. Prevalence of sexual dysfunction in men with chronic prostatitis/chronic pelvic pain syndrome: a meta-analysis. World J Urol 2016; 34:1009-17. [PMID: 26546073 PMCID: PMC4921105 DOI: 10.1007/s00345-015-1720-3] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Accepted: 10/20/2015] [Indexed: 02/05/2023] Open
Abstract
PURPOSE This study aims to estimate the prevalence of sexual dysfunction in men with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) by conducting a meta-analysis. METHODS Relevant publications were searched using PubMed, Embase, CBM, China National Knowledge Infrastructure, VIP and Wanfang databases up to August 2015. Studies that reported the prevalence of erectile dysfunction, premature ejaculation and total sexual dysfunction in men with CP/CPPS were included. RESULTS A total of 24 studies involving 11,189 men were included. Overall prevalence of sexual dysfunction in men with CP/CPPS was 0.62 (95 % CI 0.48-0.75), while the prevalence of erectile dysfunction and premature ejaculation was 0.29 (95 % CI 0.24-0.33) and 0.40 (95 % CI 0.30-0.50), respectively. From 1999 to 2010, the prevalence of sexual dysfunction, erectile dysfunction and premature ejaculation was 0.65 (95 % CI 0.45-0.83), 0.27 (95 % CI 0.22-0.33) and 0.41 (95 % CI 0.27-0.55), respectively. From 2011 to 2014, the prevalence of sexual dysfunction, erectile dysfunction and premature ejaculation was 0.50 (95 % CI 0.22-0.75), 0.35 (95 % CI 0.29- 0.40) and 0.39 (95 % CI 0.37-0.41), respectively. CONCLUSION The prevalence of sexual dysfunction in men with CP/CPPS was high, even though overall sexual dysfunction demonstrated a slightly decreasing trend. Furthermore, erectile dysfunction prevalence rate had an increasing trend in recent years. More prospective studies are needed to evaluate sexual dysfunction improvement with better management of CP/CPPS.
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Affiliation(s)
- Hong-Jun Li
- Urological Department of Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - De-Ying Kang
- Department of Evidence-based Medicine and Clinical Epidemiology, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, China.
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26
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Zhang Y, Zheng T, Tu X, Chen X, Wang Z, Chen S, Yang Q, Wan Z, Han D, Xiao H, Sun X, Deng C. Erectile Dysfunction in Chronic Prostatitis/Chronic Pelvic Pain Syndrome: Outcomes from a Multi-Center Study and Risk Factor Analysis in a Single Center. PLoS One 2016; 11:e0153054. [PMID: 27120096 PMCID: PMC4847827 DOI: 10.1371/journal.pone.0153054] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 03/23/2016] [Indexed: 11/18/2022] Open
Abstract
The aim of this study was to investigate the prevalence of erectile dysfunction (ED) in patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and explore the influence of UPOINT domains, National Institutes of Health-CP symptom index (NIH-CPSI) and other factors on ED prevalence. This was a prospective study of consecutive patients with CP/CPPS seen at 11 tertiary hospitals during January–July 2014. ED was diagnosed as a score of<21 on the International Index of Erectile Function (IIEF-5). Patients from one center were evaluated by the UPOINT system and NIH-CPSI. Each patient was assessed using clinical examination, asocio-demographic questionnaire, the Patient Health Questionnaire (PHQ), the Pain Catastrophizing Scale (PCS), NIH-CPSI and IIEF-5.1406 patients from 11 centers (mean age, 32.18 years; range 18–60 years) were enrolled. ED was found in 638/1406 patients (45.4%), and was categorized as mild in 291(45.6%), moderate in 297(46.6%) and severe in50(7.7%). 192 patients from one center(mean age,31.3 years; range 18–57 years) were further studied.IIEF-5 score correlated negatively with NIH-CPSI(r = 0.251), PHQ (r = 0.355) and PCS (r = 0.322)scores (P<0.001).PHQ score correlated positively with NIH-CPSI (r = 0.586) and PCS(r = 0.662) scores (P<0.001).NIH-CPSI, PHQ, PCS and IIEF-5 scores did not differ significantly between class IIIA and IIIB CP/CPPS. Multivariate logistic regression showed that UPOINT psychological (P) domain and NIH-CPSI symptom severity were independent risk factors for ED in CP/CPPS. It is concluded that psychological factors and symptom severity are independent risk factors for ED in CP/CPPS.
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Affiliation(s)
- Yadong Zhang
- Department of Urology, 1 Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, Guangdong Province, China
- * E-mail: (YZ); (CD)
| | - Tao Zheng
- Department of Urology, 1 Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, Guangdong Province, China
| | - Xiang'an Tu
- Department of Urology, 1 Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, Guangdong Province, China
| | - Xin Chen
- Department of Urology, 1 Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, Guangdong Province, China
| | - Zhu Wang
- Department of Ultrasound Medicine, Endocrinology, 1 Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, Guangdong Province, China
| | - Shengfu Chen
- Department of Urology, 1 Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, Guangdong Province, China
| | - Qiyun Yang
- Department of Urology, 1 Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, Guangdong Province, China
| | - Zi Wan
- Department of Urology, 1 Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, Guangdong Province, China
| | - Dayu Han
- Department of Urology, 1 Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, Guangdong Province, China
| | - Haipeng Xiao
- Department of Endocrinology, 1 Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, Guangdong Province, China
| | - Xiangzhou Sun
- Department of Urology, 1 Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, Guangdong Province, China
| | - Chunhua Deng
- Department of Urology, 1 Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, Guangdong Province, China
- * E-mail: (YZ); (CD)
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27
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Chen X, Zhou Z, Qiu X, Wang B, Dai J. The Effect of Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) on Erectile Function: A Systematic Review and Meta-Analysis. PLoS One 2015; 10:e0141447. [PMID: 26509575 PMCID: PMC4625019 DOI: 10.1371/journal.pone.0141447] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 10/07/2015] [Indexed: 12/27/2022] Open
Abstract
Background High prevalence of erectile dysfunction (ED) has been observed in patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). However, whether or not CP/CPPS is a risk factor of ED remains unknown and controversial. Therefore, we conducted this systematic review and meta-analysis to evaluate the relationship between CP/CPPS and ED. Methods PubMed, Embase, Web of Science, and The Cochrane Library were searched up to November 11, 2014 to identify studies reporting the association between CP/CPPS and ED. Case–control, cohort and cross-sectional studies were included. Quality of the included studies was assessed. The odds ratio of ED and the mean difference of five-item International Index of Erectile Function (IIEF-5) score were pooled using a random effects model. Subgroup analysis and sensitivity analyses were performed. Results Three cross-sectional studies, two case–control studies, and four retrospective studies with 31,956 participants were included to calculate the pooled odds ratio of ED, and two studies with 1499 participants were included to calculate the pooled mean difference of IIEF-5 scores. A strong correlation was found between CP/CPPS and ED (pooled odds ratio: 3.02, 95% CI: 2.18–4.17, P < 0.01), with heterogeneity across studies (I2 = 65%; P < 0.01). A significant decrease in the IIFE-5 score was observed in the CP/CPPS group (pooled mean difference: −4.54, 95% CI: −5.11–−3.98; P < 0.01). Conclusion Our study indicates that patients with CP/CPPS have an increased risk of suffering from ED. Assessment of erectile function is necessary for the therapy of patients with CP/CPPS. Further evidence is necessary to confirm the relationship between CP/CPPS and ED.
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Affiliation(s)
- Xiang Chen
- Department of Urology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - ZhiRui Zhou
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - XiaoChun Qiu
- Library of Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - Bin Wang
- Department of Andrology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
- * E-mail: (BW); (JD)
| | - JiCan Dai
- Department of Urology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- * E-mail: (BW); (JD)
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Comparison of National Institutes of Health-Chronic Prostatitis Symptom Index with International Index of Erectile Function 5 in Men with Chronic Prostatitis/Chronic Pelvic Pain Syndrome: A Large Cross-Sectional Study in China. BIOMED RESEARCH INTERNATIONAL 2015; 2015:560239. [PMID: 26273630 PMCID: PMC4530206 DOI: 10.1155/2015/560239] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Revised: 06/29/2015] [Accepted: 07/06/2015] [Indexed: 11/17/2022]
Abstract
The purpose of the study is to evaluate the relationship between NIH-CPSI and IIEF-5 in Chinese men with CP/CPPS. A large cross-sectional and multicenter survey was conducted from July 2012 to January 2014. Men were recruited from urology clinics which were located at the five cities in China. All men participated in the survey by completing a verbal questionnaire (consisted of sociodemographics, past medical history, sexual history, and self-estimated scales). The results showed that 1,280 men completed the survey. Based on the CP/CPPS definition, a total of 801 men were diagnosed as having CP/CPPS. Men with CP/CPPS reported higher scores of NIH-CPSI and lower scores of IIEF-5 than men without CP/CPPS. NIH-CPSI scores were significantly negatively correlated with IIEF-5 scores. The total scores of NIH-CPSI were significantly more strongly correlated with question 5 than other questions of IIEF-5. The total scores of IIEF-5 were significantly more strongly correlated with pain symptoms scores of NIH-CPSI. Strongest correlation was found between QoL impact and question 5 of IIEF-5. The findings suggested that NIH-CPSI scores were significantly negatively correlated with IIEF-5 scores. Strongest correlation was found between QoL impact and question 5 of IIEF-5.
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29
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Wang XJ, Xia LL, Xu TY, Zhang XH, Zhu ZW, Zhang MG, Liu Y, Xu C, Zhong S, Shen ZJ. Changes in erectile organ structure and function in a rat model of chronic prostatitis/chronic pelvic pain syndrome. Andrologia 2015; 48:243-51. [PMID: 25990367 DOI: 10.1111/and.12437] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2015] [Indexed: 12/29/2022] Open
Abstract
There is a growing recognition of the association between chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and erectile dysfunction (ED); however, most of the reports are based on questionnaires which cannot distinguish between organic and functional ED. The purpose of this study was to determine the exact relationship between CP/CPPS and ED, and to investigate the changes in erectile organ structure and function in a rat model of CP/CPPS. We established a rat model of experimental autoimmune prostatitis (EAP), which is a valid model for CP/CPPS. Erectile function in EAP and normal rats was comparable after cavernous nerve electrostimulation. The serum testosterone and oestradiol levels, ultrastructure of the corpus cavernosum and expression of endothelial nitric oxide synthase and neuronal nitric oxide synthase in the two groups were similar; however, there was a decrease in smooth muscle-to-collagen ratio and alpha-smooth muscle actin expression and an increase in transforming growth factor-beta 1 expression was observed in EAP rats. Thus, organic ED may not exist in EAP rats. We speculate that ED complained by patients with CP/CPPS may be psychological, which could be caused by impairment in the quality of life; however, further studies are needed to fully understand the potential mechanisms underlying the penile fibrosis in EAP rats.
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Affiliation(s)
- X-J Wang
- Department of Urology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - L-L Xia
- Department of Urology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - T-Y Xu
- Department of Urology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - X-H Zhang
- Department of Urology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Z-W Zhu
- Department of Urology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - M-G Zhang
- Department of Urology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Y Liu
- Department of Histology and Embryology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Reproductive Medicine, Shanghai, China
| | - C Xu
- Department of Histology and Embryology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Reproductive Medicine, Shanghai, China
| | - S Zhong
- Department of Urology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Z-J Shen
- Department of Urology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Asymptomatic prostatic inflammation in men with clinical BPH and erectile dysfunction affects the positive predictive value of prostate-specific antigen. Urol Oncol 2014; 32:946-51. [DOI: 10.1016/j.urolonc.2014.03.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Revised: 02/18/2014] [Accepted: 03/03/2014] [Indexed: 11/21/2022]
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New developments in the diagnosis and treatment of chronic prostatitis/chronic pelvic pain syndrome. Curr Opin Urol 2014; 23:565-9. [PMID: 24080807 DOI: 10.1097/mou.0b013e3283656a55] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
PURPOSE OF REVIEW To describe new developments in the diagnosis and treatment of chronic prostatitis/chronic pelvic pain syndrome (CPPS). RECENT FINDINGS Symptoms in men with chronic prostatitis/CPPS appear to cluster into a group with primarily pelvic or localized disease, and a group with more systemic symptoms. Several other chronic pain conditions can be associated with chronic prostatitis/CPPS, including irritable bowel syndrome, fibromyalgia, and chronic fatigue syndrome. Markers of neurologic inflammation and autoimmune disease parallel changes in symptoms after treatment. Treatment options include new alpha-blockers, psychological intervention, and prostate-directed therapy. The areas of acupuncture and pelvic floor physical therapy/myofascial release have received increased recent attention and appear to be good options in these patients. Future therapy may include antibodies to mediators of neurogenic inflammation and even treatment of bacteria in the bowel. SUMMARY The diagnosis of chronic prostatitis/CPPS must include conditions traditionally outside the scope of urologic practice but important for the care of men with chronic pelvic pain. The treatment is best done using multiple simultaneous therapies aimed at the different aspects of the condition.
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Zhao Z, Xuan X, Zhang J, He J, Zeng G. A prospective study on association of prostatic calcifications with sexual dysfunction in men with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). J Sex Med 2014; 11:2528-36. [PMID: 24735240 DOI: 10.1111/jsm.12534] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
INTRODUCTION Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common debilitating condition of unclear etiology. Sexual dysfunction is an important component of the clinical phenotype of CP/CPPS. Patients often have prostatic calcifications, but a link to sexual dysfunction is unknown. AIM The aim of this study was to evaluate the association of prostatic calcifications with sexual dysfunction in this condition. METHODS A total of 358 males with CP/CPPS were consecutively enrolled, and a prospectively maintained database of these patients was analyzed. Calcifications were diagnosed using ultrasound imaging of the prostate. Symptom severity was measured using the National Institutes of Health Chronic Prostatitis Symptom Index (CPSI). Sexual dysfunction was evaluated using the validated 15-item International Index of Erectile Function (IIEF-15) questionnaire and 5-item Premature Ejaculation Diagnostic Tool scales. The variables were compared between patients with prostatic calcifications and those without using the Student's t-test, Wilcoxon unpaired test, or chi-square test. MAIN OUTCOME MEASURE Logistic regression models were developed to explore a possible association between prostatic calcifications and sexual dysfunction. RESULTS Measurable calcifications in the prostate were found in 175 (48.9%) of the 358 patients. Patients with calcifications were more likely to have higher white blood cell counts or positive bacteria cultures in their prostatic fluid, longer symptoms duration, and lower scores for the total IIEF-15, IIEF-erectile function, and IIEF-intercourse satisfaction domains (P < 0.001 for each). However, the scores for CPSI, premature ejaculation, and IIEF-orgasmic function, IIEF-sexual desire, and IIEF-overall satisfaction domains were identical between men with and without calcifications (P > 0.05 for each). Furthermore, logistic regression analyses revealed that intraprostatic calcification is significantly associated with self-assessed erectile dysfunction (ED) (odds ratio:3.632, 95% confidence interval: 2.405-5.822, P < 0.001). CONCLUSION Our results showed that prostatic calcifications are significantly associated with the presence of ED in CP/CPPS males.
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Affiliation(s)
- Zhigang Zhao
- Department of Urology & Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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Cai L, Jiang M, Zeng M, Xing W, Wen Y, Zhang B. Age-Specific Clinical Features of Erectile Dysfunction. Health (London) 2014. [DOI: 10.4236/health.2014.610118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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34
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Tran CN, Shoskes DA. Sexual dysfunction in chronic prostatitis/chronic pelvic pain syndrome. World J Urol 2013; 31:741-6. [PMID: 23579441 DOI: 10.1007/s00345-013-1076-5] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Accepted: 03/12/2013] [Indexed: 12/22/2022] Open
Abstract
Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), or NIH category III prostatitis, is a common clinical syndrome characterized by genital/pelvic pain and lower urinary tract symptoms in the absence of urinary tract infection. There is also growing recognition of the association of sexual dysfunction with CP/CPPS including erectile dysfunction, ejaculatory pain, and premature ejaculation. In this review, we discuss the association between CP/CPPS and sexual dysfunction, potential mechanisms for sexual dysfunction, and treatment strategies for erectile dysfunction in CP/CPPS.
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Affiliation(s)
- Christine N Tran
- Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, 9500 Euclid Ave, Desk Q10-1, Cleveland, OH 44195, USA
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35
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Zhao Z, Zhang J, He J, Zeng G. Clinical utility of the UPOINT phenotype system in Chinese males with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS): a prospective study. PLoS One 2013; 8:e52044. [PMID: 23349680 PMCID: PMC3547952 DOI: 10.1371/journal.pone.0052044] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2012] [Accepted: 11/08/2012] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Recent data showed that a six-domain UPOINT is a flexible and responsive new classification system that has the clinical applicability in CP/CPPS. However, the utility of UPOINT algorithm in men in China with CP/CPPS has not been comprehensively studied. For international validation and adoption, we evaluated this clinical phenotype system for a large cohort of Chinese CP/CPPS patients and correlated it with patient symptoms and erectile dysfunction (ED). We also investigated the addition of an ED domain in regard to symptom correlation. METHODS A total of 389 Chinese males with CP/CPPS were prospectively collected and classified in each domain of the UPOINT system. Symptom severity was measured using the NIH-CPSI and IPSS. The erectile function was evaluated using the IIEF-5. Clinically relevant associations were calculated. RESULTS The percentage of patients positive for each domain was 54.0%, 42.1%, 41.9%, 20.8%, 26.7%, and 40.4% for the Urinary, Psychosocial, Organ-specific, Infection, Neurological/systemic, and Tenderness, respectively. There were significant correlations between the number of positive UPOINT domains and total NIH-CPSI (r = 0.706, p<0.001), IPSS (r = 0.682, p<0.001) and IIEF-5 scores (r = 0.631, P = 0.007) in Chinese cohort. Except for patients age, symptom duration was associated with a significantly greater number of positive domains (r = 0.638, P = 0.005). After adding an ED domain to create a modified UPOINT system, the correlation between the number of phenotypic domains and symptom severity was improved (0.706 to 0.844, p<0.001). CONCLUSIONS The clinical applicability of using UPOINT phenotyping system has been validated in the Chinese patients with CP/CPPS. In our cohort, the number of positive domains was also correlated with ED symptoms and the significant association between the number of UPOINT domains and NIH-CPSI scores was further refined by adding a domain for ED. Our findings presented here support the utility of using ED as a stand-alone item in the UPOINT domain.
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Affiliation(s)
- Zhigang Zhao
- Department of Urology & Andrology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical College, Guangdong Provincial Key Laboratory of Urology, Guangzhou, Guangdong Province, China.
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Shoskes DA. The Challenge of Erectile Dysfunction in the Man with Chronic Prostatitis/Chronic Pelvic Pain Syndrome. Curr Urol Rep 2012; 13:263-7. [DOI: 10.1007/s11934-012-0254-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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