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Nwagwe OR, Adefegha SA, Oboh G. Pentaclethra macrophylla leaves reduce blood glucose level, improve sexual behavior and modulate critical enzymes associated with diabetes-erectile dysfunction morbidity in rats. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2024; 21:80-87. [PMID: 37974314 DOI: 10.1515/jcim-2023-0101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 10/14/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVES This research work studied the phenolic composition of Pentaclethra macrophylla (PM), the inclusion of dietary supplementation of PM leaves on sexual functions and its connection to inhibit enzymes (arginase and phosphodiesterase-5) and nitric oxide level, linked to type 2 diabetes-induced erectile dysfunction in rats. METHODS Gallic acid, chlorogenic and ellagic acids, Kaempferol, and epicatechin etc. was spotted with High performance liquid chromatography-diode array detector from PM extract. Twenty-five (25) rats were used for the study. Five rats were placed with basal diet; diets not supplemented with PM leaves (normal rat group) while twenty rats were made diabetic by feeding them with high fat diet for two weeks, prior to single injection with 35 mg/kg of streptozotocin (STZ). After checking with glucometer, experimental animals with blood glucose level >250 mg/dL were accepted as diabetic. The diabetic rats were subsequently divided into four groups of five rats each (n=5). The diabetic rats were placed on basal diet, or diets supplemented with PM leaves (10 % or 5 % inclusion) or sildenafil citrate (SC). RESULTS The result revealed that PM supplemented diets caused significant (p<0.05) reduction in blood glucose level, and augmented erectile function by inhibiting arginase and PDE5 activities as well as enhancing nitric oxide level. CONCLUSIONS In conclusion, dietary inclusion of PM leaves could serve as a potent nutraceutical source in hyperglycemia induced erectile dysfunction management.
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Affiliation(s)
- Onyinyechi Ruth Nwagwe
- Department of Biochemistry, Functional Foods, Nutraceuticals and Phytomedicine Laboratory, Federal University of Technology, Akure, Nigeria
- Department of Biochemistry, Federal University Oye Ekiti, Oye, Nigeria
| | - Stephen Adeniyi Adefegha
- Department of Biochemistry, Functional Foods, Nutraceuticals and Phytomedicine Laboratory, Federal University of Technology, Akure, Nigeria
| | - Ganiyu Oboh
- Department of Biochemistry, Functional Foods, Nutraceuticals and Phytomedicine Laboratory, Federal University of Technology, Akure, Nigeria
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Li ASW, Wong ALY, Matthewson M, Van Niekerk L, Garry M. Barriers in chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) management: perspectives from health practitioners. Scand J Pain 2023; 23:518-530. [PMID: 37186523 DOI: 10.1515/sjpain-2022-0160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 04/18/2023] [Indexed: 05/17/2023]
Abstract
OBJECTIVES Chronic prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) is a complex condition which causes a significant burden on the diagnosed individuals. Assessment and management are perplexing, often resulting in unsatisfactory outcomes. Existing research has only focused on patients' perspectives of pain experiences, but scant evidence is available to understand the barriers that undermine effective pain management. Using an exploratory approach, this study examined these barriers from practitioners' perspectives. METHODS Twelve semi-structured interviews were conducted with practitioners across disciplines who have experience in chronic pelvic pain management in males. Practitioners expressed their views and experiences in supporting men with CP/CPPS and what barriers they perceived when providing treatment for patients. Data were analysed using reflexive thematic analysis supported by NVivo software. RESULTS Five broad and interrelated themes were identified: (1) Where to Start, (2) Insufficient Resources, (3) Prioritisation, (4) Training and Confident Practice and (5) Constraints in Help-Seeking. CONCLUSIONS Practitioners value multimodal management using a biopsychosocial approach; however, practical challenges prevent practitioners from choosing and applying this approach in clinical practice. The findings also identified some unique challenges faced by men with CP/CPPS consistent with previous evidence from patient perspective. Refining terminology, developing specific resources, and increasing psychosocial treatment options are urgently needed.
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Affiliation(s)
- Arthur Sone-Wai Li
- School of Psychological Sciences, College of Health and Medicine, University of Tasmania, Hobart, Australia
| | - Aquina Lim Yim Wong
- School of Psychological Sciences, College of Health and Medicine, University of Tasmania, Hobart, Australia
| | - Mandy Matthewson
- School of Psychological Sciences, College of Health and Medicine, University of Tasmania, Hobart, Australia
| | - Leesa Van Niekerk
- School of Psychological Sciences, College of Health and Medicine, University of Tasmania, Hobart, Australia
| | - Michael Garry
- School of Psychological Sciences, College of Health and Medicine, University of Tasmania, Hobart, Australia
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Ballester-Arnal R, Ruiz-Palomino E, Elipe-Miravet M, Gil-Llario MD. Development and Validation of a Scale for Assessing the Interference of Chronic Primary Pain Conditions in Sexual Functioning: The Sex-Pain Questionnaire. JOURNAL OF SEX & MARITAL THERAPY 2022; 48:652-662. [PMID: 35191366 DOI: 10.1080/0092623x.2022.2039336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Chronic pain represents one of the main health public problems worldwide and significantly affects the sexual life of patients. However, no specific instruments of evaluation have been found that address this population. This study presents the SEX-PAIN Questionnaire, developed for identifying chronic pain's interference with sexual functioning among people with chronic pain. Methods. The validation has been carried out with a sample of 303 Spanish non-hospitalized patients with chronic pain diagnosis aged between 20 and 71 years old (Mage = 49.49; SD = 10.7). Exploratory Factor Analysis (EFA) yielded 2-factor structure: Sexual and Relationship Dissatisfaction, and Chronic Pain Impact on Sexual Life. This structure was later verified through Confirmatory Factor Analysis (CFA). Internal consistency (Omega) of each factor was .72 and .96, respectively. This study presents the psychometric properties of a new measure addressed to patients with chronic pain. This 17-items self-administered instrument can be a useful measure of the chronic pain's interference with sexual functioning among chronic pain patients. It represents the first original questionnaire known in Spanish language to date. This measure could potentially help researchers and clinicians to obtain key information to design appropriate healthcare interventions.Supplemental data for this article is available online at https://doi.org/10.1080/0092623X.2022.2039336 .
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Affiliation(s)
- Rafael Ballester-Arnal
- Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I, Castello de la Plana, Spain
| | - Estefanía Ruiz-Palomino
- Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I, Castello de la Plana, Spain
| | - Marcel Elipe-Miravet
- Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I, Castello de la Plana, Spain
| | - María Dolores Gil-Llario
- Department of Developmental and Educational Psychology, Universitat de València, València, Spain
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Finn E, Morrison TG, McGuire BE. Correlates of Sexual Functioning and Relationship Satisfaction Among Men and Women Experiencing Chronic Pain. PAIN MEDICINE 2018; 19:942-954. [PMID: 29741742 DOI: 10.1093/pm/pnx056] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Background The aims of the study were to 1) examine the prevalence of sexual functioning difficulties in a chronic pain sample; 2) identify correlates of sexual functioning and relationship satisfaction utilizing pain variables (pain severity and pain interference) and psychological variables (mood, pain-related cognitions, self-efficacy, self-esteem, body-image); and 3) investigate possible sex differences in the correlates of sexual functioning and relationship satisfaction. Method Two hundred sixty-nine participants were recruited online from chronic pain organizations, websites, social media sites, and discussion forums. Those who met criteria for inclusion were presented with a variety of measures related to pain, sexual functioning, and relationship satisfaction (for those in a relationship), as well as cognitive and affective variables. Results Participant mean age was 37 years, and the majority were female, heterosexual, and currently in a relationship. High levels of pain severity and interference from pain, fatigue, depression, anxiety, stress, and body image concerns were reported, along with low levels of self-esteem and pain self-efficacy. In addition, substantial proportions of male (43%) and female (48%) respondents had scores indicative of sexual problems. Exploratory hierarchical regression analyses revealed that, for women, age and relationship satisfaction (which were both treated as covariates) as well as depression emerged as statistically significant correlates of sexual functioning (i.e., women who were older and reported greater levels of depression and less satisfaction with their current relationship indicated poorer sexual functioning). When relationship satisfaction was the criterion measure, age and sexual functioning (again, treated as covariates) and perceived stress emerged as significant (i.e., women who were older, reported poorer sexual functioning, and reported greater perceived stress also indicated being less satisfied with their current relationship). For male participants, age emerged as the only statistically significant correlate of sexual functioning (i.e., older men reported poorer functioning). In terms of relationship satisfaction, self-esteem was the lone significant correlate variable (men who reported lower self-esteem also were less satisfied with their current relationship). Conclusions Some sex differences were evident in the variables that predict sexual difficulties and relationship satisfaction among those suffering from chronic pain. Of note is that when psychological variables were considered, pain-specific physical variables (e.g., pain severity and activity limitations) accounted for very little additional variance.
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Affiliation(s)
- Erica Finn
- Clinical Psychology Programme, School of Psychology and Centre for Pain Research, National University of Ireland, Galway, Ireland
| | - Todd G Morrison
- Department of Psychology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Brian E McGuire
- Clinical Psychology Programme, School of Psychology and Centre for Pain Research, National University of Ireland, Galway, Ireland
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Peixoto MM, Nobre P. Distressing Sexual Problems and Dyadic Adjustment in Heterosexuals, Gay Men, and Lesbian Women. JOURNAL OF SEX & MARITAL THERAPY 2016; 42:369-381. [PMID: 26010170 DOI: 10.1080/0092623x.2015.1053020] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Empirical studies have focused on dyadic adjustment and sexual satisfaction in men and women. Nevertheless, little is known regarding the role of dyadic adjustment in sexual problems among individuals in same-sex and mixed-sex dyads. The aim of the current study was to analyze the differences in dyadic adjustment between gay and heterosexual men, and lesbian and heterosexual women, with and without distressing sexual problems. One hundred and sixty men (80 gay and 80 heterosexual) and 184 women (92 lesbian and 92 heterosexual) completed an online survey. Participants responded to the Dyadic Adjustment Scale-Short Version and to questions about self-perceived sexual problems and associated levels of distress. A 2 (gender) × 2 (sexual orientation) × 2 (group with or without sexual problems) univariate analysis of covariance was performed. The findings suggested that individuals with distressing sexual problems, regardless of gender or sexual orientation, scored significantly lower on the Dyadic Adjustment Scale. Additionally, lesbian women, regardless of having or not having a distressing sexual problem, scored significantly higher on the Dyadic Adjustment Scale, compared to heterosexual women. No gender differences were found. Overall, our findings emphasize the negative association between dyadic adjustment and distressing sexual problems, regardless of gender and sexual orientation.
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Affiliation(s)
- Maria Manuela Peixoto
- a Faculdade de Psicologia e de Ciências da Educação da Universidade do Porto , Porto , Portugal
| | - Pedro Nobre
- a Faculdade de Psicologia e de Ciências da Educação da Universidade do Porto , Porto , Portugal
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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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Assessing psychological factors, social aspects and psychiatric co-morbidity associated with Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) in men -- a systematic review. J Psychosom Res 2014; 77:333-50. [PMID: 25300538 DOI: 10.1016/j.jpsychores.2014.09.012] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Revised: 09/17/2014] [Accepted: 09/21/2014] [Indexed: 01/13/2023]
Abstract
OBJECTIVE Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) is a chronic pain disease with high prevalence rates and substantial health care costs. An interdisciplinary classification system is commonly used (UPOINT) which includes psychosocial factors. Nevertheless, psychosocial influences on CP/CPPS only recently became a research focus. Therefore, we aimed to synthesize the existing data and to identify further research topics. Then, based on our results, diagnosis and treatment can be improved. METHODS In a systematic review conducted according to the PRISMA reporting guidelines we searched different databases (MEDLINE, EMBASE, PsychINFO) using the broad search terms "chronic pelvic pain syndrome AND men". Two raters independently screened the literature and assessed the risk of bias. RESULTS We included 69 original research articles which considered psychosocial variables. We found studies investigating different psychosocial factors (pain catastrophizing, stress, personality factors, social aspects), co-morbid psychiatric disorders (depression, anxiety and trauma-related disorders, somatization disorder, substance abuse) and Quality of Life (QoL). In addition, there is a high risk of bias in most studies e.g. concerning the study design or the measures. CONCLUSIONS There is evidence suggesting that psychological factors are important in understanding CP/CPPS. However, research concentrated on a few aspects while the others were not covered adequately. We found evidence of a higher number of psychosocial factors and psychiatric co-morbidities than is currently included in the UPOINT system. More high quality research is needed to understand the interplay of psychosocial factors in CP/CPPS. Furthermore, these factors should be incorporated into treatment approaches.
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Mo MQ, Long LL, Xie WL, Chen S, Zhang WH, Luo CQ, Deng LW. Sexual dysfunctions and psychological disorders associated with type IIIa chronic prostatitis: a clinical survey in China. Int Urol Nephrol 2014; 46:2255-61. [DOI: 10.1007/s11255-014-0810-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Accepted: 07/29/2014] [Indexed: 10/24/2022]
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Berry MD, Berry PD. Contemporary Treatment of Sexual Dysfunction: Reexamining the Biopsychosocial Model. J Sex Med 2013; 10:2627-43. [DOI: 10.1111/jsm.12273] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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10
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Lee KS, Choi JD. Chronic prostatitis: approaches for best management. Korean J Urol 2012; 53:69-77. [PMID: 22379583 PMCID: PMC3285711 DOI: 10.4111/kju.2012.53.2.69] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2012] [Accepted: 02/02/2012] [Indexed: 12/14/2022] Open
Abstract
Prostatitis is a prevalent condition that encompasses a large array of clinical symptoms with significant impacts on men's life. The diagnosis and treatment of this disorder presents numerous challenges for urologists, most notably, a lack of specific and effective diagnostic methods. Chronic bacterial prostatitis is successfully treated with appropriate antibiotics that penetrate the prostate and kill the causative organisms. Prostatitis category III (chronic pelvic pain syndrome) is common, very bothersome, and enigmatic. Symptoms are usually prolonged and, generally speaking, treatment results are unsatisfactory. During the last decade, research has focused on the distress caused by the condition, but although our knowledge has certainly increased, there have been no real breakthroughs; controversies and many unanswered questions remain. Furthermore, the optimal management of category III prostatitis is not known. Conventional prolonged courses of antibiotic therapy have not proven to be efficacious. Novel therapies providing some evidence for efficacy include alpha-blocker, anti-inflammatory phytotherapy, physiotherapy, neuroleptics, and others, each offering therapeutic mechanisms. A stepwise approach involving multimodal therapy is often successful for treating patients. The UPOINT technique has been used to clinically phenotype these patients and drive the appropriate selection of multimodal therapy.
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Affiliation(s)
- Kyung Seop Lee
- Department of Urology, Dongguk University School of Medicine, Gyeongju, Korea
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Dewitte M, Van Lankveld J, Crombez G. Understanding sexual pain: A cognitive-motivational account. Pain 2011; 152:251-253. [DOI: 10.1016/j.pain.2010.10.051] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2010] [Revised: 09/30/2010] [Accepted: 10/29/2010] [Indexed: 11/26/2022]
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Abstract
BACKGROUND AND PURPOSE Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) negatively affects quality of life and sexual function in men of all ages. Typical treatment with antibiotic and antimicrobial drugs often is not successful. The purpose of this case report is to describe a multimodal physical therapy intervention that included manual therapy techniques applied to the pelvic floor in 2 patients who were unsuccessfully treated with the biomedical model of prescription drug therapies. CASE DESCRIPTION Two men, aged 45 years and 53 years and diagnosed with chronic prostatitis, were referred for physical therapy following unsuccessful pharmacological treatment. The patients were treated with manual therapy techniques applied to the pelvic floor and instructed in progressive muscle relaxation, flexibility exercises, and aerobic exercises. OUTCOMES Changes in the patients' National Institutes of Health Chronic Prostatitis Symptom Index revealed differences between preintervention and postintervention scores reflecting decreased pain and improved quality of life. One patient improved from a score of 25 (total possible score = 43) before treatment to a score of 0 after treatment, and the other patient improved from a score of 29 to a score of 21. DISCUSSION Manual therapy techniques applied to the pelvic floor and performed by a physical therapist specially trained in these techniques, along with progressive muscle relaxation, flexibility exercises, and aerobic exercises, appeared to be beneficial to both patients in reducing pain and improving sexual function.
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Davis SNP, Maykut CA, Binik YM, Amsel R, Carrier S. Tenderness as measured by pressure pain thresholds extends beyond the pelvis in chronic pelvic pain syndrome in men. J Sex Med 2010; 8:232-9. [PMID: 20946176 DOI: 10.1111/j.1743-6109.2010.02041.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Urological Chronic Pelvic Pain Syndrome (UCPPS) in men is a common complaint, and causes significant impairment in quality of life. Until recently, the focus of research has primarily been on pain symptoms or underlying prostate pathology. However, new clinical phenotyping demonstrates pelvic tenderness to be an important component of UCPPS. Unfortunately, mechanisms underlying tenderness remain to be understood, and tenderness itself has not been well quantified. AIM To validate the use of pressure pain thresholds as a method of measuring tenderness in UCPPS and to demonstrate that tenderness extends beyond the pelvis. METHODS Fifty-five men diagnosed with UCPPS and 46 healthy controls were recruited through referrals and advertisements. Each participant filled out questionnaires and was assessed by a structured interview. In addition, all UCPPS men underwent urological assessment. MAIN OUTCOME MEASURES Demographic information was collected as well as the National Institutes of Health-Chronic Prostatitis Symptom Index. Using a digital algometer, pressure pain thresholds on 10 genito-pelvic and one control site (deltoid) were measured. The four-glass test was used for all UCPPS men. RESULTS UCPPS men had reliably lower pain thresholds compared to controls in all locations, including the deltoid. UCPPS men also demonstrated consistently lower overall pain thresholds regardless of location. Furthermore, pressure pain thresholds were able to correctly distinguish patients from controls 77% of the time. Prostate infection did not influence pain thresholds. CONCLUSIONS Lower pelvic and nonpelvic thresholds suggest the involvement of a central mechanism in UCPPS. Overall, the data confirm the move away from a prostate-based view of UCPPS. This is supported by the failure to find threshold differences related to prostate infection. Pressure pain thresholds appear to be a promising method of assessing tenderness in UCPPS.
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Affiliation(s)
- Seth N P Davis
- Department of Psychology, McGill University, Montreal, Canada.
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Fall M, Baranowski AP, Elneil S, Engeler D, Hughes J, Messelink EJ, Oberpenning F, de C Williams AC. EAU guidelines on chronic pelvic pain. Eur Urol 2009; 57:35-48. [PMID: 19733958 DOI: 10.1016/j.eururo.2009.08.020] [Citation(s) in RCA: 237] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2009] [Accepted: 08/19/2009] [Indexed: 12/21/2022]
Abstract
CONTEXT These guidelines were prepared on behalf of the European Association of Urology (EAU) to help urologists assess the evidence-based management of chronic pelvic pain (CPP) and to incorporate the recommendations into their clinical practice. OBJECTIVE To revise guidelines for the diagnosis, therapy, and follow-up of CPP patients. EVIDENCE ACQUISITION Guidelines were compiled by a working group and based on a systematic review of current literature using the PubMed database, with important papers reviewed for the 2003 EAU guidelines as a background. A panel of experts weighted the references. EVIDENCE SYNTHESIS The full text of the guidelines is available through the EAU Central Office and the EAU Web site (www.uroweb.org). This article is a short version of the full guidelines text and summarises the main conclusions from the guidelines on the management of CPP. CONCLUSIONS A guidelines text is presented including chapters on chronic prostate pain and bladder pain syndromes, urethral pain, scrotal pain, pelvic pain in gynaecologic practice, neurogenic dysfunctions, the role of the pelvic floor and pudendal nerve, psychological factors, general treatment of CPP, nerve blocks, and neuromodulation. These guidelines have been drawn up to provide support in the management of the large and difficult group of patients suffering from CPP.
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Affiliation(s)
- Magnus Fall
- Department of Urology, Sahlgrenska Academy, Göteborg University, Göteborg, Sweden.
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Wagenlehner FME, Naber KG, Bschleipfer T, Brähler E, Weidner W. Prostatitis and male pelvic pain syndrome: diagnosis and treatment. DEUTSCHES ARZTEBLATT INTERNATIONAL 2009; 106:175-83. [PMID: 19568373 DOI: 10.3238/arztebl.2009.0175] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2008] [Accepted: 08/27/2008] [Indexed: 12/16/2022]
Abstract
BACKGROUND The prostatitis syndrome is a multifactorial condition of largely unknown etiology. The new NIH classification divides the prostatitis syndrome into a number of subtypes: acute bacterial prostatitis, chronic bacterial prostatitis, inflammatory and noninflammatory chronic pelvic pain syndrome, and asymptomatic prostatitis. METHODS This article is based on a selective review of the literature regarding the assessment and management of the prostatitis syndrome and on a recently published consensus statement of the International Prostatitis Collaboration Network. RESULTS Pathogenic organisms can be cultured only in acute and chronic bacterial prostatitis. These conditions should be treated with antibiotics, usually fluoroquinolones, for an adequate period of time. 90% of patients with prostatitis syndrome, however, suffer not from bacterial prostatitis but from chronic (abacterial) prostatitis / chronic pelvic pain syndrome (CP/CPPS). It remains unclear whether CP/CPPS is of infectious origin, and therefore the utility of a trial of antimicrobial treatment is debatable. Treatment with alpha receptor blockers is recommended if functional subvesical obstruction is documented or suspected. Symptomatic therapy for pelvic pain should be given as well. CONCLUSIONS The prostatitis syndrome is a complex condition with a tendency toward chronification. It is important, therefore, that the patient be fully informed about the diagnostic uncertainties and the possibility that treatment may meet with less than complete success.
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Affiliation(s)
- Florian M E Wagenlehner
- Klinik und Poliklinik für Urologie und Kinderurologie, Justus-Liebig-UniversitätGiessen, Giessen, Germany.
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Nickel JC, Alexander RB, Anderson R, Berger R, Comiter CV, Datta NS, Fowler JE, Krieger JN, Landis JR, Litwin MS, McNaughton-Collins M, O'Leary MP, Pontari MA, Schaeffer AJ, Shoskes DA, White P, Kusek J, Nyberg L. Category III chronic prostatitis/chronic pelvic pain syndrome: insights from the National Institutes of Health Chronic Prostatitis Collaborative Research Network studies. Curr Urol Rep 2009; 9:320-7. [PMID: 18765132 DOI: 10.1007/s11934-008-0055-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Chronic prostatitis/chronic pelvic pain syndrome remains an enigmatic medical condition. Creation of the National Institutes of Health-funded Chronic Prostatitis Collaborative Research Network (CPCRN) has stimulated a renewed interest in research on and clinical aspects of chronic prostatitis/chronic pelvic pain syndrome. Landmark publications of the CPCRN document a decade of progress. Insights from these CPCRN studies have improved our management of chronic prostatitis/chronic pelvic pain syndrome and offer hope for continued progress.
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Affiliation(s)
- J Curtis Nickel
- Department of Urology, Queen's University, Kingston General Hospital, Kingston, Ontario K7L 2V7, Canada.
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17
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Goldstein I. Sexual dysfunction in women: what can urologists contribute? Curr Urol Rep 2008; 9:475-82. [PMID: 18947512 DOI: 10.1007/s11934-008-0081-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Urologists have led the basic science and clinical research of organic-based issues in male sexual dysfunction. Concerning scientific, evidence-based, biologic-focused information, the field of sexual dysfunction in women is relatively new compared with sexual dysfunction in men. Basic science, epidemiology, physiology, pathophysiology, diagnosis, and treatment data on women's sexual health issues are now more regularly published than ever before, with the urologic community once again leading the way. This article reviews some pioneering, resourceful, creative, and novel contributions that urologists have made to enhance the understanding of sexual dysfunction in women. As is obvious in infertility treatment, sexual medicine health care requires biologic and psychologic attention to both members of the couple. The goal of all sexual medicine health care providers is to provide the best health care delivery to women and men with sexual health concerns.
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Affiliation(s)
- Irwin Goldstein
- San Diego Sexual Medicine, Alvarado Hospital, San Diego, CA 92120, USA.
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Jodoin M, Bergeron S, Khalifé S, Dupuis MJ, Desrochers G, Leclerc B. Male partners of women with provoked vestibulodynia: attributions for pain and their implications for dyadic adjustment, sexual satisfaction, and psychological distress. J Sex Med 2008; 5:2862-70. [PMID: 18637992 DOI: 10.1111/j.1743-6109.2008.00950.x] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Provoked vestibulodynia is a female genital pain condition that results in sexual dysfunction and impacts negatively on the couple. Although patients' causal attributions have been linked to worse psychosexual outcomes, no study has documented the male partners' perspective of this distressing problem and its potential influence on their psychosexual adaptation. AIM To identify whether male partners' attributions for vestibulodynia are possible predictors of their dyadic adjustment, sexual functioning, sexual satisfaction, and psychological distress, as well as of women's pain and sexual functioning. METHODS Thirty-eight women with vestibulodynia first completed measures of pain intensity and sexual functioning. Male partners responded to mailed questionnaires assessing their own attributions for genital pain as well as their psychological distress, relationship adjustment, sexual functioning, and sexual satisfaction. MAIN OUTCOME MEASURES Women completed the McGill-Melzack Pain Questionnaire (MPQ) and the Female Sexual Function Index (FSFI). Attributions of male partners were measured using an adapted version of the Attributional Style Questionnaire (ASQ)-Partner Version. Men also filled out the Brief Symptom Inventory (BSI), the Dyadic Adjustment Scale (DAS), the Sexual History Form (SHF), and the Global Measure of Sexual Satisfaction (GMSEX). RESULTS All four negative attribution dimensions and higher levels of women's pain intensity successfully predicted increased psychological distress in male partners. Higher levels of both internal and global attributions were associated with men's poorer dyadic adjustment, whereas global and stable attributions were related to their lower sexual satisfaction. Attributions failed to significantly predict sexual functioning in male partners and women's pain and sexual functioning. CONCLUSIONS Evaluation and treatment of sexual pain problems should involve both partners and should explore the role of negative attributions.
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Affiliation(s)
- Mélanie Jodoin
- Department of Sexology, University of Quebec at Montreal, Montreal, QC, Canada.
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Pitts M, Ferris J, Smith A, Shelley J, Richters J. Prevalence and Correlates of Three Types of Pelvic Pain in a Nationally Representative Sample of Australian Men. J Sex Med 2008; 5:1223-1229. [DOI: 10.1111/j.1743-6109.2007.00784.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Rosenbaum TY, Owens A. Continuing Medical Education: The Role of Pelvic Floor Physical Therapy in the Treatment of Pelvic and Genital Pain-Related Sexual Dysfunction (CME). J Sex Med 2008; 5:513-23; quiz 524-5. [DOI: 10.1111/j.1743-6109.2007.00761.x] [Citation(s) in RCA: 99] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Nickel JC, Mullins C, Tripp DA. Development of an evidence-based cognitive behavioral treatment program for men with chronic prostatitis/chronic pelvic pain syndrome. World J Urol 2008; 26:167-72. [PMID: 18293000 DOI: 10.1007/s00345-008-0235-6] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2007] [Accepted: 01/02/2008] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVES Psychosocial factors reported by patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) promote greater pain, disability, and ultimately poorer quality of life (QOL). We targeted those parameters in the development of a cognitive-behavioral (CB) program designed specifically for CP/CPPS. METHODS AND MATERIALS Five NIH sponsored biopsychosocial studies examined predictors of pain, disability, and QOL in CP/CPPS men. Pain, urinary symptoms, QOL, depressive symptoms, catastrophic thinking about pain, perceived control over pain, pain-contingent resting as a pain coping measure, social support and interaction, sexual functioning, and relationship issues were assessed. These data showed that CB intervention for pain catastrophizing, pain contingent rest, social support and depressive symptoms is warranted for men with CP/CPPS RESULTS: An evidence based 8-week CB program was developed. The content of the CB sessions are defined in an instructional patient workbook for each of the weekly 1-h sessions. The CB program guides patients in examining the relationship between their symptom-based distress, their thinking at such times and the emotions linked with those thoughts, and their behavioral responses to their particular thinking style (e.g., illness vs. wellness focused). Patients complete such analyses by using a Reaction Record format, which also delineates new thinking/behavioral responses. CONCLUSIONS The CB program developed for CP/CPPS is the first comprehensive attempt to target specific evidence supported biopsychosocial variables for both symptom and QOL improvement in CP/CPPS and is expected to provide a useful tool for the clinical management of this chronic condition.
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Affiliation(s)
- J Curtis Nickel
- Department of Urology and Psychology, Queen's University, Kingston, ON, K7L 2V7, Canada.
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Nickel JC, Parsons CL, Forrest J, Kaufman D, Evans R, Chen A, Wan G, Xiao X. Improvement in sexual functioning in patients with interstitial cystitis/painful bladder syndrome. J Sex Med 2007; 5:394-9. [PMID: 18086174 DOI: 10.1111/j.1743-6109.2007.00686.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Sexual functioning is one of the strongest predictors of poorer quality of life (QOL) in patients diagnosed with interstitial cystitis/painful bladder syndrome (IC/PBS). AIMS To examine the relationship between symptom reduction and sexual functioning in patients with IC/PBS. METHODS Patients with IC/PBS were treated with 300 mg/day pentosan polysulfate sodium for 32 weeks. MAIN OUTCOME MEASURES Patients completed the O'Leary-Sant Interstitial Cystitis Symptom Index, Short Form-12 QOL, and Medical Outcomes Study Sexual Functioning Scale at baseline, and at 8, 16, 24, and 32 weeks. Treatment responders were defined as those achieving a >/=30% reduction in symptom index from baseline. RESULTS A total of 128 patients were included in the analyses. At baseline, mean symptom index, QOL (physical and mental), and sexual functioning scores were 12.3, 41.7, 45.9, and 56.1, respectively. Patients showed statistically significant improvement in symptom and sexual functioning scores at weeks 8, 16, 24, and 32. At week 32, the mean change in symptom index score from baseline was -2.97 (standard deviation [SD] = 4.66, P < 0.0001), and the mean change in sexual functioning score from baseline was 8.9 (SD = 32.9, P = 0.0054). Reduction in symptom index score was moderately correlated with improvement in sexual functioning score at the end of study (r = -35, P = 0.0002). Positive correlation was observed at the end of the study between the mean change scores of sexual functioning score and physical and mental QOL components (r = 0.46, P < 0.0001 and r = 0.29, P = 0.0023, respectively). Patients achieving a >/=30% reduction in symptom index (responder, N = 47; 44%) had an adjusted mean change in sexual functioning score of 19.8 (standard error [SE] = 4.69), while nonresponders (N = 59, 56%) had an adjusted mean change -0.49 (SE = 4.17) (between groups, P = 0.0020). CONCLUSIONS Sexual dysfunction is moderate to severe in patients with IC/PBS and impacts significantly on QOL. Reduction in symptoms was associated with improvement in the patient-reported outcomes of sexual function.
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Abstract
INTRODUCTION Chronic pelvic pain (CPP) is a common gynecological problem that is also associated with sexual dysfunction. AIM The purpose of this research was to investigate the validity and reliability of Female Sexual Function Index (FSFI) in women with CPP. METHOD One hundred women with CPP and 100 age-matched subjects without CPP were compared in the study. MAIN OUTCOME MEASURES Sexual function was assessed by FSFI. RESULTS Internal consistency (Cronbach's alpha values = 0.91-0.97) was high for all scales. There were significant differences between women with and without CPP for each of the FSFI domain and total scores with very large effect sizes (1.29-2.56) (P < 0.0001, for all). Interdomain correlations of FSFI in the CPP group corresponded well to each other (P < 0.0001, for all). Moreover, test-retest reliability (r = 0.79-0.90) was also within acceptable ranges for this population. CONCLUSION We concluded that the FSFI showed good ability to discriminate between women with and without sexual dysfunctions in the CPP population.
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Affiliation(s)
- Fatma Ferda Verit
- Department of Obstetrics and Gynecology, Harran University Faculty of Medicine, Sanliurfa, Turkey.
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