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Origo D, Dal Farra F, Bruni MF, Catalano A, Marzagalli L, Bruini I. Are fascial strains involved in chronic pelvic pain syndrome? An exploratory matched case-control study. Int Urol Nephrol 2023; 55:511-518. [PMID: 36522568 DOI: 10.1007/s11255-022-03448-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 12/08/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Chronic pelvic pain (CPP) and chronic pelvic pain syndrome (CPPS) do not have a definite cause, even if their impact on quality of life was demonstrated. Furthermore, there is evidence of myofascial dysfunctions in a large number of CPP/CPPS, so that the role of fascia can be hypothesized. METHODS The aim of this exploratory matched case-control study was to assess whether fascial strains (FS) represent a factor associated with CPP/CPPS. The study followed the "Strengthening the Reporting of Observational Studies in Epidemiology" (STROBE) statement. We collected data from 189 subjects (cases: 58; controls: 131) who attended the clinic. The participants were managed through a 2:1 enrollment ratio. A standardized booklet requested for clinical information, previous FS and the following questionnaires: "National Institutes of Health Chronic Prostatitis Symptom Index" (NIH-CPSI), "Hospital Anxiety and Depression Scale" (HADS), "Fear Avoidance Belief Questionnaire" (FABQ). Each subject underwent a palpatory assessment to detect abnormal palpatory findings in the pelvic area. RESULTS The analyses showed that episiotomy, genito-urinary infections and surgery had a significantly increased odds ratio (OR) of 4.13, 3.1 and 3.08, respectively. FS as a whole had a significantly raised OR: 2.22 (1.14 to 4.33). The analysis was adjusted for physical activity and for type of job and OR decreased to 1.94 (0.82 to 4.61), losing its significance (p = 0.129). A strong correlation between symptoms' impact and CPP/CPPS was detected (rpbs = 0.710; p < 0.001) and a moderate one (0.3 < rpbs < 0.7; p < 0.001) was found considering anxiety, depression and abnormal palpatory findings. CONCLUSION This exploratory study suggests that FS could represent an etiological factor for developing CPP/CPPS. However, further research on fascial dysfunctions and relative implications in CPP/CPPS is needed for confirmation.
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Affiliation(s)
- Daniele Origo
- Research Department, SOMA Osteopathic Institute Milan, Viale Sarca 336 F, 20126, Milan, Italy
| | - Fulvio Dal Farra
- Research Department, SOMA Osteopathic Institute Milan, Viale Sarca 336 F, 20126, Milan, Italy. .,Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
| | - Maria Federica Bruni
- Research Department, SOMA Osteopathic Institute Milan, Viale Sarca 336 F, 20126, Milan, Italy
| | - Andrea Catalano
- Research Department, SOMA Osteopathic Institute Milan, Viale Sarca 336 F, 20126, Milan, Italy
| | - Lorenzo Marzagalli
- Research Department, SOMA Osteopathic Institute Milan, Viale Sarca 336 F, 20126, Milan, Italy
| | - Irene Bruini
- Research Department, SOMA Osteopathic Institute Milan, Viale Sarca 336 F, 20126, Milan, Italy
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Li ASW, Van Niekerk L, Wong ALY, Matthewson M, Garry M. Psychological management of patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS): a systematic review. Scand J Pain 2023; 23:25-39. [PMID: 35938980 DOI: 10.1515/sjpain-2022-0049] [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: 03/18/2022] [Accepted: 06/30/2022] [Indexed: 01/17/2023]
Abstract
OBJECTIVES Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a complex condition. Despite recommendations for the inclusion of non-pharmacological treatment in the management of CP/CPPS, the focus has predominantly been on the inclusion of physical therapies with minimal discussion of psychological interventions. Therefore, this systematic review aimed to evaluate peer-reviewed studies of psychological interventions for men with CP/CPPS to determine their therapeutic efficacy and quality of intervention. METHODS The review was registered in PROSPERO and based on PRISMA 2020 protocol. The systematic literature search was conducted in six databases. Quantitative studies of psychological intervention for adult men with CP/CPPS that provided outcome measures of pain, quality of life and/or psychological symptoms were reviewed. The Oxford level of evidence and Quality Assessment Tool for Quantitative Studies developed by the Effective Public Health Practice were employed. RESULTS A total of 4,503 studies were reviewed; seven met the inclusion criteria. The included studies were randomised controlled trials, cohort, repeated measures, and case-series studies, with most including combined treatment for CP/CPPS. Cognitive therapy, cognitive behavioural therapy, or paradoxical relaxation training were found to be effective. However, high risks of bias were found in all included studies, limiting the generalisability and reliability of findings. CONCLUSIONS Evidence is preliminary but shows promise for psychological treatment either as a combined or standalone treatment for CP/CPPS. However, there is a need to develop research with a more rigorous methodology to evaluate psychological treatments for men with CP/CPPS.
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Affiliation(s)
- Arthur Sone-Wai Li
- School of Psychological Sciences, College of Health and Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Leesa Van Niekerk
- School of Psychological Sciences, College of Health and Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Aquina Lim Yim Wong
- School of Psychological Sciences, College of Health and Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Mandy Matthewson
- School of Psychological Sciences, College of Health and Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Michael Garry
- School of Psychological Sciences, College of Health and Medicine, University of Tasmania, Hobart, TAS, Australia
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3
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The longitudinal association of symptom-related and psychological factors with health-related quality of life in patients with chronic pelvic pain syndrome. J Psychosom Res 2022; 153:110707. [PMID: 34954604 DOI: 10.1016/j.jpsychores.2021.110707] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 12/15/2021] [Accepted: 12/15/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To analyze the course of symptom-related measures, psychological variables and health-related quality of life (HRQoL) over a 12-month period, and to longitudinally examine symptom-related and psychological factors as predictors for HRQoL in male and female patients with chronic pelvic pain syndrome (CPPS). METHODS Data from 125 patients aged 19-83 years at baseline attending an interdisciplinary outpatient clinic for CPPS were analyzed. Participants completed a self-administered questionnaire on subjective health issues, and a postal follow-up survey was conducted 12 months later. We assessed physical and mental HRQoL, CPPS symptom severity, pain intensity, severity of somatic, depressive and anxiety symptoms, pain catastrophizing, and data on treatments during the follow-up period. Data were analyzed using multilevel linear modelling. RESULTS CPPS symptom severity, pain intensity, and pain catastrophizing significantly decreased over time. HRQoL and levels of somatic symptoms, depressive symptoms and anxiety remained stable. Lower baseline levels of somatic symptoms were associated with an increase in physical HRQoL, and lower baseline levels of depressive symptoms, anxiety and pain catastrophizing were associated with an increase in mental HRQoL after 12 months. Treatment utilization was neither related to decrease in CPPS symptom severity, pain intensity and pain catastrophizing, nor to HRQoL after 12 months. CONCLUSIONS Our data suggest that CPPS is related to persistently diminished HRQoL. Somatic symptoms and psychological factors are important determinants of HRQoL and potential therapeutic targets. To evaluate the efficacy and impact of treatment on CPPS-related outcomes, future large-scaled studies should systematically assess detailed data about therapies patients receive in routine care.
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4
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The Translational Role of Animal Models for Estrogen-Related Functional Bladder Outlet Obstruction and Prostatic Inflammation. Vet Sci 2022; 9:vetsci9020060. [PMID: 35202312 PMCID: PMC8877003 DOI: 10.3390/vetsci9020060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 01/24/2022] [Accepted: 01/27/2022] [Indexed: 12/10/2022] Open
Abstract
The prevalence of LUTS and prostatic diseases increases with age both in humans and companion animals, suggesting that a common underlying cause of these conditions may be age-associated alterations in the balance of sex hormones. The symptoms are present with different and variable micturition dysfunctions and can be assigned to different clinical conditions including bladder outlet obstruction (BOO). LUTS may also be linked to chronic non-bacterial prostatitis/chronic pelvic pain syndrome (CP/CPPS), but the relationship between these conditions is unknown. This review summarizes the preclinical data that supports a role for excessive estrogen action in the development of obstructive voiding and nonbacterial prostatic inflammation. Preclinical studies that are emphasized in this review have unequivocally indicated that estrogens can induce functional and structural changes resembling those seen in human diseases. Recognizing excessive estrogen action as a possible hormonal basis for the effects observed at multiple sites in the LUT may inspire the development of innovative treatment options for human and animal patients with LUTS associated with functional BOO and CP/CPPS.
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5
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Distribution of the positive UPOINT domain in patients with chronic prostatitis or chronic pelvic pain syndrome: A multicenter observational study. J Infect Chemother 2022; 28:631-634. [DOI: 10.1016/j.jiac.2022.01.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/10/2022] [Accepted: 01/12/2022] [Indexed: 11/21/2022]
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Brünahl CA, Klotz SGR, Dybowski C, Albrecht R, Höink J, Fisch M, Ketels G, Löwe B. Physiotherapy and combined cognitive-behavioural therapy for patients with chronic pelvic pain syndrome: results of a non-randomised controlled feasibility trial. BMJ Open 2021; 11:e053421. [PMID: 34907064 PMCID: PMC8671982 DOI: 10.1136/bmjopen-2021-053421] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To explore feasibility in terms of delivering and evaluating a combination of physiotherapy and psychotherapy for patients with chronic pelvic pain syndrome (CPPS). DESIGN Prospective non-randomised controlled pilot study. SETTING Tertiary care facility with a specialised interdisciplinary outpatient clinic for patients with CPPS. PARTICIPANTS A total of 311 patients was approached; 60 participated. 36 patients were included in the intervention group (mean age ±SD 48.6 years±14.8; 52.8% female) and 24 in the control group (mean age ±SD 50.6 years±14.5; 58.3% female). Fourteen participants were lost to follow-up. INTERVENTIONS Participants were non-randomly allocated to the intervention group with two consecutive treatment modules (physiotherapy and cognitive behavioural therapy) with a duration of 9 weeks each or to the control group (treatment as usual). MAIN OUTCOME MEASURES Feasibility was operationalised in terms of delivering and evaluating the therapeutic combination. Regarding eligibility as the first aspect of feasibility, willingness to participate, dropout and satisfaction were assessed; for the second aspect, standardised self-report questionnaires measuring health-related quality of life, depression severity and pain were applied. RESULTS Although eligibility and willingness-to-participate rates were low, satisfaction of the participants in the intervention group was high and dropout rates were low. Results indicated a small and non-significant intervention effect in health-related quality of life and significant effects regarding depression severity and pain. CONCLUSIONS The combination of physiotherapy and psychotherapy for patients with CPPS seems to be feasible and potentially promising with regard to effect. However, a subsequent fully powered randomised controlled trial is needed. TRIAL REGISTRATION NUMBER German Clinical Trials Register (DRKS00009976) and ISRCTN (ISRCTN43221600).
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Affiliation(s)
- Christian A Brünahl
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Susanne G R Klotz
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Physiotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christoph Dybowski
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Rebecca Albrecht
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Johanna Höink
- Department of Gynaecology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Margit Fisch
- Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Gesche Ketels
- Department of Physiotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Bernd Löwe
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Piontek K, Apfelbacher C, Ketels G, Brünahl C, Löwe B. Depression Partially Mediates the Association of Adverse Childhood Experiences with Pain Intensity in Patients with Chronic Pelvic Pain Syndrome: Results from a Cross-Sectional Patient Survey. PAIN MEDICINE 2021; 22:1174-1184. [PMID: 33155025 DOI: 10.1093/pm/pnaa325] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Adverse childhood experiences (ACEs), such as emotional and physical maltreatment, are linked to chronic pelvic pain syndrome (CPPS) in adults. Psychological factors are important in understanding CPPS. We aimed to determine the nature and frequency of ACEs in male and female patients with CPPS and to investigate whether somatic symptoms and psychological comorbidities mediate the relationship of ACE severity with pain intensity. DESIGN Cross-sectional study. SETTING Interdisciplinary outpatient clinic for CPPS in Hamburg, Germany. SUBJECTS Individuals with CPPS (n = 234) who were 18 to 84 years of age. METHODS Using a self-administered questionnaire, we assessed the history of ACEs (ACE Scale), pain intensity (McGill Pain Questionnaire), somatic symptoms (Patient Health Questionnaire-15]), depression (Patient Health Questionnaire-9), and anxiety (Generalized Anxiety Disorder Scale). Parallel mediation analysis was conducted to examine whether the association of ACE severity with pain intensity is mediated by somatic symptoms, depression, and anxiety. RESULTS Emotional abuse and neglect were reported more than twice as often as physical abuse and neglect (37.2% vs 17.1%). Depression partially mediated the association of ACE severity with pain intensity in the whole study population. In sex-stratified analyses, different patterns of associations were observed, but somatic symptoms predicted pain intensity in both sexes. CONCLUSIONS Emotional maltreatment was highly prevalent, supporting an increased consideration of psychological factors in CPPS and indicating the need to screen for ACEs in patients with CPPS. Findings further suggest that depression and somatic symptoms may be important targets for therapeutic interventions in patients with CPPS who have a history of childhood adversity.
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Affiliation(s)
- Katharina Piontek
- Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Christian Apfelbacher
- Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Gesche Ketels
- Department of Physiotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christian Brünahl
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Bernd Löwe
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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8
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Mohiuddin M, Park R, Wesselmann U, Pukall C, Jarvi K, Nickel C, Doiron C, Gilron I. Efficacy and Safety of Drug Combinations for Chronic Pelvic Pain: Protocol for a Systematic Review. JMIR Res Protoc 2021; 10:e21909. [PMID: 33999006 PMCID: PMC8167620 DOI: 10.2196/21909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 02/24/2021] [Accepted: 04/16/2021] [Indexed: 11/13/2022] Open
Abstract
Background Chronic pelvic pain with various etiologies and mechanisms affects men and women and is a major challenge. Monotherapy is often unsuccessful for chronic pelvic pain, and combinations of different classes of medications are frequently prescribed, with the expectation of improved outcomes. Although a number of combination trials for chronic pelvic pain have been reported, we are not aware of any systematic reviews of the available evidence on combination drug therapy for chronic pelvic pain. Objective We have developed a protocol for a systematic review to evaluate available evidence of the efficacy and safety of drug combinations for chronic pelvic pain. Methods This systematic review will involve a detailed search of randomized controlled trials investigating drug combinations to treat chronic pelvic pain in adults. The databases searched will include the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, and EMBASE from their inception until the date the searches are run to identify relevant studies. The primary outcome will be pain relief measured using validated scoring tools. Secondary outcomes, where reported, will include the following: adverse events, serious adverse events, sexual function, quality of life, and depression and anxiety. Methodological quality of each included study will be assessed using the Cochrane Risk of Bias Tool. Results The systematic review defined by this protocol is expected to synthesize available good quality evidence on combination drug therapy in chronic pelvic pain, which may help guide future research and treatment choices for patients and their health care providers. Conclusions This review will provide a clearer understanding of the efficacy and safety of combination pharmacological therapy for chronic pelvic pain. Trial Registration PROSPERO International Prospective Register of Systematic Reviews CRD42020192231; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=192231 International Registered Report Identifier (IRRID) PRR1-10.2196/21909
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Affiliation(s)
- Mohammed Mohiuddin
- Department of Anesthesiology & Perioperative Medicine, Kingston General Hospital, Queen's University, Kingston, ON, Canada
| | - Rex Park
- Department of Anesthesiology & Perioperative Medicine, Kingston General Hospital, Queen's University, Kingston, ON, Canada
| | - Ursula Wesselmann
- Departments of Anesthesiology and Perioperative Medicine, Division of Pain Medicine, Neurology and Psychology, The University of Alabama at Birmingham, Birmingham, AL, United States
| | - Caroline Pukall
- Department of Psychology, Centre for Neuroscience Studies, School of Rehabilitation Therapy, Queen's University, Kingston, ON, Canada
| | - Keith Jarvi
- Division of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Curtis Nickel
- Department of Urology, Queen's University, Kingston, ON, Canada
| | | | - Ian Gilron
- Department of Anesthesiology & Perioperative Medicine, Kingston General Hospital, Queen's University, Kingston, ON, Canada
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Zhang J, Zhang X, Cai Z, Li N, Li H. The Lifetime Risk and Prognosis of Chronic Prostatitis/Chronic Pelvic Pain Syndrome in the Middle-Aged Chinese Males. Am J Mens Health 2020; 13:1557988319865380. [PMID: 31311396 PMCID: PMC6637838 DOI: 10.1177/1557988319865380] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Knowledge is limited about the lifetime risk of chronic pelvic pain syndrome (CPPS) occurrence in Chinese middle-aged males and the prognosis of CPPS patients with and without treatment. Noninstitutionalized Chinese males aged 40 to 81 years were enrolled in this study from a total of 76 local communities across 30 provinces of China. Information about the occurrence of CPPS, symptom relief, and previous treatment was collected. Based on completed answers to specific questions about self-reported and physician-diagnosed CPPS, the lifetime risk of CPPS occurrence was 25.3% (1,091 out of 4,315) in Chinese males aged 40 to 81 years. Over 77% of patients with CPPS had received treatment. The symptom relief rate was not significantly different between the treatment (57.3%, 142/248) and nontreatment (50.1%, 422/843) groups. Regardless of whether patients had received medical treatment, engagement in sedentary work and regular alcohol consumption had a significant negative influence, while marriage had a positive influence, on the prognosis of CPPS. A good prognosis could be achieved without treatment for some cases of CPPS, while others required a timely symptom-orientated treatment using adequate medications combined with lifestyle adjustment and follow-up.
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Affiliation(s)
- Jianzhong Zhang
- 1 Department of Urology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Xinyu Zhang
- 1 Department of Urology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.,2 Department of Urology, Navy General Hospital of Chinese PLA, Beijing, China
| | - Zhonglin Cai
- 1 Department of Urology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Ni Li
- 3 Program Office for Cancer Screening in Urban China, Cancer Hospital and Institute, Chinese Academy of Medical Sciences, Beijing, China
| | - Hongjun Li
- 1 Department of Urology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
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Abdessater M, Elias S, Mikhael E, Alhammadi A, Beley S. Post orgasmic illness syndrome: what do we know till now? Basic Clin Androl 2019; 29:13. [PMID: 31508233 PMCID: PMC6721082 DOI: 10.1186/s12610-019-0093-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 07/29/2019] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Peri orgasmic dysfunctions are very rare and little information exists on their diagnosis and treatment. One of these conditions is post-orgasmic illness syndrome (POIS), manifesting by a debilitating cluster of symptoms affecting men within seconds, minutes, or hours after ejaculation. The aim of this article is to do a thorough literature review about POIS, in order to elucidate the pathophysiology, the diagnosis and the management of this rare disease. RESULTS Updated literature review on Pubmed was done, using the following terms: "orgasm illness", "post-orgasmic" and "postorgasmic illness syndrome". The references of the 17 identified publications were also reviewed for additional 8 relevant articles that were all included in the results.POIS has 5 preliminary diagnostic criteria and criterion 1 has 7 described clusters. Pathophysiological hypotheses include: immunological phenomenon (most relevant), opioid-like withdrawal, neuroendocrine response, transient deregulation of the autonomic nervous system, hypersensitivity and disordered cytokines. Differential diagnoses include: chronic prostatitis, orgasmolepsy, benign orgasmic cephalgia, sneezing and rhinorrhea, postcoital dysphoria, post-coital asthma and rhinitis. Patients have been symptomatically treated with antihistamines, non-steroidal anti-inflammatory drugs, selective serotonin reuptake inhibitors, and benzodiazepines. A trial of hyposensitization therapy with autologous semen was successful. CONCLUSION POIS is a rare condition that is underdiagnosed, most probably because of its unclear pathophysiology leading to a lack of treatment options. Further studies are warranted to investigate the prevalence, pathophysiology, and management of this debilitating condition.
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Affiliation(s)
- Maher Abdessater
- Groupe Hospitalier Diaconesses - Croix Saint Simon, 125 rue d’Avron, 75020 Paris, France
| | | | - Elie Mikhael
- Groupement hospitalier Eaubonne, Montmorency (Hôpital Simone Veil), Eaubonne, France
| | - Abdalla Alhammadi
- Groupe Hospitalier Diaconesses - Croix Saint Simon, 125 rue d’Avron, 75020 Paris, France
| | - Sebastien Beley
- Groupe Hospitalier Diaconesses - Croix Saint Simon, 125 rue d’Avron, 75020 Paris, France
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11
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Chronic prostatitis: differential diagnosis. Case report discussion. КЛИНИЧЕСКАЯ ПРАКТИКА 2019. [DOI: 10.17816/clinpract10285-90] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
The diagnostics of chronic pelvic pain is a complex interdisciplinary problem. It requires a thorough and detailed clinical examination involving clinicians of various specialties. Neuropathic pain in the structure of chronic pelvic pain is present in 1/3 of patients, which call the need for a close cooperation between the urologist and neurologist at all the stages of the management of these patients. The presented clinical analysis demonstrates an algorithm for such an interdisciplinary interaction, which provides a care for a patient with this complex and debilitating pathology.
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12
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Search for Novel Diagnostic Biomarkers of Prostate Inflammation-Related Disorders: Role of Transglutaminase Isoforms as Potential Candidates. Mediators Inflamm 2019; 2019:7894017. [PMID: 31360119 PMCID: PMC6652054 DOI: 10.1155/2019/7894017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 06/13/2019] [Indexed: 12/26/2022] Open
Abstract
Investigations on prostate inflammation-related disorders, including acute and chronic prostatitis, chronic pelvic pain syndrome, benign prostate hyperplasia (BPH), and prostate cancer (PCa), are still ongoing to find new, accurate, and noninvasive biomarkers for a differential diagnosis of those pathological conditions sharing some common macroscopic features. Moreover, an ideal biomarker should be useful for risk assessment of prostate inflammation progression to more severe disorders, like BPH or PCa, as well as for monitoring of treatment response and prognosis establishment in carcinoma cases. Recent literature evidence highlighted that changes in the expression of transglutaminases, enzymes that catalyze transamidation reactions leading to posttranslational modifications of soluble proteins, occur in prostate inflammation-related disorders. This review focuses on the role specifically played by transglutaminases 4 (TG4) and 2 (TG2) and suggests that both isoenzymes hold a potential to be included in the list of candidates as novel diagnostic biomarkers for the above-cited prostate pathological conditions.
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13
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von Gontard A, Vrijens D, Selai C, Mosiello G, Panicker J, van Koeveringe G, Apostolidis A, Anding R. Are psychological comorbidities important in the aetiology of lower urinary tract dysfunction-ICI-RS 2018? Neurourol Urodyn 2019; 38 Suppl 5:S8-S17. [PMID: 31059602 DOI: 10.1002/nau.24016] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 02/10/2019] [Accepted: 04/11/2019] [Indexed: 12/19/2022]
Abstract
AIMS To review studies on the comorbid psychological symptoms and disorders in patients with lower urinary tract disorders (LUTD) over the life-span, to analyse how they contribute toward the aetiology of LUTD and to discuss optimal service implementation. MATERIALS AND METHODS A review of relevant literature was conducted and presented during the ICI-RS meeting in 2018. Open questions and future directions were discussed. RESULTS On the basis of current research, there is overwhelming evidence in all age groups that psychological comorbidities are more common in patients with LUTD. Vice versa, patients with psychiatric disorders have higher rates of LUTD. The types of LUTDs and psychiatric disorders are heterogeneous. Complex aetiological models best explain specific associations of comorbidity. Irrespective of aetiology, it is advisable to address both urological and psychological issues in patients of all age groups with LUTD. CONCLUSIONS Psychological symptoms and disorders play a decisive role in the development of LUTD in all age groups and need to be considered in the assessment and treatment of LUTD.
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Affiliation(s)
- Alexander von Gontard
- Department of Child and Adolescent Psychiatry, Saarland University Hospital, Homburg, Germany
| | - Desiree Vrijens
- Department of Urology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Caroline Selai
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Giovanni Mosiello
- Department of Surgery, Urology and Neuro-Urology, Bambino Gesù Pediatric Hospital, Rome, Italy
| | - Jalesh Panicker
- Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Gommert van Koeveringe
- Department of Urology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Apostolos Apostolidis
- 2nd Department of Urology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ralf Anding
- Department of Urology, Pediatric Urology and Neuro-Urology, University Hospital Bonn, Bonn, Germany
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14
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Piontek K, Ketels G, Albrecht R, Schnurr U, Dybowski C, Brünahl CA, Riegel B, Löwe B. Somatic and psychosocial determinants of symptom severity and quality of life in male and female patients with chronic pelvic pain syndrome. J Psychosom Res 2019; 120:1-7. [PMID: 30929698 DOI: 10.1016/j.jpsychores.2019.02.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 02/18/2019] [Accepted: 02/20/2019] [Indexed: 02/08/2023]
Abstract
AIMS To investigate the combined impact of somatic and psychosocial factors on symptom severity and physical and mental quality of life (QoL) in male and female patients with chronic pelvic pain syndrome (CPPS). METHODS We examined 234 patients aged 18 to 84 years attending an interdisciplinary outpatient clinic for patients with CPPS in Hamburg, Germany. Using self-reports, we assessed CPPS symptom severity (NIH-CPSI), with the female counterpart of each male anatomical site used in the questionnaire for women; physical and mental QoL (SF-12) as well as symptoms of depression (PHQ-9) and anxiety (GAD-7); pain catastrophizing cognitions (PCS); social support (F-SozU) and medication intake. The presence of trigger and tender points was assessed in a physiotherapy examination. Hierarchical multiple regression analysis was calculated to analyze the contribution of somatic and psychosocial variables on CPPS symptom severity. Analyses were repeated with physical and mental QoL as outcomes. RESULTS In the overall model, the intake of pain medication (B = 3.78, SE = 1.25, p = .006), the presence of depressive symptoms (B = 0.40, SE = 0.15, p = .01) and pain catastrophizing (B = 0.18, SE = 0.05, p = .001) significantly predicted CPPS symptom severity. Corresponding analyses revealed a differential pattern of factors predicting physical and mental QoL, whereas higher levels of depressive symptoms were consistently associated with diminished mental (B = -0.63; p < .001) and physical QoL (B = -0.85; p < .001). CONCLUSION Present results emphasize the importance of psychosocial factors, in particular of depression, in CPPS symptom severity and both physical and mental QoL and give support to an integrated treatment concept encompassing both psychological support and somatic aspects of the disease.
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Affiliation(s)
- Katharina Piontek
- Institute for Medical Psychology, University Medicine Greifswald, Greifswald, Germany; Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Gesche Ketels
- Department of Physiotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Rebecca Albrecht
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ulrike Schnurr
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christoph Dybowski
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christian A Brünahl
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Björn Riegel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Bernd Löwe
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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