良性前列腺增生合并前列腺炎的研究进展

良性前列腺增生和前列腺炎是两种最常见的前列腺疾病。越来越多的研究发现良性前列腺增生常与炎症改变并存,并且具有相互诱导的关系。本文对良性前列腺增生合并前列腺炎的流行病学、组织病理学、诊断和治疗作一综述。     

雌激素及雌激素受体与前列腺疾病的关系

正前列腺疾病是影响着许多男性身体健康的常见疾病。前列腺炎、良性前列腺增生(BPH)及前列腺癌(PCa)这三种疾病的发生发展与性激素有关系。以往多从雄激素作用机制和生长因子等方面进行研究,现在雌激素的作用越来越受到重视。本文就雌激素及其受体在前列腺炎、良性前列腺增生与前列腺癌疾病中的影响进行综述,旨在为前列腺疾病的诊断和治疗发现新的思路和方法。     

PDE5抑制剂缓解前列腺炎症状的机制

目前慢性前列腺炎是一个常见的泌尿系统疾病,通常没有确定的病因和治疗方案.Grimsley SJ等人进行了一项相关研究.研究者假设PDE5抑制剂介导了前列腺导管平滑肌舒张,有助于代谢前列腺代谢产物,从而减轻前列腺炎症和缓解随之产生的前列腺炎症状.     

微波治疗前列腺疾患的疗效分析

前列腺良性增生是老年人常见疾病。慢性前列腺炎是一种治疗效果较差的疾病。近年来发现热疗不仅可用于治疗肿瘤,也可用于治疗良性前列腺增生症及前列腺炎。我院自1993年引进瑞典产大功率微波治疗     

前列腺疾病与勃起功能障碍关系的研究进展

前列腺疾病和勃起功能障碍均为泌尿外科及男科的常见病、多发病,基础及临床研究均证实两者之间存在密切联系。本文对急慢性前列腺炎、良性前列腺增生、前列腺癌等前列腺疾病引起勃起功能障碍的机制、诊断及治疗进行了综述。     

射频治疗前列腺疾病200例报告

自1993年4月至1994年4月用经尿道射频疗法治疗前列腺疾病200例,其中前列腺增生140例,慢性前列腺炎60例。前列腺增生组治疗有效率82.92%,少数病人有副反应,主要为急性尿潴留(5%)、尿路感染(2.5%)和血,尿(2.57%);慢性前列腺炎组治疗有效率80.5%,无明显副作用产生。     

前列腺炎与良性前列腺增生发生的纵向关系

目的 通过对明尼苏达州奥姆斯特德县2447名居民的研究,观察经内科确诊的前列腺炎与后来发生的良性前列腺增生症(BPH)的关系.方法 回顾分析有病史记录的内科确诊为前列腺炎以及后来发展成为前列腺增生症、大前列腺、前列腺病态及急性尿潴留的患者并同时回顾分析病史记录曾应用药物或外科治疗的BPH患者.然后用优势比评估前列腺炎与BPH的关系.结果 前列腺炎患者以后发展成为前列腺病态、大前列腺或BPH的优势比为2.4(OR:2.44,95%CI:1.48,4.01).与前列腺炎相关的BPH有70%需要治疗(OR:1.61,95%CI:0.89,1.99).结论 前列腺炎增加了BPH相关事件的发病率,前列腺炎可能是BPH的预测因素或后来发生BPH或其他泌尿系统疾病的危险因素.     

前列腺疾病相关miRNA表达的研究进展

miRNA是一类具有约22个核苷酸的非编码RNA,可以调控各种生物学过程,并调节细胞和基因表达,在细胞和疾病发展过程中发挥巨大作用。近年来,miRNA在前列腺疾病中发挥的作用成为研究热门。通过研究miRNA表达与前列腺疾病之间的关系,可以帮助我们更好的从分子生物学角度认识前列腺疾病,阐释其发病机制,并指导临床治疗及预后。目前,对于前列腺癌相关的miRNA研究较多,涉及疾病的发生、发展、发病机制、诊断、预后和治疗等多个方面。而在前列腺炎和良性前列腺增生方面,相关miRNA表达的研究则相对较少。本文简述miRNA的起源、生物学作用,并回顾了近年来相关miRNA在前列腺炎、良性前列腺增生及前列腺癌中的表达的研究进展,旨在帮助进一步了解miRNA在前列腺疾病中所发挥的作用及相关机制,为临床诊疗前列腺疾病提出新思路,并为未来miRNA在前列腺疾病中的研究提出新见解。     

前列腺炎诊治中几个问题的探讨

目的提高前列腺炎的诊治水平。方法对近5年来临床工作中遇到的前列腺炎漏诊、误诊及认识有误的病例进行分析、探讨。结果有12例急性前列腺炎被误诊、漏诊，其中5例误诊为上呼吸道感染，7例诊断为尿路感染。15例前列腺增生（BPH）伴慢性前列腺炎者，漏诊了前列腺炎。17例慢性前列腺炎伴有其它泌尿生殖系疾病者，漏诊了其中之一。15例前列腺液常规中白细胞数与前列腺炎严重程度及治疗效果不一致。4例B超检查提示前列腺炎，患者无不适，按前列腺炎治疗后反而出现症状。结论前列腺炎诊治中尚存在一些问题。临床工作中需开阔思路，多做肛指检查。对症状、体征、前列腺液检查、B超检查结果等进行综合考虑，才能作出正确的诊断和治疗。     

前列腺炎的研究现状和展望

前列腺炎是泌尿学领域内充满困惑的综合征。在所有前列腺疾病中，前列腺炎的处理是最棘手的。无论是前列腺炎病人，还是治疗前列腺炎的医师，对其治疗效果均不满意，其主要原因是人们对该病缺乏深入的了解和研究〔１，２〕。通过近年来的研究，人们对于前列腺炎的分类、诊...     

慢性非细菌性前列腺炎患者前列腺组织中细菌16SrRNA基因和大肠杆菌tufA mRNA基因的检测

目的 探讨细菌感染与慢性非细菌性前列腺炎的相关性。方法 应用PCR方法检测慢性非细菌性前列腺炎患者前列腺组织中的细菌16SrRNA基因，同时用RT-PCR方法检测其中的大肠杆菌tufAmRNA基因。结果 38例慢性非细菌性前列腺炎患者前列腺组织中31例（81．5％）呈细菌16SrRNA基因阳性；在31例细菌16SrRNA基因阳性的患者前列腺组织中，有6例（19．4％）检出大肠杆菌tufAmRNA基因。结论 慢性非细菌性前列腺炎患者的前列腺组织中不仅有细菌的存在，而且部分被证实是活力细菌。细菌在慢性非细菌性前列腺炎的病因中可能起一定的作用。     

Cytomegalovirus Prostatitis in a Heart Transplant Recipient

Cytomegalovirus (CMV) is the most common viral infection affecting the posttransplantation course of organ recipients. However, CMV involvement of the prostate even in immunocompromised hosts is rare. We describe the first case in the heart transplant literature of a 59‐year‐old heart recipient with CMV prostatitis. An elevated PSA prompted a prostate biopsy revealing an adenocarinoma, chronic prostatitis as well as viral cytopathic effect consistent with CMV infection. CMV PCR in the blood was negative. A few months prior, the patient developed CMV viremia and was treated initially with ganciclovir intravenously and subsequently with valganciclovir and CMV immunoglobulins. The patient did well with brachytherapy and additional anti‐CMV agents. We discuss the role of CMV in the prostate and management of CMV prostatitis. Relationships between CMV, prostate cancer and heart transplantation are also outlined.     

不同分型的慢性前列腺炎对精液质量的影响

目的：研究不同分型的慢性前列腺炎对精液质量恶化的影响。方法：根据目前存在感染和（或）针对前列腺的自身细胞免疫反应情况．将49例慢性前列腺炎患者进行分组。健康正常的个体作为对照组。检查包括精子密度、死亡率、形态、前列腺与精囊标记物、抗精浆抗体、白细胞计数与伴随的炎症前细胞因子。结果：最严重的畸形见于无明显感染而有针对前列腺的自身细胞免疫患者。此外,在此类患者的精浆中检测到炎症前细胞因子水平显著升高。结论：伴有针对前列腺的自身细胞免疫反应的慢性前列腺炎患者的精液质量参数有重要改变,并因此而引起不育。     

TURP术后膀胱颈挛缩的原因分析及预防

目的对经尿道前列腺电切术（transurethral resection of prostate，TURP）后发生膀胱颈挛缩（bladder neck contracture，BNC）的原因进行分析，提出预防措施。方法将TURP术后发生BNC的28例与同期未发生BNC的60例患者进行比较。结果小前列腺、切除的前列腺重量轻、合并前列腺炎、单位时间内电切重量小者均易发生BNC（P〈0．05）。结论小前列腺、合并有前列腺炎及操作不熟练是BNC的可能原因，可采取严格手术适应证、提高操作技能、膀胱颈预切开等方法加以预防。     

Chronic prostatitis/chronic pelvic pain syndrome

In the 20th century, the term "prostatitis" traditionally referred to inflammation in the prostate, often attributed to infection. Prostatitis in this century usually refers to a chronic pain syndrome for which the presence of inflammation and involvement of the prostate are not always certain. This article discusses chronic prostatitis/chronic pelvic pain syndrome and the various factors associated with diagnosis and treatment.     

The prostate has secretory dysfunction for category IIIA and IIIB prostatitis

PURPOSE: We investigated whether the prostate has secretory dysfunction for category IIIA and IIIB prostatitis. MATERIALS AND METHODS: Normal human prostatic secretions are remarkably rich in citrate, which is considered the most useful marker for determining prostate secretory function. It is certain that the prostate has secretory dysfunction for category I and II prostatitis, while it is not clear for category IIIA and IIIB prostatitis. To clarify this question expressed prostatic secretion citrate and pH were determined in 21, 25 and 25 outpatients with category II, IIIA and IIIB prostatitis, respectively, and in 21 normal controls without any prostatic disease. Outpatients with category II disease served as positive controls, while normal controls served as negative controls. No outpatients with category IIIA and IIIB prostatitis underwent treatment. RESULTS: Mean +/- SD expressed prostatic secretion citrate was 3.32 +/- 0.79, 3.41 +/- 0.88, 4.37 +/- 0.77 and 8.55 +/- 1.20 mg/ml in groups II, IIIA, IIIB and normal controls, respectively. Compared to normal controls expressed prostatic secretion citrate was significantly decreased in category II, IIIA and IIIB cases. Furthermore, there was no overlap of expressed prostatic secretion citrate values between category IIIA and IIIB cases, and the normal control group. CONCLUSIONS: The prostate has secretory dysfunction for category IIIA and IIIB prostatitis, which suggests that the prostate may be involved in category IIIA and IIIB prostatitis.     

The issue of prostate cancer evaluation in men with elevated prostate-specific antigen and chronic prostatitis

Elevated levels of prostate-specific antigen (PSA) in men may result from a variety of causes, such as prostate cancer, benign prostatic hyperplasia, acute urinary tract infection, and bacterial prostatitis. In recent years, several studies have also demonstrated a relationship between chronic prostatitis/chronic pelvic pain syndrome and increased PSA levels. However, asymptomatic patients are not routinely screened for this diagnosis before transrectal biopsy is performed to rule out prostate cancer. These asymptomatic men with elevated PSA levels frequently have evidence of inflammation when their expressed prostatic secretions are examined, or on their prostate biopsy specimens. This raises the problem of appropriate evaluation in the presence of chronic prostatitis and elevated PSA levels--not only in prostate cancer screening programmes, but also in cancer-negative biopsy findings. Evidence from the literature indicates that antimicrobial treatment may lower the PSA levels to what is considered the normal range. Despite that, general recommendations for the practical management are lacking and undetected prostate cancer in men with chronic prostatitis remains a difficult issue.     

Microbiology of the prostate

Prostatitis is a common genitourinary disease in men. The National Institutes of Health has defined four types of prostatitis. The bacteriology of acute and chronic bacterial prostatitis is well understood. Causative organisms can be isolated by four-glass urine cultures. Chronic pelvic pain syndrome (CPPS; chronic abacterial prostatitis) is an enigma; whether there is a microbiologic cause for this condition is unknown. Researchers have postulated that CPPS may be an infectious disease of the prostate. This article reviews current literature regarding the microbiology of the prostate in CPPS.     

慢性前列腺炎患者前列腺液中前列腺特异性抗原的变化

目的测定慢性前列腺炎患者前列腺特异性抗原（ＰＳＡ）在前列腺液中的变化,以探讨其对此类疾病诊断的意义。方法对５５例慢性前列腺炎及１１例泌尿外科非前列腺炎疾病患者的前列腺液进行常规检查、细菌培养和ＰＳＡ光密度值（ＯＤ值）检测。结果实验组的ＰＳＡ水平较对照组明显升高（Ｐ＜０．０１）,而在细菌性及非细菌性前列腺炎时ＰＳＡ水平无明显变化,实验组与对照组卵磷脂小体差异有极显著性（Ｐ＜０．０００５）,实验组前列腺液中的白细胞计数与ＰＳＡ相关系数ｒ＝０．２,Ｐ＜０．０４。结论慢性前列腺炎时前列腺液中的ＰＳＡ可增高,ＰＳＡ可作为诊断慢性前列腺炎的一个辅助指标。     

Die Bedeutung der chronischen Prostatitis für die Pathogenese des Prostatakarzinoms

Although prostate cancer is of crucial impact as a common disease of men, numerous relationships remain unknown, particularly concerning its pathogenesis. A novel approach regarding the origin and development of prostate cancer is a phenomenon that has already been investigated in other human cancers: cancerogenesis due to chronic inflammation. Hence, the present review introduces the current state of research concerning the relationship between chronic prostatitis and prostate cancer. In addition to histological and biochemical features, the latest discoveries are discussed, including the relationship between the pathogenesis of prostate cancer and infection by the novel gammaretrovirus XMRV, similar to cervical cancer associated with HPV.