32例急性淋菌性尿道炎并发慢性淋菌性前列腺炎诊断报告

2003-2004年乌鲁木齐市第一人民医院门诊部发现32例急性淋菌性尿道炎后淋菌性前列腺炎患者,年龄16～35岁,平均22岁.本组患者有明确的不洁性接触史,即急性淋菌性尿道炎病史,主要病状有尿痛,排尿终末尿道口有白色分泌物,呈黄白色,尿道口略发红,尿中有淋丝,腰部发酸及发困,会阴部有出汗及不适感,耻骨上区有间歇性胀痛,病程2～24个月,并且有反复急性发作史,32例均经前列腺液常规及尿道分泌物直接涂片检查,确诊为慢性淋菌性前列腺炎.     

妇科慢性盆腔疼痛的病因及治疗进展

妇科慢性盆腔痛(chronic pelvic pain,CPP)是多种疾病的临床表现,其病因复杂,发病机制尚未完全清楚,治疗上亦以对症治疗为主。本文对其病因和治疗进行综述。     

慢性前列腺炎／慢性骨盆疼痛综合征的相关危险因素分析

目的探讨慢性前列腺炎／慢性骨盆疼痛综合征（CP/CPPS）发病的危险因素。方法选择360例临床确诊的CP/CPPS患者及年龄匹配的非CP/CPPS患者360例（对照组）,采用自行设计调查表进行病例对照研究,内容主要包括吸烟及饮酒情况、受教育程度、居住地、婚姻状况,采用非条件多元Logstic回归模型测量各因素与CP/CPPS发病的相关性。结果与不吸烟者比较,吸烟者发生CWCPPS的危险性升高,吸烟量和吸烟时间均与CP/CPPS发病率呈明显正相关;与不饮酒者相比,饮酒者发生CP/CPPS的危险性降低,随饮酒量和时间增长,CP/CPPS发病危险有下降趋势;CP/CPPS发病危险性受教育程度为初中以下者高于初中以上者,居住农村者高于居住城区者,已婚者高于未婚者。结论吸烟是CP/CPPS发病的危险因素,饮酒为保护性因素,文化程度低、居住条件差及已婚等因素可增加CP／CPPS发病的危险性。     

慢性前列腺炎/慢性骨盆疼痛综合征与精神心理障碍关系的研究进展

慢性前列腺炎/慢性骨盆疼痛综合征(CP/CPPS)是CP中最常见的类型,其病因复杂,随着研究的深入,学者们发现精神心理因素与CP/CPPS关系紧密,精神心理因素影响着CP/CPPS的发生、发展和治疗。该文就CP/CPPS患者精神心理障碍的表现及其与CP/CPPS两者关系及心理治疗作一回顾性综述。     

慢性前列腺炎/盆腔疼痛综合征患者白细胞雄激素受体的改变及意义

目的探讨慢性前列腺炎/盆腔疼痛综合征(CP/CPPS)的发生与性激素及雄激素受体(AR)的关系。方法采用放射配体结合分析法检测78例CP/CPPS患者(CP/CPPS组)和32例正常对照者(对照组)外周血白细胞AR,同时采用放射免疫法检测患者血清睾酮(T)和雌二醇(E2)水平。结果CP/CPPS组与对照组血清E2和T水平无差异,外周血白细胞AR含量CP/CPPS组低于对照组(P<0.01),CP/CPPS组E2/T高于对照组,P<0.05。CP/CPPS患者CP症状指数评分(CPS I)与白细胞AR含量呈负相关(r=-0.512,P<0.01。结论CP/CPPS的发生、发展与E2、T比例失调及白细胞AR下调有密切的关系。     

淋球菌性前列腺炎的综合护理

淋菌性前列腺炎是继发于淋菌性尿道炎之后,常由于初起治疗不及时、不恰当或感染耐药菌株导致慢性淋菌性前列腺炎。本文对我院收治的40例淋菌性前列腺炎患者在常规抗生素治疗的基础上,采用中药灌肠、前列腺按摩等办法综合护理,能够使患者的临床症状得到缓解,疗效明显,有助于患者康复。     

男性尿道炎后综合征126例

男性尿道炎后综合征(male’s post urethritis syndrome,MPUS)是指男性患淋病或非淋菌性尿道炎后,经多种抗菌药物治疗,尿道炎的临床表现消失及不存在实验室客观依据,但患者存在多种症状和不适的临床表现。随着社会的发展,人们     

关注老年慢性肌筋膜疼痛综合征

老年人群是慢性疼痛的高发人群,在老年慢性疼痛病因中尤以脊柱生物力学改变所导致的间歇性、迁延性颈肩背痛、腰臀腿足痛;骨关节退变造成的髋关节、膝关节、踝关节痛,以及肩周炎所致的肩关节疼痛最为常见,并常导致老年人肢体功能障碍,严重影响生活质量。既往临床上常常把此类疼痛产生的原因归于骨性组织结构本身的病理改变,而对大多数疼痛产生的真正原因——肌筋膜疼痛综合征未予以足够重视。     

中药直肠灌注结合微波治疗性病后以疼痛为主的前列腺炎52例

1997～ 2 0 0 2年 ,采用中药直肠灌注结合微波治疗性病后以疼痛为主的前列腺炎 5 2例 ,取得了较好的疗效 ,现报道如下。1　资料来源　 5 2例患者均为 2 1～ 4 7岁的男性 ,均有不洁性接触史及性传播尿道炎病史 ,其中 2 5例曾被诊断为淋病 (NG ) ,13例为NG伴解脲支原体(UU)或 /和衣原体 (CT)感染 ,14例为UU或 /和CT感染。治疗后 ,患者尿道炎症状消失 ,化验尿道分泌物病原微生物全部转阴。但患者在尿道炎时 ,或尿道炎好转后相继出现会阴、睾丸、腹股沟、腰骶和小腹等一处或多处疼痛。多以尿道和阴茎为甚 ,个别重者因惧怕排尿时疼痛加重而…     

中药复方治疗老年慢性前列腺炎的效果及机制探讨

目的 探讨老年慢性前列腺炎的中医药治疗方法.方法 选择威海市传染病医院门诊及住院老年慢性前列腺炎患者70例,服用中药复方90 d,评价疗效;同时检测并比较患者的前列腺液中炎症细胞因子IL-6、TNF-α和IL-10的水平的变化.结果 治疗90 d后,治愈5例,显效38例,有效18例,无效9例,有效率为87.1%.治疗前、后NIH-CPSI总评分、病痛或不适、排尿症状评分差异均有统计学意义（P〈O.05）;与治疗前比较,中药治疗后有效患者（61例）前列腺液中IL-6、TNF-α水平下降,IL-10 水平上升,治疗前后变化差异有统计学意义（p〈0.05）;而无效患者 （9例） 治疗前后各细胞因子变化差异无统计学意义（P〉0.05）.结论中药复方能够有效治疗老年慢性前列腺炎,其作用机制可能是通过抑制促炎性反应、提高抗炎性反应来实现的.     

Acupuncture versus sham acupuncture for chronic prostatitis/chronic pelvic pain

Background

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) afflicts 2%-10% of adult men. Available therapies offer little or no proven benefit. Because acupuncture represents an attractive “natural” therapy, we compared the efficacy of acupuncture to sham acupuncture for CP/CPPS.

Methods

Participants met US National Institutes of Health (NIH) consensus criteria for CP/CPPS, were aged ≥20 years old, and had a total score ≥15 on the NIH Chronic Prostatitis Symptom Index (NIH-CPSI) and symptoms for at least 3 of the preceding 6 months. They were randomized 1:1 to acupuncture or sham acupuncture. Treatment consisted of twice-weekly 30-minute sessions for 10 weeks (20 sessions total) without needle stimulation, herbs, or adjuvants. The primary response criterion was a 6-point decrease from baseline to week 10 in NIH-CPSI total score (range 0-43).

Results

Thirty-two (73%) of 44 participants responded in the acupuncture group compared with 21 (47%) of 45 sham group participants (relative risk 1.81, 95% confidence interval, 1.3-3.1, P = .02). Long-term responses 24 weeks after completing therapy without additional treatment occurred in 14 (32%) of 44 acupuncture group participants and in 6 (13%) of 45 sham group participants (relative risk 2.39, 95% confidence interval, 1.0-5.6, P = .04).

Conclusions

After 10 weeks of treatment, acupuncture proved almost twice as likely as sham treatment to improve CP/CPPS symptoms. Participants receiving acupuncture were 2.4-fold more likely to experience long-term benefit than were participants receiving sham acupuncture.     

Persistent urethritis and prostatitis due to Trichomonas vaginalis: A case report

The present report describes a case of persistent urethritis accompanied by prostatitis due to Trichomonas vaginalis in a young male patient. The importance of the laboratory diagnosis of trichomoniasis in persistent or recurrent urethritis (ie, testing samples from multiple sites) is highlighted, with the aim of improving the clinical recognition of this pathogen.     

Physiotherapeutic assessment and management of chronic pelvic pain syndrome: A case report

Introduction:Chronic pelvic pain syndrome is difficult for the diagnosis and therapy and that means the patient attending the physician or physiotherapist may present various symptoms. There are no guidelines concern physiotherapy diagnosis and treatment of chronic pelvic pain syndrome. This study presents the physiotherapeutic assessment and management in men with pelvic pain symptoms.Patient concerns:Forty-six-year-old man attended the physiotherapy consulting room due to symptoms of pain in the perineum, lower abdomen, urethra, and scrotum for a year. Earlier, the patient had consulted a urologist who made a diagnosis of cystitis and prescribed medications that did not get results.Diagnosis:Ultrasound imaging and manual inspection (per rectum) of the pelvic floor was conducted by physiotherapist. Also, the abdominal and lower extremities muscles were assessed. Patient reported pain symptoms during examination of the musculus ischiocavernosus, puboanalis, pubococcygeus, iliococcygeus, coccygeus, and canalis pudentalis seu Alcocki.Interventions:The patient was given physiotherapeutic interventions consisting in the manual therapy of the lumbopelvic hip complex and the manual therapy per rectum.Outcomes:During 10th session of the physiotherapeutic treatment, patient reported improvement in pain symptoms. A month later, patient reported total alleviation of the pain symptoms during control visit.Conclusion:Therapy of chronic pelvic pain syndrome is a process that involves application of different therapies and different approaches. Functional and structural assessment and also therapy conducted by physiotherapist is becoming an integral part of urology and represents 1 possible conservative treatment form.     

Acupuncture for chronic prostatitis/ chronic pelvic pain syndrome

Chronic prostatitis/chronic pelvic pain syndrome (CP/ CPPS) is prevalent in urological practice and has a significant impact on quality of life. Standard therapies often fail to achieve sustainable amelioration of symptoms. This article attempts to show that neuromodulatory treatment in the form of electroacupuncture can be a minimally invasive and effective treatment for CP/CPPS that is refractory to standard therapies. This neuromodulatory therapy lends support to the hypothesis that the end stage of CP/CPPS may be a neuropathic pain syndrome.     

Etiologic theories of chronic prostatitis/chronic pelvic pain syndrome

The etiology of chronic prostatitis/chronic pelvic pain syndrome is unknown. Whereas infection causes category I and II prostatitis, the evidence for an ongoing infection in category III patients is lacking. Immunologic, neurologic, and psychologic factors likely play a role in the development and maintenance of symptoms in these men. The traditional concept of pain as a simple response to a noxious stimulus has some merit, but modern research indicates that the response is much more complex, and we must look at a patient’s physiology and psychology to be able to interpret each individual’s pain response. It is some advance in the field to realize that we probably need to look beyond the prostate and address the entire biopsychosocial problem to be able to offer successful treatment to these men.     

Multimodal therapy for chronic prostatitis/chronic pelvic pain syndrome

Category III chronic prostatitis/chronic pelvic pain syndrome is a syndrome rather than a specific disease and the cause can be multifactorial. In clinical practice, monotherapy often has proven ineffective. Multimodal therapy, which sequentially or simultaneously can address infection, inflammation, and neuromuscular spasm appears to have the greatest potential for symptom improvement, especially in patients with longstanding symptoms.     

Chronic proctalgia and chronic pelvic pain syndromes: new etiologic insights and treatment options

This systematic review addresses the pathophysiology, diagnostic evaluation, and treatment of several chronic pain syndromes affecting the pelvic organs:chronic proctalgia, coccygodynia, pudendal neuralgia, and chronic pelvic pain. Chronic or recurrent pain in the anal canal, rectum, or other pelvic organs occurs in 7% to 24% of the population and is associated with impaired quality of life and high health care costs. However, these pain syndromes are poorly understood, with little research evidence availab...