慢性前列腺炎/慢性骨盆疼痛综合征治疗新进展

慢性前列腺炎(CP)尤其是慢性前列腺炎/慢性骨盆疼痛综合征(CP/CPPS)(Ⅲ型)的发病机制至今尚不完全清楚,人群发病率可达2.5%~16.0%,为50岁以下男性最常见的泌尿外科疾病。20世纪90年代以来,在美国国立卫生研究院慢性前列腺炎协作研究网(NIH-CPCRN)、国际前列腺炎协作网(IPCN)等国际研究机构的协调下,各国研究者对CP的病因、诊断、治疗等诸方面进行了较以往更大规模的深入研究。CPPS是CP中最常见的也是疗效最差的一种类型,本文综述了近几年来CP/CPPS治疗新进展,探讨了其目前治疗所面临的主要问题及可能的原因,并对CP/CPPS治疗的前景予以展望。     

慢性前列腺炎/慢性骨盆疼痛综合征的治疗进展

<正>前列腺炎(prostatitis)是一个复杂的临床综合征,美国国立卫生研究院(NIH)目前将前列腺炎分为4型:Ⅰ型为急性细菌性前列腺炎,Ⅱ型为慢性细菌性前列腺炎,Ⅲ型为慢性前列腺炎/慢性骨盆疼痛综合症,Ⅳ型为无症状的前列腺炎。其中Ⅲ型慢性前列腺炎/慢性骨盆疼痛综合症(chronic prostatitis,CP/chronicpelvic pain syndrome,CPPS)是50岁以下男性最常见的疾病之一,治疗费用昂贵,治疗效果不佳~([1-4])。它的定义是在排除尿路感染的情况下,持续发生慢性盆腔疼痛或出现前列腺炎症的症状体征3～6个月。CP/CPPS的终生患病率约为2. 2%～8. 2%~([5]),其主要临     

前列平消胶囊治疗ⅢA型前列腺炎的疗效观察

慢性前列腺炎(CP)是青壮年男性的常见病、多发病.Ⅲ型前列腺炎(CP/CPPS)是CP中最常见的类型,约占CP的90%以上,而ⅢA型(炎症性)和ⅢB(非炎症性)两个亚型各占50%左右[1].目前ⅢA型前列腺炎的治疗更加偏好于非抗生素的综合治疗,中医药凸显其优势[4].我们于2004年12月至2009年12月采用中药前列平消胶囊治疗ⅢA前列腺炎126例,与西药左氧氟沙星联合坦索罗辛治疗对照,取得较好疗效,报道如下.     

傅青主五淋散、清心莲子饮治疗慢性前列腺炎临床观察

正慢性前列腺炎(chronic prostatitis,CP)是临床多发病、疑难病,严重影响患者的生活质量。慢性前列腺炎中,90%以上为慢性前列腺炎/慢性骨盆疼痛综合征(chronic prostatitis/chronic pelvic pain syndromes,CP/CPPS)。CP/CPPS病因不明,发病机制不清,至今没有一种标准而确切有效的治疗方案,已     

清浊祛毒丸在慢性前列腺炎中临床应用中国专家共识

<正>前列腺炎是泌尿男科最常见疾病之一,我国15～60岁男性人群中8.4%出现前列腺炎症状[1]。Ⅲ型前列腺炎,又称慢性前列腺炎/慢性骨盆疼痛综合征(chronic prostatitis/chronic pelvic pain syndrome,CP/CPPS)是临床最常见的类型,约占慢性前列腺炎患者90%以上,由单因素或多因素(病原体感染、炎症和其他神经、内分泌、肌肉活动、心理等)共同驱动并相互影响所致[2-4]。基于Ⅲ型前列腺炎复杂的致     

慢性前列腺炎/慢性盆腔疼痛综合征治疗进展

慢性前列腺炎/慢性盆腔疼痛综合征(Chronic Pro-statitis/Chronic Pelvic Pain Syndrome,CP/CPPS)即美国国立卫生研究院(National Institutes of Health,NIH)分类系统中的Ⅲ型前列腺炎,是泌尿男科门诊最常见的疾病之一,该病在世界范围内发病率...     

慢性前列腺炎的病因与临床治疗经验

慢性前列腺炎(chronic prostatitis,CP)是中青年男性常见的疾病.统计资料显示,慢性前列腺炎占泌尿科门诊8%～25%;在美国20岁以上男性慢性前列腺炎发病率为2%～16%,欧洲为14.2%.50%的男性一生中某个时刻患过慢性前列腺炎受到慢性前列腺炎影响.1995年美国国立卫生研究院(National Institutes of Health,NIH)制定了一种前列腺炎新的分类法:急性细菌性前列腺炎(Ⅰ型).     

慢性前列腺炎在急性附睾炎发病中的关联度分析

目的 探讨慢性前列腺炎(CP)在急性附睾炎(acute epididymitis.AE)发病中的作用及两者发病的关联度.方法 将1998年1月至2009年1月年以来222例慢性前列腺炎与181例急性附睾炎患者随机分为急性附睾炎组及慢性前列腺炎组,比较AE伴有CP发病率与CP伴发AE的发病率,分析两者发病率差异性及关联度.结果 急性附睾炎组同时伴发慢性前列腺炎发病率为96.68%(175/181例),未伴发CP者6例.慢性前列腺炎组急性附睾炎发病率为13.96%(31/222例),未伴发CP者191例.附睾炎组CP发病率高于慢性前列腺炎组AE发病率,采用t检验两者差异有统计学意义.结论 附睾炎组CP发病率明显高于慢性前列腺炎组AE发病率,CP的存在是急性附睾炎发病的重要基础性因素,但不能排除急性附睾炎引起前列腺炎的可能,两者有重要关联度.     

慢性前列腺炎中西医结合多学科诊疗指南

<正>慢性前列腺炎(chronic prostatitis,CP)是泌尿男科常见疾病,国内报道发病率为6.0%～32.9%[1-2]。CP包括Ⅱ型慢性细菌性前列腺炎(chronic bacterial prostatitis, CBP)和Ⅲ型慢性前列腺炎/慢性盆腔疼痛综合征(chronic prostatitis/chronic pelvic pain syndrome, CP/CPPS)[3]。本病属于中医"精浊"、"白浊"等范畴。由于CP     

超声治疗慢性前列腺炎的研究进展

慢性前列腺炎(CP)是男科的常见病、多发病,约占男科门诊患者的1/3.据报道,全球前列腺炎的发病率为9%～14%([1]),大约半数(35%～55%)的男性在其一生的某个时候会受到前列腺炎的影响([2]).CP治疗比较棘手,且容易反复发作,长期使用抗生素治疗效果不明显,且易产生耐药性,故CP常规用西药治疗难以治愈([3]).     

Quercetin for chronic prostatitis/chronic pelvic pain syndrome

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common condition with a heterogeneous origin that responds best to multimodal therapy. The bioflavonoid quercetin has antioxidant and antiinflammatory effects that have proven useful for treating this condition. Using the clinical phenotype system UPOINT, quercetin can be helpful for those with organ-specific complaints (bladder or prostate) and pelvic floor spasm. This article discusses the current understanding of CP/CPPS and how treatment with quercetin can be used alone or as part of multimodal therapy.     

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.     

Sexual dysfunction in chronic prostatitis/chronic pelvic pain syndrome

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), or NIH category III prostatitis, is a common clinical syndrome characterized by genital/pelvic pain and lower urinary tract symptoms in the absence of urinary tract infection. There is also growing recognition of the association of sexual dysfunction with CP/CPPS including erectile dysfunction, ejaculatory pain, and premature ejaculation. In this review, we discuss the association between CP/CPPS and sexual dysfunction, potential mechanisms for sexual dysfunction, and treatment strategies for erectile dysfunction in CP/CPPS.     

Therapeutic options for chronic prostatitis/chronic pelvic pain syndrome

Chronic prostatitis/chronic pelvic pain syndrome continues to pose a treatment challenge for urologists. Most commonly prescribed medications, such as antibiotics, α-blockers, androgen inhibitors, and anti-inflammatory agents, have been shown to help some patients. However, the efficacy and durability of such treatments lack consistency among men suffering from this disorder. The rationale for such treatments is described in this article, along with possible explanations for the apparent shortcomings. Also included is a brief summary of alternative therapies, which are growing in popularity among patients and gaining acceptance in our medical communities.     

前列腺灌注管加压灌注药物治疗慢性前列腺炎

目的：观察应用前列腺灌注管加压灌注药物治疗慢性前列腺炎的效果。方法：对１７６例慢性前列腺炎患者经尿道置入前列腺灌注管加压灌注药物并联合多功能前列腺治疗仪治疗。结果：１７６便中治愈１３４例,好转３２例,有效率９４．３％。治疗后随访６￣１８个月,８例复发。结论：应用前列腺灌中压灌注药物并联合多功能前列腺治疗仪治疗慢性前列腺炎具有疗效好,副作用少的优点,是治疗慢性前列腺炎可供选择的有效方法之一。     

Paediatric chronic pain

Many children and adolescents experience chronic pain at some point in their childhood. While the majority may be successfully supported by their local services, some may develop persistent pain-related functional disability that should prompt referral to a multidisciplinary paediatric pain service for assessment. These teams work with the family to provide a framework for promoting rehabilitation and restoration of function based on the biopsychosocial model. Mental health difficulties including psychological trauma are often a significant factor. Individualized therapeutic work is core to the pain management pathway. Medications and therapeutic injections are used less frequently in children compared to adult practice but may have a role in facilitating rehabilitation as part of a multidisciplinary approach.