New Supplement on Prostatitis in "Urology"

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New Supplement on Prostatitis in "Urology"

Post by webslave »

Looks like "Urology" just published a new supplement on prostatitis. Here are the abstracts:

1: Urology 2002 Dec;60(6 Suppl):42-3

Bladder training biofeedback and pelvic floor myalgia.

Nadler RB.

Department of Urology, Northwestern University Medical School, Chicago, Illinois, USA

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a debilitating condition, traditionally treated with antimicrobials, nonsteroidal anti-inflammatory drugs, and alpha-blockers. Pelvic floor tension myalgia is hypothesized to be a contributing factor in CPPS. Biofeedback training for CPPS is based on the principle that maximum muscle contraction prompts maximum muscle relaxation. Similar chronic pain conditions have been treated successfully with biofeedback-assisted techniques of neuromuscular reeducation. Preliminary study by our group has shown biofeedback, pelvic floor reeducation, and bladder training to be helpful in the treatment of CP/CPPS. Overall, 8 of 11 patients had improvement in either pain scores or their chronic prostatitis pain index scores. With no cure for CP/CPPS available, biofeedback and pelvic floor reeducation merit further evaluation in the treatment of this condition.

PMID: 12521595 [PubMed - in process]

2: Urology 2002 Dec;60(6 Suppl):38-40 Related Articles, Links

Heat therapy in the treatment of prostatitis.

Zeitlin SI.

Department of Urology, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California, USA

There is a dearth of literature on heat therapy and prostatitis. The therapies used different energy sources, including interstitial heat and microwaves, and were delivered both transrectally and transurethrally. Most data precede our present system of nomenclature and therefore are difficult to compare, even with the literature of their day. Validated instruments were rarely used to determine efficacy, and most outcome measures were subjective. We will need well-designed prospective clinical trials using objective outcome measures and validated symptom indexes. Until then the use of heat therapy for prostatitis should be considered experimental.

PMID: 12521593 [PubMed - in process]

3: Urology 2002 Dec;60(6 Suppl):35-7 Related Articles, Links

Phytotherapy in chronic prostatitis.

Shoskes DA.

Cleveland Clinic Florida, Weston, Florida, USA

Chronic prostatitis is a very common condition that is poorly understood and has a significant impact on quality of life. Given the lack of proven efficacy of conventional therapies, such as antibiotics, it is not surprising that patients have turned with increasing frequency to phytotherapy and other alternative treatments. Although alternative therapies are plentiful, few have been subjected to scientific scrutiny and prospective controlled clinical trials. This review will cover phytotherapies commonly used in prostatitis patients and focus in detail on those with published data. These treatments include zinc, cernilton (bee pollen), quercetin, and saw palmetto. Although many of these therapies appear promising in small preliminary studies, phytotherapy requires the same scientific criteria for validation and acceptance as do conventional medical therapies.

PMID: 12521591 [PubMed - in process]

4: Urology 2002 Dec;60(6 Suppl):29-33 Related Articles, Links

Inflammation and anti-inflammatory therapy in chronic prostatitis.

A Pontari M.

Department of Urology, Temple University School of Medicine, Philadelphia, Pennsylvania, USA

Anti-inflammatory medications have been used for the treatment of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), given that inflammation and pain are traditionally associated with this condition. The National Institutes of Health (NIH) classification divides category III into (1) category IIIA-patients with white blood cells (WBCs) in their expressed prostatic secretions, post-prostate massage urine (voided bladder urine-3 [VB(3)]) or semen; and (2) category IIIB-those without WBCs. However, recent studies indicate that the ability of WBC count alone to distinguish men with symptoms from those without appears limited. Other markers of inflammation, such as cytokines, may correlate better with clinical findings. The mechanisms of inflammation continue to be investigated, including contributions from reactive oxygen species, autoimmune response, neurogenic inflammation, and even endocrine dysfunction. There have been few controlled studies of anti-inflammatory therapy for chronic prostatitis. In the only randomized double-blind placebo-controlled trial, the NIH-Chronic Prostatitis Symptom Index (CPSI) total, domain, and pain scores significantly decreased from baseline in all groups, but the difference was not statistically significant. Other medications that have some theoretic anti-inflammatory properties have shown promising early results. Further study of currently available anti-inflammatory medications may be warranted, especially in longer trials, which may allow resolution of the significant placebo effect commonly seen in the short term in men with CPPS. Further discussion is needed to either validate, modify, or abolish the distinction between category IIIA and IIIB in the NIH classification.

PMID: 12521589 [PubMed - in process]

5: Urology 2002 Dec;60(6 Suppl):27-8 Related Articles, Links

Role of alpha-blockers in the treatment of chronic prostatitis.

Datta NS.

Division of Urology, Martin Luther King/Drew Medical Center, Charles R. Drew University, Los Angeles, California, USA

Treatment of nonbacterial chronic prostatitis/chronic pelvic pain syndrome continues to be a challenge for the treating physician. However, results from studies on the use of alpha-blockers seem to show some promise. Further studies on this class of drugs in the treatment of this condition are recommended.

PMID: 12521587 [PubMed - in process]

6: Urology 2002 Dec;60(6 Suppl):24-6 Related Articles, Links

Antimicrobial therapy for bacterial and nonbacterial prostatitis.

Fowler JE.

Division of Urology, University of Mississippi School of Medicine, Jackson, Mississippi, USA

Antimicrobial therapy is the standard of care for the unusual man with true chronic bacterial prostatitis but does not have much of a role in the treatment of men with nonbacterial prostatitis. The fluoroquinolone antibiotics given for 2 to 4 weeks will cure about 70% of chronic bacterial infections of the prostate. If this treatment fails, the symptomatic manifestations of the infections can almost always be eliminated with suppressive antimicrobial therapy using trimethoprim-sulfamethoxazole, a fluoroquinolone antibiotic, or nitrofurantoin.

PMID: 12521585 [PubMed - in process]

7: Urology 2002 Dec;60(6 Suppl):20-2 Related Articles, Links

Clinical evaluation of the man with chronic prostatitis/chronic pelvic pain syndrome.

Nickel JC.

Department of Urology, Queen's University, Kingston, Ontario, Canada

The various investigative procedures used in clinical, laboratory, and imaging evaluations for the patient presenting with chronic pelvic pain are discussed and categorized as mandatory, recommended, or optional procedures. These categories primarily serve to rule out underlying pathology because there is no diagnostic test for chronic prostatitis/chronic pelvic pain syndrome (CPPS). Mandatory category investigations should be performed in all patients with CPPS, and those procedures categorized as recommended or optional are generally prompted by specific findings in the history or physical examination, or by poor response to standard therapies.

PMID: 12521583 [PubMed - in process]

8: Urology 2002 Dec;60(6 Suppl):14-8 Related Articles, Links

A review of the development and validation of the national institutes of health chronic prostatitis symptom index.

Litwin MS.

David Geffen School of Medicine, School of Public Health, University of California, Los Angeles, Los Angeles, California, USA

Chronic nonbacterial prostatitis or chronic pelvic pain syndrome (CPPS) causes morbidity, both through symptoms and associated impairment in health-related quality of life, both of which illustrate the importance of patient-centered outcomes. Despite preliminary work by several investigators, research and clinical efforts to provide help for men afflicted with CPPS have been hampered by the absence of a widely accepted, reliable, and valid instrument to measure symptoms and quality-of-life impact. Investigators from the National Institutes of Health (NIH)-funded Chronic Prostatitis Collaborative Research Network (CPCRN) sought to remedy this problem by developing a psychometrically valid index of symptoms and quality-of-life impact in men with chronic prostatitis. This instrument, now validated in English, Spanish, German, and Korean, is known as the NIH Chronic Prostatitis Symptom Index (NIH-CPSI). It contains 13 items that are scored in 3 discrete domains: pain, urinary symptoms, and quality-of-life impact. In early studies, the NIH-CPSI has been shown to be reliable, valid, and responsive to change. Further work is needed to determine whether it performs as well in minority populations, men seeking care in nonreferral centers, and other diverse populations.

PMID: 12521581 [PubMed - in process]

9: Urology 2002 Dec;60(6 Suppl):8-12 Related Articles, Links

Chronic prostatitis: epidemiology and role of infection.

KRIEGER JO, ROSS SU, RILEY DO.

Department of Urology, University of Washington School of Medicine, Seattle, Washington, USA

We review the epidemiology of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and the role of infectious agents, emphasizing critical data necessary to define current research issues. The epidemiologic literature is limited, but the worldwide prevalence appears to be in the range of 2% to 10%, indicating that CP/CPPS represents an important international health problem. Recent molecular studies have documented bacterial DNA sequences in prostate tissue from CP/CPPS patients. These data suggest that colonization and/or infection occurs in the prostates of many patients with CP/CPPS. Further molecular research is needed to define the role of bacteria in the etiology of CP/CPPS.

PMID: 12521579 [PubMed - in process]

10: Urology 2002 Dec;60(6 Suppl):5-6 Related Articles, Links

Classification (traditional and national institutes of health) and demographics of prostatitis.

Schaeffer AJ.

Department of Urology, Northwestern University Medical School, Chicago, Illinois, USA

This article reviews the National Institutes of Health (NIH) classification system for prostatitis and summarizes the baseline analysis of the Chronic Prostatitis Cohort Study, a longitudinal study, which has enrolled 488 patients diagnosed with category III prostatitis. The prevalence of category IIIA in this cohort was 54% to 90%, depending on the cut points used. In all, 8% (37 of 488) had >/=1 localizing uropathogen. However, leukocyte and bacterial counts did not correlate with severity of symptoms as assessed by the NIH Chronic Prostatitis Symptom Index. Continued follow-up study of this cohort will likely answer important questions about the natural and treated history of this syndrome.

PMID: 12521577 [PubMed - in process]

11: Urology 2002 Dec;60(6 Suppl):1-4 Related Articles, Links

Overview summary statement.

Schaeffer AJ, Datta NS, Fowler JE, Krieger JN, Litwin MS, Nadler RB, Nickel JC, Pontari MA, Shoskes DA, Zeitlin SI, Hart C.

Department of Urology, Northwestern University Medical School, Chicago, Illinois, USA

Members of the Chronic Prostatitis Collaborative Research Network (CPCRN) met in a 1-day symposium to review recent findings and to debate unanswered issues in the diagnosis and management of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). The meeting was focused on producing an overview summary statement that would, as nearly as possible, represent the consensus views of the attendees. As discussed below, the participants agreed that a history, physical examination, and urinalysis/urine culture are mandatory for the evaluation of all patients presenting with CP/CPPS, with other assessments categorized as recommended or optional, depending on the history and physical findings. Observations and suggestions regarding first- and second-line therapies are also offered, with the recognition that randomized, placebo-controlled trials to guide selection of therapies for chronic nonbacterial prostatitis are currently lacking.
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Hepcat
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Post by Hepcat »

This last abstract is interesting.

Thats exactly what our group did (produce a precise consesus paper amongst recognized leaders in the field).

I can tell you that once a disease entity has been established and verified by published peer consensus, doors open and money starts flowing.

Thats one objective down. Time to leverage it :)
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J Dimitrakov
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Re: New Supplement on Prostatitis in "Urology"

Post by J Dimitrakov »

webmaster wrote:Looks like "Urology" just published a new supplement on prostatitis. Here are the abstracts
All of the articles are available for free at the UROLOGY (GOLD JOURANL) website:

http://www.medicinedirect.com/journal/j ... &sdid=6105
This communication provides general information, and is not a substitute for face-to-face medical care. A doctor-patient relationship should not be assumed by the reader.
Jordan Dimitrakov, M.D., Ph.D.
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Post by webslave »

There's enough material at that link to keep readers busy for a while!

:shock:
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