New developments in diagnosis and treatment

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Curr Opin Urol. 2013 Nov;23(6):565-569.
New developments in the diagnosis and treatment of chronic prostatitis/chronic pelvic pain syndrome.
Pontari M, Giusto L.
Temple University Hospital, Department of Urology, Philadelphia, Pennsylvania, USA.

PURPOSE OF REVIEW: To describe new developments in the diagnosis and treatment of chronic prostatitis/chronic pelvic pain syndrome (CPPS).

RECENT FINDINGS: Symptoms in men with chronic prostatitis/CPPS appear to cluster into a group with primarily pelvic or localized disease, and a group with more systemic symptoms. Several other chronic pain conditions can be associated with chronic prostatitis/CPPS, including irritable bowel syndrome, fibromyalgia, and chronic fatigue syndrome. Markers of neurologic inflammation and autoimmune disease parallel changes in symptoms after treatment. Treatment options include new alpha-blockers, psychological intervention, and prostate-directed therapy. The areas of acupuncture and pelvic floor physical therapy/myofascial release have received increased recent attention and appear to be good options in these patients. Future therapy may include antibodies to mediators of neurogenic inflammation and even treatment of bacteria in the bowel.

SUMMARY: The diagnosis of chronic prostatitis/CPPS must include conditions traditionally outside the scope of urologic practice but important for the care of men with chronic pelvic pain. The treatment is best done using multiple simultaneous therapies aimed at the different aspects of the condition.

PMID: 24080807
[PubMed - as supplied by publisher]

[robertpagen]

I agree the tissue inflammation from allergic reactions is an important proximal cause leading to symptoms of pelvic pain.

Though Krissiloffs allergen restrictions have been dismissed as simplistic, they are actually a good, harmless foundation for treatment. If they result after 12 weeks in marginal or substantial improvement then rational sense says to make the dietary changes permanent.

For the record, no caffeine, alcohol, or spicy foods. I have found dairy and bread to also be irritants. None of these are needed for proper nutrition.

The blocking of adenosine by caffeine is a particularly pernicious effect in those with tight myalgic muscles.

Same for the ischemic effect of alcohol.

I had been raised to believe that bread and dairy were needed for a proper diet, though apparently that is not true. Don't be afraid to question any dogma or prevailing wisdom about your diet or anything else.

I have often found yoga to be constructive and helpful to this condition.

My personal experience with some very famous mayo fascial therapists has been negative over the years, with terrible exacerbations of symptoms. I accept that that may not be universal but may be due to my particular physiology. The point is to listen to your bodies reactions.

[JammyDodger]

Hi Robert,

Read a few of your posts going back over the years.

Was there anything in particular that you associate with your improvement?

Thanks,

Jamie

[webslave]

Fibromyalgia is associated with CPPS. Here's a primer