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The role of the prostatic stroma in chronic prostatitis/chronic pelvic pain syndrome

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Abstract

Objective

To confirm the hypothesis of prostatic stromal involvement in chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).

Materials and methods

A literature review to analyze mechanisms commonly indicated as a cause of CP/CPPS that can interfere with the processes of cell growth of smooth muscle fibrocells and may cause smooth muscle cell hypertrophy, periurethral edema, and inflammation.

Results

Our review strongly suggests a prevalent stromal involvement, specifically of the smooth muscle cells, in CP/CPPS physiopathology. The involvement of the endocrine system, in particular the role of estrogens, the neurological pathway mediated by noradrenalin, and the presence of inflammation, support the hypothesis that CP/CPPS could be a disease with a prevalent role of smooth muscle stromal cells rather than glandular structures. Neurogenous inflammation, oxidative stress and psychological factors may be involved in the chronic nature of the disease.

Conclusions

We believe that new studies regarding chronic prostatitis should also be focused on prostatic stromal involvement in the inflammatory pathway.

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Authors and Affiliations

  1. Department of Clinic and Specialistic Sciences-Urology and Andrology, Polytechnic University of the Marche Region, Azienda Ospedaliero-Universitaria Ospedali Riuniti Umberto I-G.M. Lancisi-G. Salesi, via Conca 71, 60100, Ancona, Italy

    Marco Dellabella, Giulio Milanese, Gianluca d’Anzeo & Giovanni Muzzonigro

  2. Section of Pharmacology, Department of Biomedical Sciences and Biotechnology, University of Brescia Medical School, Brescia, Italy

    Sandra Sigala, Nicola Arrighi & Serena Bodei

Authors
  1. Marco Dellabella
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  2. Giulio Milanese
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  3. Sandra Sigala
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  4. Gianluca d’Anzeo
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  5. Nicola Arrighi
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  6. Serena Bodei
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  7. Giovanni Muzzonigro
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Correspondence to Marco Dellabella.

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Responsible Editor: G. Geisslinger.

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Dellabella, M., Milanese, G., Sigala, S. et al. The role of the prostatic stroma in chronic prostatitis/chronic pelvic pain syndrome. Inflamm. Res. 58, 829–836 (2009). https://doi.org/10.1007/s00011-009-0086-7

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  • DOI: https://doi.org/10.1007/s00011-009-0086-7

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