Abstract
Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common urological diagnosis affecting young and middle aged men. Symptoms of genital or pelvic pain associated with voiding or sexual dysfunction were historically attributed to an inflamed prostate gland. A review of urological and non-urological literature pertaining to CPPS was conducted in order to devise a plausible alternative description of this syndrome. Due to publisher's criteria, only select articles are included and cited for this purpose. Evidence of a bacterial etiology is non-existent, while evidence of prostatic inflammation is conflicting and non-specific. More plausible causes of prostatitis-like symptoms include musculoskeletal pain, pelvic floor muscular dysfunction, myofascial pain syndromes or functional somatic syndromes. Thorough evaluation and appropriate therapy for patients has been seriously hindered by decades of a prostatocentric approach to CP/CPPS. The following article introduces an alternative perspective.
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References
Aaron LA, Herrell R, Ashton S et al. (2001) Comorbid clinical conditions in chronic fatigue: a co-twin control study. Gen Int Med 16:24–31
Alagari M, Chottiner S, Ratner V, et al. (1997) Interstitial cystitis: unexplained associations with other chronic disease and pain syndrome. Urology 49 (5a):52–57
Alexander RB, Ponniah S, Hasday J, Hebel R (1998) Elevated level of proinflammatory cytokines in the semen of patients with chronic prostatitis/chronic pelvic pain syndrome. Urology 52:744–749
Bass C, Peveler R, House A (2001) Somatoform disorders: severe psychiatric illnesses neglected by psychiatrists. Br J Psychol 179:11–14
Ginsberg KS, Kundsin RB, Walter CW et al. (1992) Ureaplasma urealyticum and mycoplasma hominis in women with systemic lupus erythemotosus. Arthritis Rheum 35: 429–433
Hochreiter WW, Nadler RD, Koch AE, Campbell PL, Ludwig M, Weidner W, Schaeffer AJ (2000) Evaluation of the cytokines interleukin 8 and epithelial neutrophil activating peptide 78 as indicators of inflammation in prostatic secretions. Urology 56 (6):1025–1029
Kaplan SA, Santarosa RP, D'Alisera PM, et al. (1997) Pseudodyssynergia (contraction of the external sphincter during voiding) misdiagnosed as chronic non-bacterial prostatitis and the role of biofeedback as a therapeutic option. J Urol 157:2234–2237
McNaughton Collins M, Fowler FJJr, Elliott DB, Albertsen PC, Barry MJ (2000) Diagnosing and treating chronic prostatitis: do urologists use the four glass-test? Urol 55 (3): 403–407
Moldwin RM (2000) Similarities between intersitital cystitis and male chronic pelvic pain syndrome. Curr Urol Rep 3:313–318
Nickel JC, Downey J, Johnston B et al. (2001) Predictors of patient response to antibiotic therapy for the chronic prostatitis/chronic pelvic pain syndrome: a prospective multicenter study. J Urol 165:1539–1544
Nicolson GL, Masralla MY, Franco AR, De Meirleir K, Nicolson NL, Ngweny R, Haier J (1999) Role of mycoplasmal infections in fatigue illnesses: chronic fatigue and fibromyalgia syndromes, gulf war illness and rheumatoid arthritis. J Chronic Fatigue Syndr (Microbiol) 6:1–8
Pasqualotto FF, Sharma RK, Potts JM, Nelson DR, Thomas AJJr, Agarwal A (2000) Seminal oxidative stress in chronic prostatitis patients. Urology 55:881–885
Potts JM (2000) Prospective identification of National Institutes of Health category IV prostatitis in men with elevated prostate specific antigen. J Urol 164:1550–1553
Potts JM, Moritz N, Everson D et al. (2001) Chronic abacterial prostatitis: a functional somatic syndrome? J Urol 165 (Suppl):125
Potts JM, O'Dougherty E (2000) Pelvic floor physical therapy for patients with prostatitis. Curr Urol Rep 1:155–158
Roberts RO, Lieber MM, Bostwick DG, Jacobsen SJ (1997). A review of clinical and pathological prostatitis syndromes. Urology 49: 809–21
Shahed AR, Shoskes DA (2000) Oxidative stress in prostatic fluid of patients with chronic pelvic pain syndrome: correlation with gram positive bacterial growth and treatment response. J Androl 21:669–675
True LD, Berger RE, Rothman I et al. (1999) Prostate histopathology and chronic prostatitis/chronic pelvic pain syndrome: a prospective biopsy study. J Urol 162:2014–2018
Wessely S, Nimnuin C, Sharpe M (1999) Functional somatic syndromes: one or many? Lancet 354:936–939
Wright ET, Chmiel JS, Grayhack JT, Schaeffer AJ (1994) Prostatic fluid inflammation in prostatitis. J Urol 152:2300–2303
Zermann DH, Ishigooka M, Doggweiler R, Schmidt RA (1999) Chronic prostatitis: a myofascial pain syndrome? Infect Urol 12(: 84–88, 92
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Potts, J.M. Chronic pelvic pain syndrome: a non-prostatocentric perspective. World J Urol 21, 54–56 (2003). https://doi.org/10.1007/s00345-003-0327-2
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DOI: https://doi.org/10.1007/s00345-003-0327-2