Diagnosis and treatment of chronic bacterial prostatitis and chronic prostatitis/chronic pelvic pain syndrome: a consensus guideline

Rees, Jon; Abrahams, Mark; Doble, Andrew; Cooper, Alison M.

doi:10.1111/bju.13101

Cited by 239 publications

(251 citation statements)

References 98 publications

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“…Differential diagnosis is important during clinical assessment, given that the symptoms of CP are not specific. Many other conditions may share the same symptoms as CP, such as cancer of the pelvic organs; prostatic abscess; urinary tract infection; urethral stricture; benign prostate enlargement; urinary stones; epididymo-orchitis; and bladder dysfunction [11]. Currently, validated symptom-scoring instruments, including NIH-CPSI, IPSS, UPOINT, and IIEF-5, could help in assessing symptom severity and guiding therapy, but a proper biomarker is still unavailable during diagnosis/ differential diagnosis and the classification of CP [4].…”

Section: Discussionmentioning

confidence: 99%

Clinical Evaluation of Urine Prostatic Exosomal Protein in the Diagnosis of Chronic Prostatitis

Li¹,

Jiang²,

Liu³

et al. 2017

Urol Int

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Objective: To evaluate the clinical potential of urine prostatic exosomal protein (PSEP) as a diagnostic biomarker of chronic prostatitis (CP). Materials andmethods: Using an enzyme-linked immunosorbent assay kit, urine PSEP levels were detected in 103 control cases as well as 283 cases of CP, with 82 cases fulfilling the definition of the USA National Institutes of Health category II (NIH-II), 108 cases of NIH-IIIa and 93 cases of NIH-IIIb. The values of age, body mass index, prostate volume, serum prostatic specific antigen (PSA) urine PSEP levels, and seminal parameters were analyzed. Results: The PSEP levels were significantly higher in patients of NIH-II (2.09 [2.35] ng/mL), NIH-IIIa (1.80 [2.95] ng/mL) and NIH-IIIb (1.64 [2.48] ng/mL) compared to the value of 0.24 (0.76) ng/mL in the controls. ROC identified a cutoff value of 1.387 ng/mL, with a sensitivity of 59.0% and specificity of 94.2%. The area under the ROC curve was 0.833. PSEP levels positively correlated with serum PSA levels in the NIH-IIIb group, and with EPS WBC count in the NIH-IIIa group, and with semen WBC count in each CP subgroups but negatively correlated with sperm motility in both the NIH-IIIa group and the NIH-IIIb group. Conclusion: Urine PSEP could be a potential biomarker for CP.

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Section: Discussionmentioning

confidence: 99%

Clinical Evaluation of Urine Prostatic Exosomal Protein in the Diagnosis of Chronic Prostatitis

Li¹,

Jiang²,

Liu³

et al. 2017

Urol Int

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“…4 Both NICE and PERG advise a referral to a urologist, stool softener, non-steroidal antiinflammatory drugs (NSAIDs) and a single four-to six-week course of antibiotics. For the CP/CPPS patient, a single four-to six-week course of alpha-blockers is also advised, although not in combination with antibiotics.…”

Section: Initial Assessmentmentioning

confidence: 99%

“…PERG guidelines for the treatment of CP/CPPS strongly advise against the unnecessary repeat prescription of NSAIDs, alpha-blockers and antibiotics if ineffective in reducing patient symptoms, in order to prevent unwanted side-effects. 4 Overall, alpha-blockers have shown mixed results as a standalone treatment in the clinically significant reduction of CP/CPPS symptoms, with even greater limitations in long-standing CP/CPPS patients. 5 Empirical antibiotic therapy for prostatitis is widely used, yet the evidence for its success in treating CP/CPPS is very weak.…”

Section: Initial Assessmentmentioning

confidence: 99%

The inflammatory journey of a prostatitis patient

Monahan¹

2017

Trends Urology & Men Health

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“…Some authors have advocated for a subclassification to discriminate early versus late stages of the disease by separating those that have recurrent symptoms for greater than 6 months from those who have failed initial management [33]. Infectious etiologies (active urethritis, cystitis), lower urinary tract malignancy, stricture, or other neurologic diseases must be ruled out prior to a diagnosis of CP/CPPS.…”

Section: Chronic Prostatitis/chronic Pelvic Pain Syndromementioning

confidence: 99%

Update in Diagnosis and Treatment of Chronic Pelvic Pain Syndromes

Shah

Ginzburg

Morrissey

et al. 2015

Curr Bladder Dysfunct Rep

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The diagnosis and treatment of chronic pelvic pain have shifted from organ-specific to multifactorial, multidisciplinary, and individualized approach. While many organizations have had diverse outlooks on classification and treatment plans, new research has identified varied clinical phenotypes and updated classification systems. These phenotypes are based on pain, gender, symptomatology, and comorbid pain syndromes. These new classification systems allow a multimodal therapeutic approach and evaluation of patients. Multidisciplinary care, including urology, gynecology, gastroenterology, neurology, psychology, physiotherapy, and pain medicine, is also further recognized for adequate management of patients with chronic pelvic pain because of its variable etiology. The purpose of this review is to emphasize these changes and discuss management strategies.

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Diagnosis and treatment of chronic bacterial prostatitis and chronic prostatitis/chronic pelvic pain syndrome: a consensus guideline

Cited by 239 publications

References 98 publications

Clinical Evaluation of Urine Prostatic Exosomal Protein in the Diagnosis of Chronic Prostatitis

Clinical Evaluation of Urine Prostatic Exosomal Protein in the Diagnosis of Chronic Prostatitis

The inflammatory journey of a prostatitis patient

Update in Diagnosis and Treatment of Chronic Pelvic Pain Syndromes

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