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Pharmacological interventions for treating chronic prostatitis/chronic pelvic pain syndrome.

Paterson, Catherine; Kennedy, Catriona

Authors

Catherine Paterson



Abstract

Prostatitis is a common condition which can affect men of all ages; however, it is more frequently experienced in younger men with an initial onset around 40 years of age. The two main presenting clinical features of prostatitis are lower urinary tract symptoms and pelvic pain. Other symptoms might include obstructive or irritative voiding symptoms, ejaculatory pain, and hematospermia. A diagnosis is usually based on the man's history, physical examination, urinalysis, and the two-or four-glass test (also known as obtaining urine specimens before, during, and after prostatic massage). Further investigations may also be performed when considering the differential diagnosis. Prostatitis can result in a significant reduction in quality of life (QOL) and pain can be associated with sexual dysfunction in men. Prostatitis can be classified as four distinct types, namely, type I acute prostatitis, type II chronic bacterial prostatitis, type III chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), and type IV asymptomatic prostatitis. It is unclear whether type III can be linked in all cases to prostatic involvement therefore the alternate denomination CPPS is used in clinical practice. Furthermore, CP/CPPS is further subclassified as type IIIa (inflammatory), and type IIIb (noninflammatory) which is dependent on the presence of inflammatory cells in prostatic secretions. CP/CPPS is considered when pelvic pain is present for at least three of the preceding 6 months with no other identifiable causes determined. There are several hypothesized causes of CP/CPPS which include: neuropsychological factors, infection, inflammation/autoimmunity, and dyssynergia voiding associated with bladder neck hypertrophy. Given the wide range of potential causes of CP/CPPS, there are many pharmacological interventions available in clinical practice to manage this complex condition. It is important to critically summarize evidence-based recommendations to inform the clinical management of men affected by CP/CPPS (Franco et al., 2019).

Journal Article Type Review
Journal Research in nursing and health
Print ISSN 0160-6891
Electronic ISSN 1098-240X
Publisher Wiley Open Access
Peer Reviewed Peer Reviewed
Item Discussed FRANCO, J.V.A., TURK, T., JUNG, J.H., XIAO, Y.-T., IAKHNO, S. TIRAPEGUI, F.I., GARROTE, V. and VIETTO, V. 2019. Pharmacological interventions for treating chronic prostatitis/chronic pelvic pain syndrome. Cochrane database of systematic reviews, 10, artic
Institution Citation PATERSON, C. and KENNEDY, C. [2020]. Pharmacological interventions for treating chronic prostatitis/chronic pelvic pain syndrome. Research in nursing and health [online], Early View. Available from: https://doi.org/10.1002/nur.22027
DOI https://doi.org/10.1002/nur.22027
Keywords Prostatitis; Men; Lower urinary tract; Pelvic pain; Pharmacological therapies; Sexual dysfunction; Quality of life; Depression
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