Urologic chronic pelvic pain syndrome

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Urologic chronic pelvic pain syndrome (UCPPS) is ongoing bladder pain in either sex, chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) in men and interstitial cystitis [1] [2] [3] or painful bladder syndrome (IC/PBS) in women. [4] [5]

Contents

It was coined as an umbrella term for use in research into urologic pain syndromes in men and women.

Treatment

Multimodal therapy is the most successful treatment option in chronic pelvic pain, [6] and includes physical therapy, [7] myofascial trigger point release, [7] relaxation techniques, [7] α-blockers, [8] and phytotherapy. [9] [10] The UPOINT diagnostic approach suggests that antibiotics are not recommended unless there is clear evidence of infection. [11]

Research

In 2007, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the United States National Institutes of Health (NIH), began using UCPPS as a term to refer to chronic pelvic pain syndromes (interstitial cystitis|interstitial cystitis/bladder pain syndrome (IC/BPS) in women and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) in men). [12]

MAPP Research Network

The NIDDK established the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network in 2008. [13]

MAPP Network scientists use a whole–body, systemic approach to the study of UCPPS, as well as investigating potential relationships between UCPPS and other chronic conditions that are sometimes seen in IC/PBS and CP/CPPS patients, such as irritable bowel syndrome, fibromyalgia, and chronic fatigue syndrome. [13]

Related Research Articles

<span class="mw-page-title-main">Interstitial cystitis</span> Medical condition

Interstitial cystitis (IC), a type of bladder pain syndrome (BPS), is chronic pain in the bladder and pelvic floor of unknown cause. It is the urologic chronic pelvic pain syndrome of women. Symptoms include feeling the need to urinate right away, needing to urinate often, and pain with sex. IC/BPS is associated with depression and lower quality of life. Many of those affected also have irritable bowel syndrome and fibromyalgia.

<span class="mw-page-title-main">Urology</span> Medical specialty

Urology, also known as genitourinary surgery, is the branch of medicine that focuses on surgical and medical diseases of the urinary-tract system and the reproductive organs. Organs under the domain of urology include the kidneys, adrenal glands, ureters, urinary bladder, urethra, and the male reproductive organs.

<span class="mw-page-title-main">Prostatitis</span> Medical condition

Prostatitis is an umbrella term for a variety of medical conditions that incorporate bacterial and non-bacterial origin illnesses in the pelvic region. In contrast with the plain meaning of the word, the diagnosis may not always include inflammation. Prostatitis is classified into acute, chronic, asymptomatic inflammatory prostatitis, and chronic pelvic pain syndrome.

Dyspareunia is painful sexual intercourse due to medical or psychological causes. The term dyspareunia covers both female dyspareunia and male dyspareunia, but many discussions that use the term without further specification concern the female type, which is more common than the male type. In females, the pain can primarily be on the external surface of the genitalia, or deeper in the pelvis upon deep pressure against the cervix. Medically, dyspareunia is a pelvic floor dysfunction and is frequently underdiagnosed. It can affect a small portion of the vulva or vagina or be felt all over the surface. Understanding the duration, location, and nature of the pain is important in identifying the causes of the pain.

Pudendal nerve entrapment (PNE), also known as Alcock canal syndrome, is an uncommon source of chronic pain in which the pudendal nerve is entrapped or compressed in Alcock's canal. There are several different types of PNE based on the site of entrapment anatomically. Pain is positional and is worsened by sitting. Other symptoms include genital numbness, fecal incontinence and urinary incontinence.

Glomerulation refers to bladder hemorrhages which are thought to be associated with some types of interstitial cystitis (IC).

<span class="mw-page-title-main">Urinary retention</span> Inability to completely empty the bladder

Urinary retention is an inability to completely empty the bladder. Onset can be sudden or gradual. When of sudden onset, symptoms include an inability to urinate and lower abdominal pain. When of gradual onset, symptoms may include loss of bladder control, mild lower abdominal pain, and a weak urine stream. Those with long-term problems are at risk of urinary tract infections.

Mycoplasmataceae is a family of bacteria in the order Mycoplasmatales. This family consists of the genera Mycoplasma and Ureaplasma.

Percutaneous tibial nerve stimulation (PTNS), also referred to as posterior tibial nerve stimulation, is the least invasive form of neuromodulation used to treat overactive bladder (OAB) and the associated symptoms of urinary urgency, urinary frequency and urge incontinence. These urinary symptoms may also occur with interstitial cystitis and following a radical prostatectomy. Outside the United States, PTNS is also used to treat fecal incontinence.

Prostatic congestion is a medical condition of the prostate gland that happens when the prostate becomes swollen by excess fluid and can be caused by prostatosis. The condition often results in a person with prostatic congestion feeling the urge to urinate frequently. Prostatic congestion has been associated with prostate disease, which can progress due to age. Oftentimes, the prostate will grow in size which can lead to further problems, such as prostatitis, enlarged prostate, or prostate cancer.

<span class="mw-page-title-main">Pelvic pain</span> Medical condition

Pelvic pain is pain in the area of the pelvis. Acute pain is more common than chronic pain. If the pain lasts for more than six months, it is deemed to be chronic pelvic pain. It can affect both the male and female pelvis.

<span class="mw-page-title-main">Mepartricin</span> Chemical compound

Mepartricin is a macrolide polyene compound that is useful for urethra, prostate, and bladder function. It has been studied for use in treating chronic pelvic pain syndrome and benign prostatic hyperplasia.

Lower urinary tract symptoms (LUTS) refer to a group of clinical symptoms involving the bladder, urinary sphincter, urethra and, in men, the prostate. The term is more commonly applied to men—over 40% of older men are affected—but lower urinary tract symptoms also affect women. The condition is also termed prostatism in men, but LUTS is preferred.

<span class="mw-page-title-main">Chronic bacterial prostatitis</span> Bacterial infection of the prostate gland

Chronic bacterial prostatitis is a bacterial infection of the prostate gland. It should be distinguished from other forms of prostatitis such as acute bacterial prostatitis and chronic pelvic pain syndrome (CPPS).

<span class="mw-page-title-main">Chronic prostatitis/chronic pelvic pain syndrome</span> Medical condition

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), previously known as chronic nonbacterial prostatitis, is long-term pelvic pain and lower urinary tract symptoms (LUTS) without evidence of a bacterial infection. It affects about 2–6% of men. Together with IC/BPS, it makes up urologic chronic pelvic pain syndrome (UCPPS).

<span class="mw-page-title-main">Asymptomatic inflammatory prostatitis</span> Medical condition

Asymptomatic inflammatory prostatitis is a painless inflammation of the prostate gland where there is no evidence of infection. It should be distinguished from the other categories of prostatitis characterised by either pelvic pain or evidence of infection, such as chronic bacterial prostatitis, acute bacterial prostatitis and chronic pelvic pain syndrome (CPPS). It is a common finding in men with benign prostatic hyperplasia.

Urinary bladder disease includes urinary bladder inflammation such as cystitis, bladder rupture and bladder obstruction (tamponade). Cystitis is common, sometimes referred to as urinary tract infection (UTI) caused by bacteria, bladder rupture occurs when the bladder is overfilled and not emptied while bladder tamponade is a result of blood clot formation near the bladder outlet.

Urologic diseases or conditions include urinary tract infections, kidney stones, bladder control problems, and prostate problems, among others. Some urologic conditions do not affect a person for that long and some are lifetime conditions. Kidney diseases are normally investigated and treated by nephrologists, while the specialty of urology deals with problems in the other organs. Gynecologists may deal with problems of incontinence in women.

Pelvic floor physical therapy (PFPT) is a specialty area within physical therapy focusing on the rehabilitation of muscles in the pelvic floor after injury or dysfunction. It can be used to address issues such as muscle weakness or tightness post childbirth, dyspareunia, vaginismus, vulvodynia, constipation, fecal or urinary incontinence, pelvic organ prolapse, and sexual dysfunction. Licensed physical therapists with specialized pelvic floor physical therapy training address dysfunction in individuals across the gender and sex spectra, though PFPT often associated with women's health for its heavy focus on addressing issues of pelvic trauma after childbirth.

References

  1. ↑ Dimitrakov J, Joffe HV, Soldin SJ, Bolus R, Buffington CA, Nickel JC (February 2008). "Adrenocortical hormone abnormalities in men with chronic prostatitis/chronic pelvic pain syndrome". Urology. 71 (2): 261–6. doi:10.1016/j.urology.2007.09.025. PMC   2390769 . PMID   18308097.
  2. ↑ Masiutin MG, Yadav MK (2022). "Letter to the editor regarding the article "Adrenocortical hormone abnormalities in men with chronic prostatitis/chronic pelvic pain syndrome"". Urology. 169: 273. doi:10.1016/j.urology.2022.07.051. ISSN   0090-4295. PMID   35987379. S2CID   251657694.
  3. ↑ Dimitrakoff J, Nickel JC (2022). "AUTHOR REPLY". Urology. 169: 273–274. doi:10.1016/j.urology.2022.07.049. ISSN   0090-4295. PMID   35985522. S2CID   251658492.
  4. ↑ Dimitrakov J, Dimitrakova E (2009). "Urologic chronic pelvic pain syndrome--looking back and looking forward". Folia Med (Plovdiv). 51 (3): 42–4. PMID   19957562.
  5. ↑ Adamian L, Urits I, Orhurhu V, Hoyt D, Driessen R, Freeman JA, Kaye AD, Kaye RJ, Garcia AJ, Cornett EM, Viswanath O (May 2020). "A Comprehensive Review of the Diagnosis, Treatment, and Management of Urologic Chronic Pelvic Pain Syndrome". Curr Pain Headache Rep. 24 (6): 27. doi:10.1007/s11916-020-00857-9. PMID   32378039. S2CID   218513050.
  6. ↑ Potts JM (2005). "Therapeutic options for chronic prostatitis/chronic pelvic pain syndrome". Current Urology Reports. 6 (4): 313–7. doi:10.1007/s11934-005-0030-5. PMID   15978236. S2CID   195364765.
  7. 1 2 3 Potts J, Payne RE (May 2007). "Prostatitis: Infection, neuromuscular disorder, or pain syndrome? Proper patient classification is key". Cleve Clin J Med. 74 (Suppl 3): S63–71. doi:10.3949/ccjm.74.suppl_3.s63. PMID   17549825.
  8. ↑ Yang G, Wei Q, Li H, Yang Y, Zhang S, Dong Q (2006). "The effect of alpha-adrenergic antagonists in chronic prostatitis/chronic pelvic pain syndrome: a meta-analysis of randomized controlled trials". J. Androl. 27 (6): 847–52. doi: 10.2164/jandrol.106.000661 . PMID   16870951. ...treatment duration should be long enough (more than 3 months)
  9. ↑ Shoskes DA, Zeitlin SI, Shahed A, Rajfer J (1999). "Quercetin in men with category III chronic prostatitis: a preliminary prospective, double-blind, placebo-controlled trial". Urology. 54 (6): 960–3. doi:10.1016/S0090-4295(99)00358-1. PMID   10604689.
  10. ↑ Elist J (2006). "Effects of pollen extract preparation Prostat/Poltit on lower urinary tract symptoms in patients with chronic nonbacterial prostatitis/chronic pelvic pain syndrome: a randomized, double-blind, placebo-controlled study". Urology. 67 (1): 60–3. doi:10.1016/j.urology.2005.07.035. PMID   16413333.
  11. ↑ Sandhu J, Tu HY (2017). "Recent advances in managing chronic prostatitis/chronic pelvic pain syndrome". F1000Res. 6: 1747. doi: 10.12688/f1000research.10558.1 . PMC   5615772 . PMID   29034074.
  12. ↑ Clemens JQ, Mullins C, Kusek JW, Kirkali Z, Mayer EA, Rodríguez LV, et al. (August 2014). "The MAPP research network: a novel study of urologic chronic pelvic pain syndromes". BMC Urol. 14: 57. doi: 10.1186/1471-2490-14-57 . PMC   4134515 . PMID   25085007.
  13. 1 2 "A New Look at Urological Chronic Pelvic Pain". Multi-Disciplinary Approach to the Study of Chronic Pelvic Pain. Retrieved 8 March 2021.
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