- Daily phosphodiesterase type 5 inhibitor therapy: a new treatment option for prostatitis/prostatodynia? [Review]
- BIBJU Int 2014; 113(5):694-5
- Chronic prostatitis does not influence urinary PCA3 score. [Journal Article]
- PProstate 2012; 72(5):549-54
- CONCLUSIONS: In this study, NIH II and III chronic prostatitis did not influence the PCA3 score. Our results suggest that increased PCA3 score is unlikely to be explained by the sole chronic prostatitis and warrants prostate biopsies to eliminate prostate cancer.
- Demystifying pleomorphic forms in persistence and expression of disease: Are they bacteria, and is peptidoglycan the solution? [Review]
- DMDiscov Med 2010; 10(52):234-46
- There is considerable circumstantial evidence linking tissue pleomorphic forms of unknown origin with idiopathic chronic inflammatory, collagen, lymphoproliferative, nephro-urological (including inte...
There is considerable circumstantial evidence linking tissue pleomorphic forms of unknown origin with idiopathic chronic inflammatory, collagen, lymphoproliferative, nephro-urological (including interstitial cystitis and prostatodynia), and neoplastic diseases. Although these forms have been observed in stained tissue histopathologic specimens for many decades, most are ignored and generally regarded as diagnostically insignificant staining artifacts or debris. It is hypothesized that these pleomorphic forms are not staining artifacts/cellular debris, but instead represent various stages in the life cycle of stressed bacteria: cell wall-deficient/defective (often called L-forms) that are difficult-to-culture or nonculturable. Essential to the thesis is that small, electron dense, non-vesiculated L-forms are the central (core) element in bacterial persistence. Depending on the stimulus received, these dense forms might be considered as undifferentiated cells, with the capacity to develop along several different routes. Hence, these altered forms created in vivo take up intracellular and/or extracellular residence; possibly establishing a sort of immune protected parasitic relationship, resisting/surviving phagocytic action, and creating subtle pathologic changes in the host during a prolonged period of tissue persistence. This might translate into an etiology for chronic inflammatory diseases, when the stressed bacteria increase in numbers and overwhelm the normal biological functions of the host. In the last few decades, an increasing percentage of the population has become immunosuppressed. Some mechanisms for this increase are aging; autoimmunity; congenital, metabolic and degenerative disorders; and AIDS. The life of a patient so affected is prolonged by therapy with hormones, antimicrobials, and immunosuppressants. It is therefore not surprising that pleomorphic, dormant, and mutant bacterial populations arise in vivo when bacteria are exposed to agents that interfere with structural components and metabolic processes necessary to survival of the microbe. Recent provocative, microbiological data lend credence to the hypothesis and corroborate the multiplicity of pleomorphic forms that develop during reproduction of L forms in vitro. It is proposed that in vivo persistence of these bacterial elements escape immune surveillance partially, completely, or may integrate with host cell organelles to create bacteria-host-cell-antigen complexes which could provoke immunopathologic consequences. Highly relevant, newly published data on modifications of gene expression, modes of division for stressed bacteria, and the paradoxical finding of peptidoglycan in L-forms are pertinent to the hypothesis that atypical, pleomorphic bacteria are the organisms operative in persistence and expression of pathology over a wide spectrum of diagnostically troublesome human diseases.
- Prostatitis: acute and chronic. [Review]
- PCPrim Care 2010; 37(3):547-63, viii-ix
- Prostatitis, one of the most common urological infections afflicting adult men, has recently been divided into 4 different categories based on the National Institutes of Health consensus classificati...
Prostatitis, one of the most common urological infections afflicting adult men, has recently been divided into 4 different categories based on the National Institutes of Health consensus classification: acute bacterial prostatitis, chronic bacterial prostatitis, chronic nonbacterial prostatitis and pelvic pain syndrome, and asymptomatic inflammatory prostatitis. Most patients with prostatitis are found to have either nonbacterial prostatitis or prostatodynia. Prostatitis poses an international health problem, with epidemiologic studies suggesting a worldwide prevalence of more than 10%. This article reviews current modes of diagnosis and therapy for acute and chronic prostatitis.
- Urologic chronic pelvic pain syndrome. [Review]
- PCPrim Care 2010; 37(3):527-46, viii
- Painful bladder syndrome or urologic chronic pelvic pain syndrome is a chronic condition that presents with lower urinary tract symptoms that include dysuria, urgency, frequent urination, and chronic...
Painful bladder syndrome or urologic chronic pelvic pain syndrome is a chronic condition that presents with lower urinary tract symptoms that include dysuria, urgency, frequent urination, and chronic pelvic pain. Diagnoses included in the painful bladder syndrome are interstitial cystitis and prostatodynia. The history, physical examination, and laboratory evaluation of patients with lower urinary tract symptoms are important in ruling out other diagnoses. Treatment options that are US Food and Drug Administration approved and evidence based are limited; however, many symptom-based treatment options can reduce symptoms and improve quality of life.
- A pure primary low-grade neuroendocrine carcinoma (carcinoid tumor) of the prostate. [Case Reports]
- IUInt Urol Nephrol 2010; 42(3):683-7
- The first time in Scandinavia we present a case report of a pure primary low-grade neuroendocrine carcinoma (carcinoid tumor) of the prostate. Our patient is a 34-year-old male with a long history of...
The first time in Scandinavia we present a case report of a pure primary low-grade neuroendocrine carcinoma (carcinoid tumor) of the prostate. Our patient is a 34-year-old male with a long history of symptomatic chronic prostatitis/prostatodynia. After developing severe obstructive uropathy, a transurethral resection was performed. An unexpected diagnosis of a low-grade neuroendocrine carcinoma was made. Subsequently, in radical prostatovesiculectomy, we noted metastases to both seminal vesicles and two inguinal lymph nodes. Follow up is ongoing.
- Intrathecal administration of resiniferatoxin produces analgesia against prostatodynia in rats. [Journal Article]
- CMChin Med J (Engl) 2007 Sep 20; 120(18):1616-21
- CONCLUSIONS: Intrathecal RTX administration could produce an analgesic effect on rat prostatodynia. Suppression of pelvic nerve afferent electrical activity may be a crucial mechanism underlying RTX-induced analgesia. RTX intrathecal application may present a novel analgesic strategy of prostatodynia.
- Cryptic bacterial infection in chronic prostatitis: diagnostic and therapeutic implications. [Journal Article]
- COCurr Opin Urol 1998; 8(1):45-9
- Chronic idiopathic prostatitis, sometimes called prostatodynia or abacterial prostatitis, is a commonly diagnosed and poorly treated urological syndrome. Clinically, this condition frustrates the pat...
Chronic idiopathic prostatitis, sometimes called prostatodynia or abacterial prostatitis, is a commonly diagnosed and poorly treated urological syndrome. Clinically, this condition frustrates the patient and physician due to its chronicity and resistance to therapy. Recent studies suggest that the etiology of chronic idiopathic prostatitis may be of bacterial origin. Three types of provocative data have demonstrated bacterial presence from prostatic specimens (tissue and secretions) that were negative by traditional clinical microbiologic tests: (i) presence of bacterial gene sequences in prostatic tissue encoding 16S rRNA and tetracycline resistance (tetM-tetO-tetS); (ii) controlled cultural findings showing coagulase-negative staphylococci as the most common isolates (68%) in prostatodynia (chronic idiopathic prostatitis); and (iii) culture of difficult-to-grow coryneforms in expressed prostatic secretions (EPS) on enriched culture media and direct microscopic observation of these pleomorphic bacteria in EPS. Additionally, earlier experimental studies in a rat model support the concept that antibiotic therapy in chronic bacterial prostatitis may not be due to altered antibiotic pharmacokinetics in the chronically inflamed prostate gland. Rather, ineffective antimicrobial eradication might result from protected bacterial micro-colonies within an infection-induced altered micro-environment deep within the prostate gland. We postulate that extracellular slime substances produced by bacteria that are buried in prostatic tissues could impair host defenses by their anti-phagocytic and anti-chemotactic properties that affect neutrophils as well as anti-proliferative characteristics that affect lymphocytes. These extracellular slime substances could also have cytoprotective properties which can conceal bacteria from otherwise bactericidal levels of antibiotics and lead to recrudescent infections resistant to therapy. Persistence of bacterial antigens might initiate a cascade of cellular immunologic events resulting in chronic inflammation of the prostate gland.
- [Molida therapy in the out-patient department for patients with III B prostatitis]. [Randomized Controlled Trial]
- ZNZhonghua Nan Ke Xue 2006; 12(8):714-6
- CONCLUSIONS: Molida therapy in the out-patient department is useful in improving the psychological disorder and enhancing the therapeutic effect for patients with III B prostatitis.
New Search Next
- The management of chronic prostatitis in men with HIV. [Review]
- CUCurr Urol Rep 2006; 7(4):313-9
- Prostatitis is a common urologic diagnosis. Although treatment algorithms are available for this poorly understood entity, several adaptations must be made in order to accommodate the therapeutic nee...
Prostatitis is a common urologic diagnosis. Although treatment algorithms are available for this poorly understood entity, several adaptations must be made in order to accommodate the therapeutic needs of HIV-positive patients. The most important consideration when treating HIV-infected patients for prostatitis is their current immune status, whether they are immunocompromised or not (non-progressive disease or reconstituted with highly active antiretroviral therapy). A treatment algorithm for those with chronic bacterial prostatitis (Category II), chronic nonbacterial prostatitis (Category IIIA), and prostatodynia (Category IIIB) is presented in this article. In the HIV-positive patient population, there is a greater likelihood for atypical pathogens including fungi, tuberculosis, anaerobes, and viruses. Because the HIV-infected patient is at increased risk for the development of prostatic abscess and urosepsis than the general population, increased monitoring and evaluation and longer-term appropriately directed antimicrobial therapy are required.