ABSTRACT
Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common condition obsessing urologists and patients. It is also known as a heterogeneous syndrome, with varied etiologies, progression courses and responses to treatment. Based on the deeper insights into its pathogenesis and re-evaluation of its clinical trials, a novel phenotypic classification system UPOINT has been developed, which clinically classifies CP/CPPS patients into six domains: urinary (U), psychosocial (P), organ-specific (O), infection (I) , neurologic/systemic (N) and tenderness of pelvic floor skeletal muscles (T), and directs individualized and multimodal therapeutic approaches to CP/CPPS. This review systematically summarizes the theoretical foundation, clinical characteristics of UPOINT and treatment strategies based on the UPOINT phenotypic classification system.
Subject(s)
Humans , Male , Chronic Disease , Pelvic Pain , Classification , Diagnosis , Therapeutics , Phenotype , Prostatitis , Classification , Diagnosis , Therapeutics , Severity of Illness IndexABSTRACT
<p><b>AIM</b>To identify the factors influencing diagnosis and treatment of chronic prostatitis (CP) among Chinese urologists.</p><p><b>METHODS</b>A sample of 656 urologists from 29 provinces of China were asked to complete a questionnaire that explored attitudes towards CP as well as diagnosis and treatment patterns in the management of CP. Both univariate and multivariate logistic regression analysis schemes were used to determine the factors that influence the diagnosis and treatment of CP.</p><p><b>RESULTS</b>A total of 656 questionnaires were given out. All were returned and 410 of those were included in the final univariate and multivariate analysis. Multivariate logistic regression analysis indicated that belief of bacterial infection in the etiology of CP (odds ratio [OR], 2.544; 95% confidence interval [CI], 1.650-3.923; P < 0.001) was the most significant factor influencing the routine performance of bacterial culture test. Using the same model, the type of hospital (OR, 2.799; 95% CI, 1.719-4.559; P < 0.001) and the routine use of the 4- or the 2-glass test (OR, 3.194; 95% CI, 2.069-4.931; P < 0.001) were determined to be significant factors influencing the use of the National Institutes of Health (NIH) new classification system. According to the same model, belief of bacterial infection in the etiology of CP (OR, 3.415; 95% CI, 2.024-5.762; P < 0.001) and the routine use of bacterial culture test (OR, 2.261; 95% CI, 1.364-3.749; P < 0.01) were important factors influencing the routine prescription of antibiotics.</p><p><b>CONCLUSION</b>Our findings suggest that attitudes towards CP, and the characteristics of individual urologists' practices may influence the diagnosis and treatment of CP among Chinese urologists.</p>
Subject(s)
Adult , Aged , Humans , Male , Middle Aged , Anti-Bacterial Agents , Therapeutic Uses , China , Chronic Disease , Cross-Sectional Studies , Health Knowledge, Attitudes, Practice , Health Surveys , Logistic Models , Multivariate Analysis , Practice Patterns, Physicians' , Prostatitis , Diagnosis , Drug Therapy , Microbiology , Surveys and QuestionnairesABSTRACT
OBJECTIVE@#To detect the expression of Ki-67, Bcl-2, Bax and caspase-3 in simple benign prostatic hyperplasia (BPH) and BPH combined with prostatitis,and to evaluate the effect of inflammation on the development and progression of BPH.@*METHODS@#All specimens were obtained from patients undergoing surgical resection of the prostate. The paraffin section of the specimens was stained with hemotoxyline and eosin, and observed under light microscope to examine the inflammation hispathological changes. Sixteen patients with simple BPH (Group A) and 42 patients with BPH combined with prostatitis (Group B) were included. Immunohistochemical analysis and Western blot were used to examine the expression of Ki-67, Bcl-2, Bax and caspase-3.@*RESULTS@#The expression of Ki-67 and Bcl-2 was significantly higher in Group B than that in Group A (P0.05).@*CONCLUSION@#Prostatitis can up-regulate Ki-67, Bcl-2 expression, and down-regulate the expression of caspase-3 in BPH. Prostatitis appeared to play an important role in the development of BPH by affecting the proliferation and apoptosis of the prostatic cells.