ABSTRACT
In this review article, the authors describe all relevant aspects of the new S2k guideline from the German Society of Urology (Deutschen Gesellschaft für Urologie, DGU) for the diagnosis and treatment of IC/PBS (interstitial cystitis/painful bladder syndrome). A list of necessary and optional examinations and the necessity of diagnosis of exclusion are summarized and evaluated. The treatment options listed (ranging from conservative, oral drug, and complementary medicine to interventional surgical procedures) also give the reader a good overview of the contents of the guideline and possible therapeutic approaches. Finally, the recommendations including consensus of the guideline group are also summarized in various information boxes.
Subject(s)
Cystitis, Interstitial/diagnosis , Cystitis, Interstitial/therapy , Practice Guidelines as Topic , Urology/standards , Germany , Humans , Pain , Physical Examination , Societies, MedicalABSTRACT
Chronic pelvic pain has a negative impact on quality of life, resulting in a tremendous cost of illness. This condition has a multifactorial etiology and its treatment is often a frustrating experience for patients and therapists alike. Therefore, patients frequently initiate alternative medical treatment methods, which are explained below.
Subject(s)
Chronic Pain/etiology , Chronic Pain/therapy , Complementary Therapies/methods , Pelvic Pain/etiology , Pelvic Pain/therapy , Analgesics/therapeutic use , Combined Modality Therapy , Guideline Adherence , Humans , Treatment FailureABSTRACT
BACKGROUND: Chronic pelvic pain represents a multifactorial problem of unknown etiology. International standardized diagnostic and therapeutic approaches do not exist. METHODS: Medline and PubMed databases were searched for systematic reviews and guidelines for prevalence and therapy of chronic pelvic pain syndrome. RESULTS: Frequency, clinical picture, and treatment concepts for various forms of chronic pelvic pain are presented. If established treatments fail, then multimodal therapy concepts are recommended. Controlled studies, which fulfill evidence-based medicine criteria, are lacking. CONCLUSION: The success of multimodal therapeutic approaches in other chronic pain diseases should lead to the development and verification of these for chronic pelvic pain.
Subject(s)
Prostatitis/therapy , Combined Modality Therapy , Diagnosis, Differential , Humans , Male , Male Urogenital Diseases/etiology , Male Urogenital Diseases/therapy , Pain Management/methods , Practice Guidelines as Topic , Prostatitis/etiologyABSTRACT
The vast majority of surgical patients suffer from postoperative pain, which has an enormous influence on quality of life and the progress of the stationary stay. This article gives practical advice on perioperative pain management, taking into consideration the European Association of Urology guidelines for 2009 and the S3 guideline on the treatment of acute perioperative and traumatic pain.
Subject(s)
Pain, Postoperative/etiology , Pain, Postoperative/therapy , Perioperative Care/standards , Practice Guidelines as Topic , Practice Patterns, Physicians'/standards , Urologic Surgical Procedures/adverse effects , Urology/standards , Acute Disease , Adult , Europe , Humans , Pain, Postoperative/diagnosis , Urologic Surgical Procedures/standardsABSTRACT
Approximately 10% of the population suffers from chronic pain in the urogenital region. The multidimensionality of this chronic pain syndrome must be taken into consideration.The cause of urologic chronic pelvic pain syndrome (UCPPS) is mostly unclear. Treatment of these patients should be carried out in specialized institutions.
Subject(s)
Pain Measurement/methods , Pelvic Pain/diagnosis , Pelvic Pain/therapy , Urologic Diseases/diagnosis , Urologic Diseases/therapy , HumansABSTRACT
The diagnosis of acute or chronic pain syndromes of the urogenital system can be verified and successfully treated by exact exploration of the patients medical history, the physical examination and a few image-guided or laboratory analyses Pain conditions which remain of unknown etiology even after extensive investigations are difficult to treat by the urologist alone. In cases where no causally determined morphological changes can be found or the alteration is disproportionate to the discomfort sensed by the patient, a multidisciplinary therapy strategy offers an approach to find a solution.
Subject(s)
Pain Management , Pain Measurement/methods , Pain/diagnosis , Practice Patterns, Physicians'/trends , Urologic Diseases/diagnosis , Urologic Diseases/therapy , HumansABSTRACT
The symptom complex called prostatitis represents a multifactorial problem of unclear etiology. Standardized diagnostic and therapeutic approaches do not exist. Controlled studies which fulfil evidence-based medical criteria are missing. A review of the currently available literature leads to the conclusion that a multimodal therapy concept should be developed and examined.
Subject(s)
Pelvic Pain/etiology , Prostatitis/physiopathology , Chronic Disease , Diagnosis, Differential , Humans , Male , Pelvic Pain/physiopathology , Prostatitis/classification , Prostatitis/therapy , Socioeconomic FactorsABSTRACT
If a patient presents with symptoms of a functional somatic pain syndrome in the primary care setting, it is important to confirm the diagnosis based on a thorough history and physical examination including selected diagnostic tests to exclude somatic diseases with a similar clinical presentation. Important aspects of psychosomatic medicine in the primary care setting are to discuss the diagnosis, treatment options, and prognosis of the functional psychosomatic pain syndromes with the patient in detail. Patients who present with a functional somatic pain syndrome to secondary or tertiary care centers, should be screened for additional functional pain syndromes. A psychiatric-psychosomatic evaluation might be indicated. Based on criteria of evidence-based medicine, psychotherapy and/or tricyclic antidepressants seem to be the most promising treatment approaches for the functional somatic pain syndromes.
