Chronic prostatitis and sensory urgency: whose pain is it?
Difficulties encountered in diagnosing and effectively treating chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is frustrating for clinicians and patients. Scientific evidence cannot establish an exact relationship between the prostate and the symptoms of CP/CPPS, and the prostate continues to be the diagnosis of convenience in this complex syndrome in men. However, if the pain is not the prostate's, whose pain is it? A heterogeneous group of insults can result in a common neurogenic pain response, resulting in recurring pain and voiding or sexual dysfunction. To add to this dilemma, certain life-threatening diagnoses, such as carcinoma-in-situ, is in the differential diagnosis and must be excluded. Urodynamics may be useful in evaluating and treating patients whose voiding symptoms predominate. However, many patients with CP/CPPS will not have measurable abnormalities by conventional methods and likely suffer from a functional somatic syndrome that is best treated with a multimodality approach.
Gonzalez
Ricardo R
RR
Department of Urology, Weill Medical College of Cornell University, 525 East 68th Street, F918, New York, NY 10021, USA. ricardorgonzalez@stanfordalumni
Te
Alexis E
AE
D002908:Chronic Disease; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D017699:Pelvic Pain / Q000209:etiology* / Q000503:physiopathology; D011472:Prostatitis / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D014555:Urination Disorders / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D014563:Urodynamics