Electrophysiological Identification of Central Sensitization in Patients with Chronic Prostatitis.
OBJECTIVE
Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) is a chronic pain condition and a com­mon problem in urology clinics. Although many different etiologies and mechanisms exist, the exact cause of the disease has been unknown. Central sensitization (CS) is defined as an augmentation of responsiveness of central cortical neurons to input from peripheral nociceptive structures. Somato-sensory evoked potentials (SEPs) is an electroneurophysiological method to assess cortical activity in somatosensory area of brain related to sensorial stimuli. We aimed to determine the presence of CS using the SEPs of dorsal penile nerve stimulation in patients with CP/CPPS.


METHODS
Seventeen male patients diagnosed CP/CPPS and 17 male healthy controls were pro­spectively included in the study. For SEP study, electrical stimulus was applied with penile ring electrodes. Re­cording electrodes were placed as active to Cz' and reference electrode on Fz' according to the 10-20 Interna­tional System. Latency of N50 was defined as the second negative (up-ward) deflection of the W-shaped averaged cortical waveform.


RESULTS
N50 latencies were significantly shortened in the patient group compared to the healthy controls (P < .001).


CONCLUSIONS
These results support the presence of central sensitization because of exaggerated trans-mission of pain sensation to the somatosensory cortex. Therefore, normalization of transmission might be an important step in treatment of pain in patients with CP/CPPS. This study can be counted as an important guiding on pathogenesis and treatment of disease.
NIH/NINDS Human Motor Control Section, Bethesda, Maryland, USA.. korkmazs78@gmail.com.
Selda
S
Korkmaz
Department of Urology, Kafkas University College of Medicine, Kars, Turkey.
Mert Ali
MA
Karadag
Department of Neurology, Acibadem Kayseri Hospital, Kayseri, Turkey.
Kemal
K
Hamamcioglu
Department of Urology, Acibadem Kayseri Hospital, Acibadem University College of Medicine, Istanbul, Turkey.
Mustafa
M
Sofikerim
Department of Neurology, Acibadem Kayseri Hospital, Acibadem University College of Medicine, Istanbul, Turkey.
Murat
M
Aksu
D000328:Adult; D059333:Central Nervous System Sensitization / Q000502:physiology*; D002908:Chronic Disease; D059350:Chronic Pain / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D004558:Electric Stimulation / Q000295:instrumentation*; D004566:Electrodes; D005071:Evoked Potentials; D006801:Humans; D008297:Male; D010147:Pain Measurement / Q000379:methods*; D017288:Pain Threshold / Q000502:physiology*; D011472:Prostatitis / Q000150:complications / Q000503:physiopathology*; D012189:Retrospective Studies