• bixie fenqing decoction
• chronic prostatitis
• traditional chinese medicine

• Humans
• Male
• Chronic Disease/drug therapy
• Drugs, Chinese Herbal/therapeutic use
• Medicine, Chinese Traditional/methods
• Prostatitis/diagnosis
• Prostatitis/drug therapy
• Randomized Controlled Trials as Topic
• Treatment Outcome

• No.2024 Evidence-based capacity improvement project for traditional Chinese medicine Local projects for central government transfer payments
• National Natural Science Foundation of China

• benign prostatic hyperplasia
• chronic inflammation
• microbiome
• pelvic ischemia
• treatments
• urine reflux

• Humans
• Prostatic Hyperplasia/physiopathology
• Prostatic Hyperplasia/complications
• Prostatic Hyperplasia/therapy
• Male
• Lower Urinary Tract Symptoms/etiology
• Lower Urinary Tract Symptoms/physiopathology
• Lower Urinary Tract Symptoms/drug therapy
• Lower Urinary Tract Symptoms/therapy
• Prostate/pathology
• Prostate/immunology
• Prostate/physiopathology
• Prostatitis/physiopathology
• Prostatitis/drug therapy
• Prostatitis/immunology
• Prostatitis/therapy
• Prostatitis/etiology
• Chronic Disease
• Phosphodiesterase 5 Inhibitors/therapeutic use
• Inflammation/physiopathology
• 5-alpha Reductase Inhibitors/therapeutic use
• Adrenergic alpha-1 Receptor Antagonists/therapeutic use

• AHPFS
• PROM
• hyperactive pelvic floor
• overactive pelvic floor
• pelvic floor dysfunctions
• pelvic pain
• psychometric evaluation
• questionnaire
• validation

• Humans
• Female
• Psychometrics
• Pelvic Floor
• Reproducibility of Results
• Pelvic Pain/diagnosis
• Surveys and Questionnaires
• Norway

• RNA-seq technology
• analgesic mechanism
• animal experiment
• chronic prostatitis/chronic pelvic pain syndrome
• electroacupuncture

• manual therapy
• musculoskeletal manipulation
• patient reported outcome measures
• physiotherapy
• prostatitis

• Chronic pelvic pain syndrome
• Health-related quality of life
• Psychosocial factors

• Dysfunction
• Lower urinary tract
• Male
• Pelvic floor
• Sexual health

• Chronic pelvic pain
• chronic pelvic pain syndrome
• chronic prostatitis
• inflammation
• interstitial cystitis
• multimodal therapy
• painful bladder syndrome
• quality of life

• EHS
• ESWT
• IIEF-5
• NIH-CPSI
• QoL
• chronic pelvic pain syndrome
• chronic prostatitis
• extracorporeal shockwave therapy

Chronic pelvic pain with various etiologies and mechanisms affects men and women and is a major challenge. Monotherapy is often unsuccessful for chronic pelvic pain, and combinations of different classes of medications are frequently prescribed, with the expectation of improved outcomes. Although a number of combination trials for chronic pelvic pain have been reported, we are not aware of any systematic reviews of the available evidence on combination drug therapy for chronic pelvic pain.

We have developed a protocol for a systematic review to evaluate available evidence of the efficacy and safety of drug combinations for chronic pelvic pain.

This systematic review will involve a detailed search of randomized controlled trials investigating drug combinations to treat chronic pelvic pain in adults. The databases searched will include the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, and EMBASE from their inception until the date the searches are run to identify relevant studies. The primary outcome will be pain relief measured using validated scoring tools. Secondary outcomes, where reported, will include the following: adverse events, serious adverse events, sexual function, quality of life, and depression and anxiety. Methodological quality of each included study will be assessed using the Cochrane Risk of Bias Tool.

The systematic review defined by this protocol is expected to synthesize available good quality evidence on combination drug therapy in chronic pelvic pain, which may help guide future research and treatment choices for patients and their health care providers.

This review will provide a clearer understanding of the efficacy and safety of combination pharmacological therapy for chronic pelvic pain.

PROSPERO International Prospective Register of Systematic Reviews CRD42020192231; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=192231

PRR1-10.2196/21909

• CPPS
• bladder pain syndrome
• chronic pain
• chronic pelvic pain
• chronic pelvic pain syndrome
• chronic prostatitis
• clinical studies
• combination
• combination therapy
• drug
• efficacy
• interstitial cystitis
• pain
• pelvis
• protocol
• safety
• systematic review
• therapy
• treatment

• Chronic Pelvic Pain
• Coccygeal Transverse Approach
• Inferior Hypogastric Plexus
• Trans-sacral Fluoroscopic Technique

• chronic pelvic pain syndrome
• medicinal plants
• preclinical and clinical studies
• secondary metabolites

• Chronic Disease
• Chronic Pain/drug therapy
• Drug Compounding/methods
• Drug Compounding/trends
• Drug Discovery/methods
• Drug Discovery/trends
• Female
• Humans
• Male
• Pelvic Inflammatory Disease/drug therapy
• Pelvic Pain/drug therapy
• Phytochemicals/isolation & purification
• Phytochemicals/therapeutic use
• Plants, Medicinal/chemistry
• Plants, Medicinal/classification
• Quality of Life
• Syndrome

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is identified as a urinary andrological diseases that afflict men due to various discomforts. It is urgent and meaningful to develop the novel and effective treatments as a result of the unclear etiology and dismal therapeutic effect of CP/CPPS. Lycopene exerts a crucial role in numerous chronic inflammatory diseases owing to its potent antioxidant capacity.

This study aimed to observe the effect of lycopene on CP/CPPS and to explore the underlying mechanisms.

A CP/CPPS model with complete Freund's adjuvant was established in this study. Afterward, intragastric lycopene or corn oil was administered daily for 4 consecutive weeks. Finally, the cardiac blood and prostate tissue samples were collected from rats to carry out related evaluation and testing.

It was found in this study that lycopene alleviated changes in prostate histopathology compared with those in the complete Freund's adjuvant‐induced CP/CPPS model rats without lycopene treatment. Furthermore, lycopene was suggested to reduce the levels of chemokines MCP1 and MIP‐1α, down‐regulate the expression levels of cytokines (such as TNFα, IL‐1β, IL‐2, and IL‐6), and up‐regulate those of CAT, GSH‐PX, and T‐SOD, decrease that of malondialdehyde. Moreover, it also inhibited the phosphorylation of MAPKs, NF‐κB, and enhanced phosphorylation of the Nrf2 in the CP/CPPS rat model.

The findings in this study suggest that lycopene exerts potent anti‐ CP/CPPS Seffects through alleviating inflammatory response and oxidative stress, which is probably attributed to the interaction of NF‐κB, MAPKs, and Nrf2 signaling pathways in rats. As a natural antioxidant, lycopene may serve as a promising pharmaceutical preparation for treating CP/CPPS.

• anti-inflammation
• antioxidant
• chronic pelvic pain syndrome
• chronic prostatitis
• lycopene
• signaling pathways

• Chronic prostatitis/Chronic pelvic pain syndrome
• Diagnosis
• Etiology
• Future CP/CPPS therapies
• Treatment

• Chronic pelvic pain syndrome
• Chronic prostatitis
• Evaluation
• Treatment

• Humans
• Male
• Prostatitis/diagnosis
• Prostatitis/therapy

Chronic prostatitis typically occurs in aging men, and its symptoms include frequent and painful urination. In recent study, several studies have shown that Korean red ginseng (KRG) can be used in the prevention and treatment of various diseases. The objective of this study is to investigate whether KRG can play a role in repressing the development of chronic nonbacterial prostatitis (CNP) in male Wistar rats. To induce CNP, rats were castrated and beta-estradiol (0.25 mg/kg) was subcutaneously (s.c.) injected daily. 7-week-old male Wistar rats were divided into 5 groups (the normal group, CNP group, positive group, and KRG group (0.25g/kg) and another KRG (0.50g/kg) group. After 4 weeks, all rats were sacrificed and their prostate and serum were analyzed. Compared to the positive group, the KRG groups (0.25g/kg and 0.50g/kg) showed similar protective properties on CNP based on the histopathologic morphology of the prostate and the inflammation cytokines in the prostate tissue. Also, results of the immunohistochemistry staining showed that expression levels of vascular endothelial growth factor A (VEGFA), interleukin 6 (IL6), interleukin 1 beta (IL-1ß), tumor necrosis factor (TNF-alpha), and cytochrome c oxidase subunit II (COX2) were also decreased in KRG group (0.25g/kg) and KRG group (0.50g/kg). These results suggested that KRG inhibited the development of CNP and might a useful herbal treatment or functional food for CNP.

The current study aimed to identify a comprehensive expression-profile of microRNAs (miRNAs) in expressed prostatic secretion (EPS) collected from healthy men and patients with CP/CPPS (Chronic prostatitis/Chronic pelvic pain syndrome). After clinical screening of 382 participants, 60 healthy men and 59 IIIA CP/CPPS patients with significant pelvic-pain were included into this study from March 2012 to December 2014. High-throughput sequencing was employed to identify characteristic expression-profile of EPS-miRNAs. QRT-PCR was further performed to confirm elevated levels of differential EPS-miRNAs. Finally, candidate EPS-miRNAs were measured traceably in 21 follow-up patients and their classify-accuracy on IIIA CP/CPPS were analyzed by ROC (receiver operating characteristic) curve. In discovery-phage, 41 and 43 predominant EPS-miRNAs were found in pooled EPS-sample from 40 healthy men and 39 IIIA CP/CPPS patients, respectively. Furthermore, 22 abundant EPS-miRNAs were up-regulated with ≥ 2-fold in 20 patients compared to 20 healthy men. In testing-phage, elevated levels of miR-21-5p, miR-30a-5p, miR-30d-5p, miR-103a-3p and miR-141-3p were further confirmed in 33 patients by comparing to 30 healthy men. In validation-phage, relieved pelvic-pain symptom of 21 follow-up patients was found to be accompanied by significant down-regulation of miR-21-5p, miR-103a-3p and miR-141-3p. Particularly, ROC curve analysis indicated the highest area under ROC curve (AUC) was found for miR-21-5p (0.891), followed in order by miR-141-3p and miR-103a-3p. Our studies provided evidence that secretory miRNAs existed in EPS and dysregulated EPS-miRNAs were associated with prostatitis. In particular, miR-21-5p possessed a high classify-accuracy for IIIA CP/CPPS patients with significant pelvic pain.

• chronic prostatitis/chronic pelvic pain syndrome
• high-throughput sequencing
• microRNAs
• mir-21
• prostate

Purpose. In order to find key risk factors of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) among urban men in China, an age-matched case-control study was performed from September 2012 to May 2013 in Yichang, Hubei Province, China. Methodology. A total of 279 patients and 558 controls were recruited in this study. Data were collected by a self-administered questionnaire, including demographics, diet and lifestyle, psychological status, and a physical exam. Conditional logistic regression model was used to analyze collected data. Results. Chemical factors exposure, night shift, severity of mood, and poor self-health cognition were entered into the regression model, and result displayed that these four factors had odds ratios of 1.929 (95% CI, 1.321–2.819), 1.456 (95% CI, 1.087–1.949), 1.619 (95% CI, 1.280–2.046), and 1.304 (95% CI, 1.094–1.555), respectively, which suggested that these four factors could significantly affect CP/CPPS. Conclusion. These results suggest that many factors affect CP/CPPS, including biological, social, and psychological factors.

• Hunner lesion
• bladder pain syndrome
• chronic pelvic pain syndromes
• comorbidities
• condition
• disease
• domain
• female genital pain
• gastrointestinal pain
• hypersensitive bladder
• interstitial cystitis
• lower urinary tract pain
• male genital pain
• musculoskeletal pain
• neurological aspects
• phenotype
• psychological aspects
• sexual aspects
• sign
• symptom
• syndrome

• Levofloxacin
• Prostatitis
• Terazosin
• Treatment

Prostatitis comprises of a group of syndromes that affect almost 50% of men at least once in their lifetime and makeup the majority of visits to the Urology Clinics. After much debate, it has been divided into four distinct categories by National Institutes of Health namely (1) acute bacterial prostatitis; (2) chronic bacterial prostatitis; (3) chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) which is further divided into inflammatory and non-inflammatory CP/CPPS; and (4) asymptomatic inflammatory prostatitis. CP/CPPS has been a cause of great concern for both patients and physicians because of the lack of presence of thorough information about the etiological factors along with the difficult-to-treat nature of the syndrome. For the presented manuscript an extensive search on PubMed was conducted for CP/CPPS aimed to present an updated review on the evaluation and treatment options available for patients with CP/CPPS. Several diagnostic criteria’s have been established to diagnose CP/CPPS, with prostatic/pelvic pain for at least 3 mo being the major classifying symptom along with the presence of lower urinary tract symptoms and/or ejaculatory pain. Diagnostic tests can help differentiate CP/CPPS from other syndromes that come under the heading of prostatitis by ruling out active urinary tract infection and/or prostatic infection with uropathogen by performing urine cultures, Meares-Stamey Four Glass Test, Pre- and Post-Massage Two Glass Test. Asymptomatic inflammatory prostatitis is confirmed through prostate biopsy done for elevated serum prostate-specific antigen levels or abnormal digital rectal examination. Researchers have been unable to link a single etiological factor to the pathogenesis of CP/CPPS, instead a cluster of potential etiologies including atypical bacterial or nanobacterial infection, autoimmunity, neurological dysfunction and pelvic floor muscle dysfunction are most commonly implicated. Initially monotherapy with anti-biotics and alpha adrenergic-blockers can be tried, but its success has only been observed in treatment naïve population. Other pharmacotherapies including phytotherapy, neuromodulatory drugs and anti-inflammatories achieved limited success in trials. Complementary and interventional therapies including acupuncture, myofascial trigger point release and pelvic floor biofeedback have been employed. This review points towards the fact that treatment should be tailored individually for patients based on their symptoms. Patients can be stratified phenotypically based on the UPOINT system constituting of Urinary, Psychosocial, Organ-specific, Infectious, Neurologic/Systemic and symptoms of muscular Tenderness and the treatment algorithm should be proposed accordingly. Treatment of CP/CPPS should be aimed towards treating local as well as central factors causing the symptoms. Surgical intervention can cause significant morbidity and should only be reserved for treatment-refractory patients that have previously failed to respond to multiple drug therapies.

• Chronic prostatitis
• Antibiotics
• Myofascial trigger point
• Pelvic biofeedback
• Chronic pelvic pain syndrome
• Phytotherapy
• Nanobacteria
• Dysfunctional voiding
• Acupuncture

The complex network of etiological factors, signals and tissue responses involved in chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) cannot be successfully targeted by a single therapeutic agent. Multimodal approaches to the therapy of CP/CPPS have been and are currently being tested, as in the frame of complex diagnostic-therapeutic phenotypic approaches such as the urinary, psychosocial, organ-specific, infection, neurological and muscle tenderness (UPOINTS) system. In this study, the effect of combination therapy on 914 patients diagnosed, phenotyped and treated in a single specialized prostatitis clinic was analyzed. Patients received α-blockers, Serenoa repens (S. repens) extracts combined or not with supplements (lycopene and selenium) and, in the presence of documented or highly suspected infection, antibacterial agents. Combination treatment induced marked and significant improvements of National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) prostatitis symptom scores, International Index of Erectile Function (IIEF) sexual dysfunction scores, urinary peak flow rates and bladder voiding efficiency. These improvements, assessed after a 6-month course of therapy, were sustained throughout a follow-up period of 18 months. A clinically appreciable reduction of ≥6 points of the total NIH-CPSI score was achieved in 77.5% of patients subjected to combination therapy for a period of 6 months. When the patients were divided in two cohorts, depending on the diagnosis of CP/CPPS [inflammatory (IIIa) vs. non-inflammatory (IIIb) subtypes], significant improvements of all signs and symptoms of the syndrome were observed in both cohorts at the end of therapy. Intergroup comparison showed that patients affected by the IIIa sub-category of CP/CPPS showed more severe signs and symptoms (NIH-CPSI total, pain and quality of life impact scores, and Qmax) at baseline when compared with IIIb patients. However, the improvement of symptoms after therapy was significantly more pronounced in IIIa patients when compared with IIIb patients. In contrast to current opinion, the evidence emerging from the present investigation suggests that the inflammatory and non-inflammatory sub-categories of CP/CPPS may represent two distinct pathological conditions or, alternatively, two different stages of the same condition. In conclusion, a simple protocol based on α-blockers, S. repens extracts and supplements and antibacterial agents, targeting the urinary, organ specific and infection domains of UPOINTS, may induce a clinically appreciable improvement of the signs and symptoms of CP/CPPS in a considerable percentage of patients. In patients not responding sufficiently to such therapy, second-line agents (antidepressants, anxiolytics, muscle relaxants, 5-phosphodiesterase inhibitors and others) may be administered in order to achieve a satisfactory therapeutic response.

• Meares and Stamey test
• NIH-CPSI
• Serenoa repens
• UPOINT
• UPOINTS
• alfuzosin
• azithromycin
• chronic bacterial prostatitis
• chronic pelvic pain syndrome
• ciprofloxacin
• prostatitis
• sexual dysfunction

• IELT
• NIH-CPSI
• Premature Ejaculation Syndromes

• Chronic prostatitis/chronic pelvic pain syndrome
• Depression
• Somatization

• Depression/complications
• Humans
• Male
• Middle Aged
• Prospective Studies
• Prostatitis/complications
• Prostatitis/drug therapy
• Prostatitis/psychology
• Somatosensory Disorders/complications
• Treatment Outcome

• Chronic prostatitis/chronic pelvic pain syndrome
• Clinical variable
• Depression
• Improvement
• Personality trait
• Response
• Somatization
• Treatment outcomes