Hedelin Hans, Jonsson Karin
Centre for Research and Development and Department of Urology, Kärnsjukhuset, Skövde, Sweden.
Scand J Urol Nephrol. 2007;41(5):430-5. doi: 10.1080/00365590701365123. Epub 2007 May 9.
Chronic abacterial prostatitis/pelvic pain syndrome (CP/CPPS) is characterized by pain, voiding and sexual dysfunction persisting fo r> 3 months. The symptoms tend to occur in relapses of varying length. To evaluate what causes a relapse and what precautions patients with CP/CPPS undertake to avoid a relapse and/or aggravation of symptoms, individual semi-structured interviews were performed.
Information was obtained from semi-structured in-depth interviews with 10 selected men with CP/CPPS (mean age 44 years; 30-62 years). The interviews were transcribed and analysed according to Girorgi's phenomenological method as modified by Malterud.
CP/CPPS tended to start in connection with a specific event involving cold exposure, suggesting cold as an initiating stimulus for CP/CPPS. The informants also reported that cold exposure caused aggravation of symptoms and provoked their relapse. Sitting on cold objects, spending time in cold, damp or windy surroundings and walking on a cold floor were provocative and thus were avoided. The exposure did not have to be either prolonged or intense. Heat applied to the perineum, as well as spending time in a warmer climate, gave relief from symptoms.
It appears that cold is one of the factors that can trigger a process resulting in CP/CPPS. The fact that cold also causes aggravation of symptoms and can initiate a relapse was evident, as was the fact that symptoms could be relieved by heat. The connection between cold and symptom aggravation is well known among clinicians but has not previously been studied in a systematic way. The fact that cold, in a susceptible man, can initiate a process resulting in CP/CPSS has not been reported before. Studies aimed at elucidating the mechanisms behind this phenomenon are warranted. Reflex vasoconstriction in a susceptible individual is a possible cause.
慢性非细菌性前列腺炎/盆腔疼痛综合征（CP/CPPS）的特征是疼痛、排尿及性功能障碍持续超过3个月。症状往往呈不同时长的复发。为评估导致复发的原因以及CP/CPPS患者采取了哪些预防措施来避免复发和/或症状加重，我们进行了个体半结构式访谈。
从对10名选定的CP/CPPS男性患者（平均年龄44岁；30 - 62岁）进行的半结构式深入访谈中获取信息。访谈内容经转录后，根据马尔特鲁德修改后的 Giorgi 现象学方法进行分析。
CP/CPPS往往与涉及寒冷暴露的特定事件有关而发病，提示寒冷是CP/CPPS的起始刺激因素。受访者还报告称，寒冷暴露会使症状加重并引发复发。坐在冷的物体上、在寒冷、潮湿或有风的环境中停留以及在冰冷的地板上行走都会诱发症状，因此要避免。这种暴露不一定需要持续时间长或强度大。对会阴部进行热敷以及在温暖的气候中停留能缓解症状。
看来寒冷是能够引发导致CP/CPPS过程的因素之一。寒冷会使症状加重并能引发复发这一事实很明显，症状能通过热敷缓解这一事实也很明显。寒冷与症状加重之间的关联在临床医生中是众所周知的，但此前尚未进行过系统研究。寒冷在易感男性中可引发导致CP/CPSS的过程这一事实此前未曾有过报道。有必要开展旨在阐明这一现象背后机制的研究。易感个体的反射性血管收缩可能是一个原因。
