Marszalek Martin, Wehrberger Clemens, Temml Christian, Ponholzer Anton, Berger Ingrid, Madersbacher Stephan
Department of Urology and Andrology, Donauspital, Vienna, Austria.
Eur Urol. 2009 Feb;55(2):499-507. doi: 10.1016/j.eururo.2008.03.073. Epub 2008 Apr 1.
Recent studies question the role of the prostate as the key factor in the pathogenesis of chronic pelvic pain syndrome (CPPS).
To compare symptoms related to CPPS and lower urinary tract symptoms (LUTS) in both sexes.
DESIGN, SETTING, AND PARTICIPANTS: Participants of a voluntary health examination in Vienna.
All participants completed a detailed questionnaire containing the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI), with the female homolog of each male anatomical term use on questionnaires for female participants, the International Prostate Symptom Score (IPSS), and additional questions on pelvic pain. Furthermore, all participants underwent a detailed health investigation performed by a general practitioner.
The study cohort comprised 1768 men and 981 women. The mean NIH-CPSI was 7.2+/-0.1 in women and 3.8+/-0.2 in men (p<0.001). In subject up to the age of 70 yr, the NIH-CPSI was higher in women (p<0.001). The NIH-CPSI increased with age in men (p<0.001), yet not in women (p=0.4). The prevalence of symptoms suggestive of CPPS in this selected population was 5.7% in women and 2.7% in men, and was higher in premenopausal women (p=0.03). Until the age of 50 yr, NIH-CPSI pain score in women exceeded that of men (p<0.001). The mean IPSS was higher in women (p<0.001). Storage symptoms were higher in women up to 60 yr, and voiding symptoms were higher in men above 60 yr. In men and women with symptoms suggestive of CPPS, the mean IPSS was significantly higher compared with those without CPPS symptoms (p<0.001). Limitations of our study are (1) that a urological evaluation was not performed and (2) that the questionnaire was not formerly validated for females.
The preponderance of CPPS in females raises questions about the etiological role of the prostate in all cases with chronic pelvic pain and suggests that other pathomechanisms are likely to be involved.
近期研究对前列腺在慢性盆腔疼痛综合征（CPPS）发病机制中作为关键因素的作用提出质疑。
比较男女与CPPS相关的症状及下尿路症状（LUTS）。
设计、背景与参与者：维也纳自愿健康检查的参与者。
所有参与者完成一份详细问卷，其中包含美国国立卫生研究院慢性前列腺炎症状指数（NIH-CPSI），在女性参与者问卷中使用与男性各解剖学术语对应的女性术语，国际前列腺症状评分（IPSS），以及关于盆腔疼痛的其他问题。此外，所有参与者均接受了全科医生进行的详细健康检查。
研究队列包括1768名男性和981名女性。女性的平均NIH-CPSI为7.2±0.1，男性为3.8±0.2（p<0.001）。在70岁及以下的受试者中，女性的NIH-CPSI更高（p<0.001）。男性的NIH-CPSI随年龄增长而升高（p<0.001），而女性则不然（p=0.4）。在该特定人群中，提示CPPS的症状患病率女性为5.7%，男性为2.7%，且绝经前女性更高（p=0.03）。在50岁之前，女性的NIH-CPSI疼痛评分超过男性（p<0.001）。女性的平均IPSS更高（p<0.001）。60岁及以下女性的储尿症状更高，60岁以上男性的排尿症状更高。在有提示CPPS症状的男性和女性中，平均IPSS显著高于无CPPS症状者（p<0.001）。我们研究的局限性在于：（1）未进行泌尿外科评估；（2）该问卷此前未在女性中验证。
女性中CPPS占优势引发了对于前列腺在所有慢性盆腔疼痛病例中病因学作用的质疑，并提示可能涉及其他发病机制。
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