Shoskes D A, Nickel J C, Rackley R R, Pontari M A
Glickman Urological and Kidney Institute, The Cleveland Clinic, Cleveland, OH 44195, USA.
Prostate Cancer Prostatic Dis. 2009;12(2):177-83. doi: 10.1038/pcan.2008.42. Epub 2008 Jul 22.
The urologic chronic pain conditions such as chronic prostatitis/chronic pelvic pain syndrome and interstitial cystitis are syndromes whose evaluation and management are controversial. Part of the difficulty in diagnosis and therapy is the heterogeneity of etiologies and symptoms. We propose a six-domain phenotype, which can classify these patients clinically and can direct the selection of therapy in the most evidence based multimodal manner. The domains are urinary, psychosocial, organ specific, infection, neurologic and tenderness of skeletal muscles. This system is flexible and responsive to new biomarkers and therapies as their utility and efficacy are proven.
诸如慢性前列腺炎/慢性盆腔疼痛综合征和间质性膀胱炎等泌尿系统慢性疼痛病症,是其评估和管理存在争议的综合征。诊断和治疗的部分困难在于病因和症状的异质性。我们提出了一种六领域表型,它可以在临床上对这些患者进行分类,并能以最具循证依据的多模式方式指导治疗选择。这些领域包括泌尿、心理社会、器官特异性、感染、神经和骨骼肌压痛。随着新生物标志物和疗法的效用及疗效得到证实,该系统具有灵活性并能做出相应反应。