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男性慢性盆腔疼痛综合征的感觉感知阈值。

Sensory perception thresholds in men with chronic pelvic pain syndrome.

机构信息

Department of Urology, University of Washington, Seattle, Washington, USA.

出版信息

Urology. 2010 Jan;75(1):34-7. doi: 10.1016/j.urology.2009.08.013. Epub 2009 Oct 24.

Abstract

OBJECTIVES

To compare sensory thresholds in different nerve-fiber types in men with chronic pelvic pain syndrome (CPPS) and healthy controls, using thermal sensory testing and measuring current perception thresholds (CPT).

METHODS

We enrolled 22 men with CPPS and 20 healthy control participants. We determined the thermal sensory perception thresholds of C and Adelta nerve fibers on the perineum and left posterior thigh. To test CPT, we used sine wave electrical stimulation at 5, 250, and 2000 Hz, resulting in the selective depolarization of small unmyelinated C fibers, small myelinated Adelta, and large myelinated Abeta fibers, respectively. We bilaterally tested the hypothenar surface of the palms, medial parts of soles, midshaft of penis, and 1 site in the midperineum, for a total of 7 sites.

RESULTS

The mean age of men with CPPS was similar to that of controls [42.8 (standard deviation, 9.4) and 40.4 (standard deviation, 13.2) years, respectively, P = .548]. There was no significant difference between the 2 groups for thermal perception thresholds in both the perineum and left thigh (P >.05). There was also no difference between the 2 groups for CPT values of all 3 frequencies of stimuli in each area tested (P >.05 for all comparisons).

CONCLUSIONS

The absence of sensory threshold differences between men with CPPS and controls, with either thermal stimulation of C and Adelta fiber afferents or electrical stimulation of C, Adelta, and Abeta fiber afferents, discounts the existence of a peripheral neuropathy as a cause for pain in men with CPPS.

摘要

目的

通过热感觉测试和测量电流感知阈值(CPT),比较慢性盆腔疼痛综合征(CPPS)男性患者和健康对照者不同神经纤维类型的感觉阈值。

方法

我们纳入了 22 名 CPPS 男性患者和 20 名健康对照者。我们测定了会阴和左大腿后侧 C 和 Adelta 神经纤维的热感觉感知阈值。为了测试 CPT,我们使用正弦波电刺激 5、250 和 2000Hz,分别导致小无髓鞘 C 纤维、小有髓鞘 Adelta 纤维和大有髓鞘 Abeta 纤维选择性去极化。我们双侧测试了手掌小鱼际、足底内侧、阴茎中段和会阴中间的 1 个部位,共 7 个部位。

结果

CPPS 男性患者的平均年龄与对照组相似[分别为 42.8(标准差 9.4)和 40.4(标准差 13.2)岁,P=.548]。两组会阴和左大腿的热感觉阈值均无显著差异(P>.05)。在每个测试区域的 3 种刺激频率的 CPT 值方面,两组之间也没有差异(所有比较 P>.05)。

结论

CPPS 男性患者和对照组之间无论是 C 和 Adelta 纤维传入的热刺激还是 C、Adelta 和 Abeta 纤维传入的电刺激,其感觉阈值均无差异,这否定了外周神经病变是 CPPS 男性患者疼痛的原因。

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