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男性 CP/CPPS:我们处于什么位置?

Male CP/CPPS: where do we stand?

机构信息

Department of Urology, Queen's University, Empire 4, Kingston General Hospital, 76 Stuart St, Kingston, ON, K7L 2V7, Canada.

Department of Urology, Glickman Urologic and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA.

出版信息

World J Urol. 2019 Jun;37(6):1015-1022. doi: 10.1007/s00345-019-02718-6. Epub 2019 Mar 12.

Abstract

INTRODUCTION

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), commonly encountered in urologic practice, carries with it a stigma of poor understanding, ineffective treatment, and significant financial and quality of life burden.

MATERIALS AND METHODS

This clinically practical review is based on the authors' personal clinical experience in interpretation and application of currently available evidence.

RESULTS

Significant progress has been made in terms of classification and evaluation of the disease, leading to encouraging improvements in treatment outcomes. The Chronic Prostatitis Symptom Index (CPSI) is a helpful tool in clinical evaluation and has proven invaluable for research purposes, while UPOINT has demonstrated the heterogeneity of the disease and provides physicians with a uniquely patient-centered approach to treatment. The importance of the microbiome in the evaluation of CP/CPPS patients has yet to be fully appreciated. While personalized, multi-modal therapy appears to be the key to treatment, the addition of pelvic floor physiotherapy (PFPT) with injection of trigger points, and psychosocial therapies to the multi-modal approach armamentarium are promising advances. Innovative interventional approaches are encouraging but require study.

CONCLUSIONS

While encouraging therapies have been added to personalized, multi-modal treatment strategies, newer innovative therapies appear promising for improved treatment of CP/CPPS patients.

摘要

简介

前列腺炎/慢性盆腔疼痛综合征(CP/CPPS)在泌尿科临床实践中较为常见,其特点是人们对其认识不足、治疗效果不佳,且给患者带来了沉重的经济和生活质量负担。

材料和方法

本临床实用综述基于作者在解释和应用现有证据方面的个人临床经验。

结果

在疾病的分类和评估方面取得了显著进展,治疗结果得到了令人鼓舞的改善。慢性前列腺炎症状指数(CPSI)是一种有助于临床评估的工具,在研究方面具有重要价值,而 UPOINT 则显示出疾病的异质性,并为医生提供了一种以患者为中心的独特治疗方法。微生物组在 CP/CPPS 患者评估中的重要性尚未得到充分认识。虽然个性化、多模式治疗似乎是治疗的关键,但将盆底物理疗法(PFPT)与触发点注射以及心理社会疗法添加到多模式治疗方案中是很有前途的进展。创新的介入方法令人鼓舞,但需要进一步研究。

结论

虽然个性化、多模式治疗策略中增加了令人鼓舞的治疗方法,但新型创新疗法似乎有望改善 CP/CPPS 患者的治疗效果。

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