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泌尿科慢性盆腔疼痛综合征的诊断、治疗和管理的全面综述。

A Comprehensive Review of the Diagnosis, Treatment, and Management of Urologic Chronic Pelvic Pain Syndrome.

机构信息

Creighton University School of Medicine, Omaha, NE, USA.

Beth Israel Deaconess Medical Center, Department of Anesthesia, Critical Care, and Pain Medicine, Harvard Medical School, Boston, MA, USA.

出版信息

Curr Pain Headache Rep. 2020 May 6;24(6):27. doi: 10.1007/s11916-020-00857-9.

Abstract

PURPOSE OF REVIEW

Urologic chronic pelvic pain syndrome (UCPPS) is a chronic, noncyclic pain condition which can lead to significant patient morbidity and disability. It is defined by pain in the pelvic region, lasting for greater than 3 to 6 months, with no readily identifiable disease process. The aim of this review is to provide a comprehensive update of diagnosis and treatment of UCPPS.

RECENT FINDINGS

UCPPS encompasses chronic pelvic pain syndrome or chronic prostatitis (CP/CPPS) in men and interstitial cystitis or painful bladder syndrome (IC/PBS) in women. Underlying inflammatory, immunologic, and neuropathic components have been implicated in the pathogenesis of UCPPS. For optimal patient management, an individualized and multimodal approach is recommended. Medical management and physical therapy are the mainstays of treatment. Injection therapy may offer additional relief in medically refractory patients. Further minimally invasive management may include spinal cord and peripheral nerve stimulation, though evidence supporting efficacy is limited.

摘要

目的综述

泌尿科慢性盆腔疼痛综合征(UCPPS)是一种慢性、非周期性疼痛疾病,可导致患者出现明显的发病和残疾。其定义为骨盆区域疼痛,持续时间超过 3 至 6 个月,且无明确的疾病过程。本篇综述的目的是提供 UCPPS 的诊断和治疗的全面更新。

最新发现

UCPPS 包括男性的慢性盆腔疼痛综合征或慢性前列腺炎(CP/CPPS)和女性的间质性膀胱炎或膀胱疼痛综合征(IC/PBS)。在 UCPPS 的发病机制中,潜在的炎症、免疫和神经病变成分已被涉及。为了实现最佳的患者管理,建议采用个体化和多模式方法。医学管理和物理治疗是治疗的主要方法。注射疗法可能为药物难治性患者提供额外的缓解。进一步的微创管理可能包括脊髓和周围神经刺激,但支持疗效的证据有限。

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