Khattak Ahmed S, Raison Nicholas, Hawazie Arie, Khan Azhar, Brunckhorst Oliver, Ahmed Kamran
Urology, King's College Hospital, London, GBR.
MRC Centre for Transplantation, Guy's Hospital Campus, King's College London, King's Health Partners, London, GBR.
Cureus. 2021 Dec 7;13(12):e20243. doi: 10.7759/cureus.20243. eCollection 2021 Dec.
Chronic prostatitis (CP) is a common condition, yet remains a challenge to treat in clinical practice due to the heterogeneity of symptoms. The aim of this article is to undertake a narrative review using key research papers in this field in order to develop a treatment algorithm and research recommendations for the management of type II and type III prostatitis taking a broader look at interventions beyond those recommended in the European Association of Urology Guidelines. A search was performed using multiple databases and trial registries with no language restrictions. Searches were completed on March 1, 2021, with a focus on randomized controlled trials (RCTs), meta-analyses, and systematic reviews. However, in areas with a dearth of such studies, we included case series and observational studies, thus allowing us to assess current levels of evidence and areas of potential research. We identified and reviewed 63 studies. The level of evidence and the quality of trials were assessed and reported. Research recommendations, where applicable, were also highlighted. CP/chronic pelvic pain syndrome (CPPS) is a heterogenous term referring to diverse symptomology that requires tailored treatments depending on the patients' complaints. After a review of the evidence available, we present a treatment algorithm that is based on the much-discussed UPOINT (urinary symptoms, psychosocial dysfunction, organ-specific findings, infection, neurologic/systemic, and tenderness of muscles) framework. Future studies should focus on multimodal therapy based on such frameworks and provide the future direction of this complex condition.
慢性前列腺炎（CP）是一种常见疾病，但由于症状的异质性，在临床实践中治疗仍然具有挑战性。本文的目的是利用该领域的关键研究论文进行叙述性综述，以便制定一种治疗算法，并针对II型和III型前列腺炎的管理提出研究建议，同时更广泛地审视欧洲泌尿外科学会指南中未推荐的干预措施。使用多个数据库和试验注册库进行了检索，无语言限制。检索于2021年3月1日完成，重点是随机对照试验（RCT）、荟萃分析和系统评价。然而，在缺乏此类研究的领域，我们纳入了病例系列和观察性研究，从而使我们能够评估当前的证据水平和潜在的研究领域。我们识别并审查了63项研究。对证据水平和试验质量进行了评估并报告。在适用的情况下，还突出了研究建议。CP/慢性盆腔疼痛综合征（CPPS）是一个异质性术语，指的是多种症状，需要根据患者的主诉进行针对性治疗。在对现有证据进行综述后，我们提出了一种基于备受讨论的UPOINT（泌尿系统症状、心理社会功能障碍、器官特异性发现、感染、神经/系统以及肌肉压痛）框架的治疗算法。未来的研究应聚焦于基于此类框架的多模式治疗，并为这种复杂疾病提供未来的研究方向。
