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中东和北非地区男性慢性前列腺炎/慢性骨盆疼痛综合征的临床表型和多模态治疗:确定治疗结果和临床改善的预测因素。

Clinical Phenotyping and Multimodal Treatment of Men With Chronic Prostatitis/Chronic Pelvic Pain Syndrome From the Middle East and North Africa: Determining Treatment Outcomes and Predictors of Clinical Improvement.

机构信息

Department of Urology, Hamad Medical Corporation, Doha, Qatar; Department of Clinical Urology, Weil Cornell Medicine -Qatar, Doha, Qatar.

Department of Urology, Hamad Medical Corporation, Doha, Qatar.

出版信息

Urology. 2022 Sep;167:179-184. doi: 10.1016/j.urology.2022.04.028. Epub 2022 May 6.

Abstract

OBJECTIVE

To evaluate the effectiveness of UPOINT based multimodal treatment on patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), and determine factors that could be associated with clinical improvement.

METHODS

A retrospective study was conducted in Doha, Qatar including patients with CP/CPPS from the Middle East and North Africa. The UPOINT phenotyping system was used to classify patients and guide their multimodal therapy. NIH-CPSI scores were computed initially and after 3 months of treatment, and predictors of clinical improvement were assessed.

RESULTS

The total NIH-CPSI improved significantly with a mean reduction of 8.21 after 3 months of treatment (P < .001). 66.2% of patients had a clinical improvement demonstrated as a total NIH-CPSI score reduction by at least 6 points after 3 months of treatment. No significant association was found between clinical improvement, and extent of pain (ORa = 1.198, 95% CI 0.392-3.662, P = .751), initial total NIH-CPSI (ORa = 0.983, 95% CI 0.886-1.089, P = .738), number of positive UPOINT domains (ORa = 0.871, 95% CI 0.451-1.681, P = .681), and number of prescribed therapies (ORa = 1.118, 95% CI 0.699-1.789, P = .641).

CONCLUSION

UPOINT phenotyping and directed therapy is associated with an important improvement in the CP/CPPS. Therapeutic response does not appear to related to age or ethnicity. Clinical improvement is also not predicted by initial extent and severity of the disease, whether relating to NIH-CPSI or the number of positive UPOINT phenotypes, neither to the number of therapies involved in the multimodal treatment strategy.

摘要

目的

评估基于 UPOINT 的多模式治疗对慢性前列腺炎/慢性盆腔疼痛综合征(CP/CPPS)患者的疗效,并确定与临床改善相关的因素。

方法

在卡塔尔多哈进行了一项回顾性研究,纳入了来自中东和北非的 CP/CPPS 患者。采用 UPOINT 表型系统对患者进行分类,并指导其多模式治疗。最初和治疗 3 个月后计算 NIH-CPSI 评分,并评估临床改善的预测因素。

结果

NIH-CPSI 总分显著改善,治疗 3 个月后平均降低 8.21 分(P<0.001)。66.2%的患者在治疗 3 个月后 NIH-CPSI 总分降低至少 6 分,表现出临床改善。临床改善与疼痛程度(ORa=1.198,95%CI 0.392-3.662,P=0.751)、初始 NIH-CPSI 总分(ORa=0.983,95%CI 0.886-1.089,P=0.738)、阳性 UPOINT 域数(ORa=0.871,95%CI 0.451-1.681,P=0.681)和规定治疗方法数(ORa=1.118,95%CI 0.699-1.789,P=0.641)之间无显著相关性。

结论

UPOINT 表型和定向治疗与 CP/CPPS 的重要改善相关。治疗反应似乎与年龄或种族无关。临床改善也不能根据疾病的初始严重程度和范围来预测,无论是与 NIH-CPSI 还是阳性 UPOINT 表型的数量,也不能预测多模式治疗策略中涉及的治疗方法数量。

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