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[慢性前列腺炎/慢性盆腔疼痛综合征]

[Chronic prostatitis/chronic pelvic pain syndrome].

作者信息

Magistro G, Wagenlehner F M E, Pilatz A

机构信息

Urologische Klinik, Asklepios Westklinikum Hamburg, Suurheid 20, 22559, Hamburg, Deutschland.

Klinik und Poliklinik für Urologie, Kinderurologie und Andrologie, Justus-Liebig-Universität Giessen, Gießen, Deutschland.

出版信息

Urologie. 2023 Jun;62(6):590-596. doi: 10.1007/s00120-023-02089-2. Epub 2023 Apr 30.

Abstract

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is defined as chronic pain or discomfort in the pelvic region for at least 3 of the past 6 months. It is variably associated with lower urinary tract symptoms, psychosocial consequences, and sexual dysfunction. Specific test systems or biomarkers for a definitive diagnosis are still not available. The purposes of the basic diagnostic assessment are to determine the individual spectrum of symptoms and to rule out differential diagnoses of pelvic pain. Patient-reported outcome measures (PROMs) like the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) are valuable instruments for the initial diagnostic assessment and to evaluate treatment response. Classification systems like UPOINTS (urinary, psychosocial, organ specific, infection, neurologic/systemic, tenderness of skeletal muscles, sexual dysfunction) are valuable tools to determine the individual spectrum of symptoms, to guide the adapted diagnostic assessment, and to identify relevant targets for a multimodal and tailored treatment. Close urological monitoring of CP/CPPS patients is usually necessary, especially to minimize the unwarranted use of antibiotics in the case of undulating complaints.

摘要

慢性前列腺炎/慢性盆腔疼痛综合征(CP/CPPS)的定义为在过去6个月中至少有3个月存在盆腔区域的慢性疼痛或不适。它与下尿路症状、心理社会后果及性功能障碍存在不同程度的关联。目前仍没有用于明确诊断的特定检测系统或生物标志物。基本诊断评估的目的是确定个体症状谱,并排除盆腔疼痛的鉴别诊断。患者报告结局指标(PROMs),如美国国立卫生研究院慢性前列腺炎症状指数(NIH-CPSI),是初始诊断评估及评估治疗反应的重要工具。UPOINTS(泌尿系统、心理社会、器官特异性、感染、神经/系统、骨骼肌压痛、性功能障碍)等分类系统是确定个体症状谱、指导适应性诊断评估以及识别多模式和个性化治疗相关靶点的重要工具。通常需要对CP/CPPS患者进行密切的泌尿外科监测,尤其是在症状波动的情况下尽量减少不必要的抗生素使用。

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