Egan Kelly J, Krieger John L
Department of Anesthesiology, Multidisciplinary Pain Center, UWMC-Roosevelt, 4245 Roosevelt Way, N.E. Seattle, WA 98105-6920, USA Department of Urology, Multidisciplinary Pain Center, UWMC-Roosevelt, 4245 Roosevelt Way, N.E. Seattle, WA 98105-6920, USA.
Pain. 1997 Feb;69(3):213-218. doi: 10.1016/S0304-3959(96)03203-4.
Chronic abacterial prostatitis has all the hallmarks of a chronic pain syndrome without having been identified as such, either in the urology literature or in the pain literature. This review proposes that this common urological syndrome merits consideration as a 'chronic pain syndrome', as it is commonly defined. The presentation of this syndrome in PAIN results from the unlikely collaboration of a clinical psychologist and a urologist with an interest in exploring unconventional assessment and treatment recommendations for the patients he saw in a university-based Prostatitis Clinic. In addition to providing a review of the chronic prostatitis syndrome as it appears in the urology literature, we surveyed the journal, PAIN, from 1985 through 1995 to identify the 'body parts' specifically named in titles of articles on non-malignant pain. There was only one case study report on male genital or urological pain. Similar to other more commonly accepted chronic pain syndromes, chronic abacterial prostatitis has the following characteristics: pain as a primary complaint, low correspondence between symptoms and medical findings, a history of multiple, unsuccessful treatments. The consequence of recognizing this very common urological syndrome as a chronic pain syndrome is that a large group of symptomatic men for whom urologists have little to offer stands to benefit from a different perspective. Experience with other chronic pain syndromes, including back pain and headaches; has shown that interventions based on a multidisciplinary approach can prove complementary to traditional 'organ system' approaches to treatment of these frustrated, and frustrating, patients.
慢性非细菌性前列腺炎具备慢性疼痛综合征的所有特征,但在泌尿外科文献或疼痛文献中均未被明确认定为此类。本综述提出,这种常见的泌尿外科综合征理应被视为一种如通常所定义的“慢性疼痛综合征”。本文在《疼痛》(PAIN)杂志上发表,源于一位临床心理学家与一位泌尿外科医生的意外合作,这位泌尿外科医生对为他在大学前列腺炎诊所所诊治的患者探索非常规评估及治疗建议很感兴趣。除了对泌尿外科文献中出现的慢性前列腺炎综合征进行综述外,我们还查阅了1985年至1995年的《疼痛》杂志,以确定关于非恶性疼痛的文章标题中特别提及的“身体部位”。仅有一篇关于男性生殖器或泌尿系统疼痛的病例研究报告。与其他更被广泛认可的慢性疼痛综合征相似,慢性非细菌性前列腺炎具有以下特征:以疼痛为主要诉求、症状与医学检查结果之间的相关性较低、有多次治疗失败的病史。将这种非常常见的泌尿外科综合征认定为慢性疼痛综合征的结果是,一大批有症状但泌尿外科医生几乎无计可施的男性患者可能会从不同的角度中受益。对其他慢性疼痛综合征,包括背痛和头痛的经验表明,基于多学科方法的干预措施可证明是对治疗这些感到沮丧且令人沮丧的患者的传统“器官系统”治疗方法的补充。