Clinical Significance of National Institutes of Health Classification in Patients with Chronic Prostatitis/chronic Pelvic Pain Syndrome

Overview

Journal Korean J Urol

Specialty Urology

Date 2014 Apr 18

PMID 24741418

Citations 4

Authors

Yun Hsien Sung

Jae Hung Jung

Seung Hoon Ryang

Sung Jin Kim

Kwang Jin Kim

Affiliations

Soon will be listed here.

Abstract

Purpose: We determined the effects of alpha-blockers and quinolone in patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) classified by National Institute of Health (NIH) consensus group.

Materials And Methods: Data from a total of 111 patients who were diagnosed with CP/CPPS between June 2010 and June 2012 were analyzed retrospectively. The patients were classified into group 1 (category IIIA, n=40) and group 2 (category IIIB, n=71). Treatment using alfuzosin and levofloxacin was given to both groups for 6 weeks. International Prostate Symptom Score (IPSS) and NIH Chronic Prostatitis Symptom Index were measured before and after therapy.

Results: Group 1 had a significant decrease in total IPSS score, CPSI pain score, CPSI quality of life (QoL) score, and total CPSI score (p=0.043, p=0.006, p=0.015, and p=0.006, respectively). Group 2 had a significant decrease in IPSS voiding symptom score, IPSS storage symptom score, total IPSS, CPSI pain score, CPSI voiding score, CPSI QoL score, and total CPSI score (p=0.002, p=0.004, p=0.001, p=0.001, p=0.006, p=0.001, and p=0.001, respectively). The CPSI score was reduced by 6 points or more in 50.0% of patients (n=18) in group 1 and in 51.6% of patients (n=32) in group 2. However, there was no statistically significant difference between the changes in IPSS and CPSI scores across the 2 groups.

Conclusions: Although combination treatment reduced the CPSI score in both groups, there was no significant difference between the groups after combination treatment. We suggest that factors other than inflammation also contribute to symptoms associated with CP/CPPS.

Citing Articles

Using the UPOINT system to manage men with chronic pelvic pain syndrome.

Bryk D, Shoskes D Arab J Urol. 2021; 19(3):387-393.

PMID: 34552790 PMC: 8451687. DOI: 10.1080/2090598X.2021.1955546.

Chronic Prostatitis/Chronic Pelvic Pain Syndrome: A Disease or Symptom? Current Perspectives on Diagnosis, Treatment, and Prognosis.

Zhang J, Liang C, Shang X, Li H Am J Mens Health. 2020; 14(1):1557988320903200.

PMID: 32005088 PMC: 7256330. DOI: 10.1177/1557988320903200.

Anti-Inflammatory Effect of Dialyzable Leukocyte Extract in Autoimmune Prostatitis: Evaluation in Animal Model.

Perez-Alvarado C, Gomez C, Reyes M, Garcia M, Perez E, Perez de la Mora C Biomed Res Int. 2017; 2017:1832853.

PMID: 28386549 PMC: 5366182. DOI: 10.1155/2017/1832853.

Multimodal therapy for category III chronic prostatitis/chronic pelvic pain syndrome in UPOINTS phenotyped patients.

Magri V, Marras E, Restelli A, Wagenlehner F, Perletti G Exp Ther Med. 2015; 9(3):658-666.

PMID: 25667610 PMC: 4316954. DOI: 10.3892/etm.2014.2152.

References

Bjerklund Johansen T, Gruneberg R, Guibert J, Hofstetter A, Lobel B, Naber K . The role of antibiotics in the treatment of chronic prostatitis: a consensus statement. Eur Urol. 1998; 34(6):457-66. DOI: 10.1159/000019784. View

Nickel J . Classification and diagnosis of prostatitis: a gold standard?. Andrologia. 2003; 35(3):160-7. DOI: 10.1046/j.1439-0272.2003.00557.x. View

Shoskes D, Nickel J, Rackley R, Pontari M . Clinical phenotyping in chronic prostatitis/chronic pelvic pain syndrome and interstitial cystitis: a management strategy for urologic chronic pelvic pain syndromes. Prostate Cancer Prostatic Dis. 2008; 12(2):177-83. DOI: 10.1038/pcan.2008.42. View

McNaughton Collins M, Fowler Jr F, Elliott D, Albertsen P, Barry M . Diagnosing and treating chronic prostatitis: do urologists use the four-glass test?. Urology. 2000; 55(3):403-7. DOI: 10.1016/s0090-4295(99)00536-1. View

Nickel J, Downey J, Johnston B, Clark J . Predictors of patient response to antibiotic therapy for the chronic prostatitis/chronic pelvic pain syndrome: a prospective multicenter clinical trial. J Urol. 2001; 165(5):1539-44. View

Krieger J, Nyberg Jr L, Nickel J . NIH consensus definition and classification of prostatitis. JAMA. 1999; 282(3):236-7. DOI: 10.1001/jama.282.3.236. View

Nickel J, Alexander R, Schaeffer A, Landis J, Knauss J, Propert K . Leukocytes and bacteria in men with chronic prostatitis/chronic pelvic pain syndrome compared to asymptomatic controls. J Urol. 2003; 170(3):818-22. DOI: 10.1097/01.ju.0000082252.49374.e9. View

Krieger J, Ross S, Deutsch L, Riley D . The NIH Consensus concept of chronic prostatitis/chronic pelvic pain syndrome compared with traditional concepts of nonbacterial prostatitis and prostatodynia. Curr Urol Rep. 2002; 3(4):301-6. DOI: 10.1007/s11934-002-0054-z. View

Schaeffer A, Knauss J, Landis J, Propert K, Alexander R, Litwin M . Leukocyte and bacterial counts do not correlate with severity of symptoms in men with chronic prostatitis: the National Institutes of Health Chronic Prostatitis Cohort Study. J Urol. 2002; 168(3):1048-53. DOI: 10.1016/S0022-5347(05)64572-7. View

10.

Nickel J . The three As of chronic prostatitis therapy: antibiotics, alpha-blockers and anti-inflammatories. What is the evidence?. BJU Int. 2004; 94(9):1230-3. DOI: 10.1111/j.1464-410X.2004.05148.x. View

11.

Thakkinstian A, Attia J, Anothaisintawee T, Nickel J . α-blockers, antibiotics and anti-inflammatories have a role in the management of chronic prostatitis/chronic pelvic pain syndrome. BJU Int. 2012; 110(7):1014-22. DOI: 10.1111/j.1464-410X.2012.11088.x. View

12.

Collins M, Stafford R, OLeary M, Barry M . How common is prostatitis? A national survey of physician visits. J Urol. 1998; 159(4):1224-8. View

13.

Fall M, Baranowski A, Elneil S, Engeler D, Hughes J, Messelink E . EAU guidelines on chronic pelvic pain. Eur Urol. 2009; 57(1):35-48. DOI: 10.1016/j.eururo.2009.08.020. View

14.

Shoskes D, Nickel J, Kattan M . Phenotypically directed multimodal therapy for chronic prostatitis/chronic pelvic pain syndrome: a prospective study using UPOINT. Urology. 2010; 75(6):1249-53. DOI: 10.1016/j.urology.2010.01.021. View

15.

Shoskes D, Nickel J, Dolinga R, Prots D . Clinical phenotyping of patients with chronic prostatitis/chronic pelvic pain syndrome and correlation with symptom severity. Urology. 2009; 73(3):538-42. DOI: 10.1016/j.urology.2008.09.074. View

16.

Kim T, Lee K, Kim J, Jee J, Seo Y, Choi D . Tamsulosin Monotherapy versus Combination Therapy with Antibiotics or Anti-Inflammatory Agents in the Treatment of Chronic Pelvic Pain Syndrome. Int Neurourol J. 2011; 15(2):92-6. PMC: 3138850. DOI: 10.5213/inj.2011.15.2.92. View

17.

Magri V, Wagenlehner F, Perletti G, Schneider S, Marras E, Naber K . Use of the UPOINT chronic prostatitis/chronic pelvic pain syndrome classification in European patient cohorts: sexual function domain improves correlations. J Urol. 2010; 184(6):2339-45. DOI: 10.1016/j.juro.2010.08.025. View

18.

Mobley D . Semen cultures in the diagnosis of bacterial prostatitis. J Urol. 1975; 114(1):83-5. DOI: 10.1016/s0022-5347(17)66949-0. View

19.

Alexander R, Propert K, Schaeffer A, Landis J, Nickel J, OLeary M . Ciprofloxacin or tamsulosin in men with chronic prostatitis/chronic pelvic pain syndrome: a randomized, double-blind trial. Ann Intern Med. 2004; 141(8):581-9. DOI: 10.7326/0003-4819-141-8-200410190-00005. View

20.

Schaeffer A . Clinical practice. Chronic prostatitis and the chronic pelvic pain syndrome. N Engl J Med. 2006; 355(16):1690-8. DOI: 10.1056/NEJMcp060423. View