The overlapping lower urinary tract symptoms of benign prostatic hyperplasia and prostatitis

Current Opinion in Urology

Volumn 16, Issue 1, 2006, Pages 5-10

  Nickel, J Curtis ^a  

^a QUEEN S UNIVERSITY   (Canada)

Author keywords

Benign prostatic hyperplasia; Chronic pelvic pain syndrome; Lower urinary tract symptoms; Prostatitis

Indexed keywords

ALFUZOSIN; ALPHA ADRENERGIC RECEPTOR BLOCKING AGENT; ANTIBIOTIC AGENT; DUTASTERIDE; FINASTERIDE; MEPARTRICIN; POLLEN EXTRACT; SABAL EXTRACT; STEROID 5ALPHA REDUCTASE INHIBITOR; TAMSULOSIN; TERAZOSIN;

CLINICAL TRIAL; DIFFERENTIAL DIAGNOSIS; DISEASE ASSOCIATION; DISEASE SEVERITY; HUMAN; PHYTOTHERAPY; POLLEN; PRIORITY JOURNAL; PROSTATE HYPERTROPHY; PROSTATITIS; QUALITY OF LIFE; REVIEW; SABAL; SEX ROLE; TREATMENT OUTCOME; URETHRA DISEASE; URINARY TRACT DISEASE;

ADRENERGIC ALPHA-ANTAGONISTS; CHRONIC DISEASE; DIAGNOSIS, DIFFERENTIAL; HUMANS; MALE; PHYTOTHERAPY; PROSTATIC HYPERPLASIA; PROSTATITIS;

EID: 29944432696     PISSN: 09630643     EISSN: None     Source Type: Journal    
DOI: 10.1097/01.mou.0000193365.46081.cd     Document Type: Review

References (38)

1. Berry SJ, Coffey DS, Walsh PC, et al. The development of human benign prostatic hyperplasia with age. J Urol 1984; 132:474-479.
2. Pontari MA. Chronic prostatitis/chronic pelvic pain syndrome in elderly men: toward better understanding and treatment. Drugs Aging 2003; 20:1111-1125.
3. Roberts RO, Lieber MM, Rhodes T, et al. Prevalence of a physician-assigned diagnosis of prostatitis: the Olmsted County Study of Urinary Symptoms and Health Status Among Men. Urology 1998; 51:578-584.
4. Nickel JC, Downey J, Hunter D, et al. Prevalence of prostatitis-like symptoms in a population based study using the National Institutes of Health Chronic Prostatitis Symptom Index. J Urol 2001; 165:842-845.
5. Collins MM, Stafford RS, O'Leary MP, et al. Distinguishing chronic prostatitis and benign prostatic hyperplasia symptoms: results of a national survey of physician visits. Urology 1999; 53:921-925.
6. Collins MM, Meigs JB, Barry MJ, et al. Prevalence and correlates of prostatitis in the health professionals follow-up study cohort. J Urol 2002; 167:1363-1366.
7. Shoskes DA, Landis JR, Wang Y, et al. Impact of post-ejaculatory pain in men with category III chronic prostatitis/chronic pelvic pain syndrome. J Urol 2004; 172:542-547. Pain/discomfort on ejaculation is the most differentiating and bothersome symptom in men diagnosed with prostatitis.
8. Vallancien G, Emberton M, Harving N, van Moorselaar RJ. Sexual dysfunction in 1,274 European men suffering from lower urinary tract symptoms. J Urol 2003; 169:2257-2261.
9. Frankel SJ, Donovan JL, Peters TJ, et al. Sexual dysfunction in men with lower urinary tract symptoms. J Clin Epidemiol 1998; 51:677-685.
10. Brookes ST, Donovan JL, Peters TJ, et al. Sexual dysfunction in men after treatment for lower urinary tract symptoms: Evidence from randomized control trial. BMJ 2002; 324:1059-1061.
11. Rosen R, Altwein J, Boyle P, et al. Lower urinary tract symptoms and male sexual dysfunction: the multinational survey of the aging male (MSAM-7). Eur Urol 2003; 44:637-649.
12. Nickel JC, Elhilali M. Vallancien G for the ALF-ONE Study Group. Benign prostatic hyperplasia (BPH) and prostatitis: Prevalence of painful ejaculation in men with clinical BPH. BJU Int 2005; 95:571-574. Approximately one in five men with LUTS presumably secondary to BPH have pain/discomfort on ejaculation and this group has higher LUTS and bother severity and a higher prevalence of erectile dysfunction and reduced ejaculation compared with men with LUTS only.
13. Nickel JC, Downey J, Young I, et al. Asymptomatic inflammation and/or infection in benign prostatic hyperplasia. BJU Int 1999; 84:976-981.
14. Nickel JC, Bostwick D, Somerville M, et al. Lack of relationship between clinical prostatitis and prostate inflammation: baseline data from the REDUCE trial. Abstract presented at the 6th International Consultation on New Developments in Prostate Cancer and Prostate Diseases Paris June 24-27, 2005. No correlation between histological Category IV prostatitis and LUTS/pain associated with prostatitis was noted in patients enrolled in a high-risk cancer-prevention protocol.
15. Roehrborn CG, Kaplan SA, Noble WD, et al. The impact of acute or chronic inflammation in baseline biopsy on the risk of clinical progression of BPH: Results from the MTOPS study. J Urol 2005; 173(Suppl 4):346 [Abstract 1277]. Analyses of the histological findings of acute and chronic inflammation in baseline biopsies done in selected patients in the MTOPS study of BPH treatment indicate that inflammation is highly predictive of progression outcomes of acute urinary retention and BPH-related surgery.
16. Barry MJ, Fowler FJ, O'Leary MP, et al. The American Urological Association symptom index for benign prostatic. The Measurement Committee of the American Urological Association. J Urol 1992; 148:1549-1557.
17. Litwin MS, McNaughton-collins M, Fowler FJ Jr, et al. The National Institutes of Health chronic prostatitis symptom index: development and validation of a new outcome measure. Chronic Prostatitis Collaborative Research Network. J Urol 1999; 162:369-375.
18. McConnell JD, Bruskewitz R, Walsh P, et al. The effect of finasteride on the risk of acute urinary retention and the need for surgical treatment among men with benign prostatic hyperplasia. N Engl J Med 1998; 338:557-563.
19. Roehrborn C, Boyle P, Nickel J, et al. Efficacy and safety of a dual inhibitor of 5α-reductase types 1 and 2 (dutasteride) in men with benign prostatic hyperplasia. Urology 2002; 60:434-439.
20. Leskinen M, Lukkarinen O, Marttilla T. Effects of finasteride in patients with inflammatory chronic pelvic pain syndrome: a double-blind, placebo controlled, pilot study. Urology 1999; 53:502-505.
21. Nickel JC, Downey J, Pontari MA, et al. Randomized placebo-controlled, multi-center study to evaluate the safety and efficacy of finasteride in the treatment of male, chronic, pelvic pain syndrome: category IIIA CPPS (chronic non-bacterial prostatitis). BJU Int 2004; 93:991-995. A small, randomized, placebo-controlled study could not confirm the efficacy of finasteride as a monotherapy in patients diagnosed with chronic prostatitis (Category IIIA).
22. De Rose AF, Gallo F, Giglio M, Carmignani G. Role of mepartricin in category III chronic nonbacterial prostatitis/chronic pelvic pain syndrome: a randomized prospective placebo-controlled trial. Urology 2004; 63:13-16. A small, randomized, placebo-controlled study comparing mepartricin with placebo suggesting the clinical benefit of this agent in chronic prostatitis.
23. Djavan B, Marberger M. A meta-analysis on the efficacy and tolerability of alpha1-adrenoceptor antagonists in patients with lower urinary tract symptoms suggestive of benign prostatic obstruction. Eur Urol 1999; 36:1-13.
24. Cheah P, Liong ML, Yuen KH, et al. Terazosin therapy for chronic prostatitis/chronic pelvic pain syndrome: a randomized, placebo controlled trial. J Urol 2003; 169:592-596.
25. Mehik A, Alas P, Nickel JC. Alfusozin treatment for chronic prostatitis/chronic pelvic pain syndrome: a prospective, randomized double-blind placebo controlled pilot study. J Urol 2003; 62:425-429.
26. Nickel JC, Narayan P, MacKay J, Doyle C. Treatment of chronic prostatitis/chronic pelvic pain syndrome with tamsulosin: a randomized double blind trial. J Urol 2004; 171:1594-1597. A small, randomized, placebo-controlled study suggested that tamsulosin may be effective in selected patients with CP/CPPS.
27. Alexander RB, Propert KJ, Schaeffer AJ, et al. Chronic Prostatitis Collaborative Research Network. Ciprofloxacin or tamsulosin in men with chronic prostatitis/chronic pelvic pain syndrome: a randomized, double-blind trial. Ann Intern Med 2004; 141:581-589. This large multicenter study funded by the NIH did not suggest efficacy of tamsulosin (with or without antibiotics) in patients with long-term treatment refractory CP/CPPS.
28. Nickel JC. The 3 A's of chronic prostatitis therapy: antibiotics, alpha-blockers, and anti-inflammatories: what is the evidence? BJU Int 2004; 94:1230-1233. This review of treatment trials investigating therapies for chronic prostatitis suggested that α-blockers are effective when prescribed for more than 12 weeks in relatively recently diagnosed, treatment-naive patients.
29. Nickel JC, Elhilali M, Vallancien G. Efficacy of alfuzosin 10 mg OD in men with LUTS, BPH and prostatitis-like symptoms. J Urol 2005; 173(Suppl 4):446 [Abstract 1645]. A sub-analyses of a 6-month open label study (ALF-ONE Study) suggested that the α-blocker alfuzosin significantly improved LUTS, bother, sexual function and pain/discomfort on ejaculation in men with BPH and prostatitis-like symptoms.
30. Wilt TJ, Ishani A, Stark G, et al. Saw palmetto extracts for treatment of benign prostatic hyperplasia: a systematic review. JAMA 1998; 280:1604-1609.
31. Bent S, Kane CJ, Shinohara K, et al. A randomized controlled trial of saw palmetto for the treatment of benign prostatic hyperplasia. J Urol 2005; 173(Suppl 4):443 [Abstract 1637]. This randomized, placebo-controlled trial did not confirm efficacy for saw palmetto in the treatment of BPH.
32. Kaplan SA, Volpe MA, Te AE. A prospective, 1 year trial using saw palmetto versus finasteride in the treatment of category III prostatitis/chronic pelvic pain syndrome. J Urol 2004; 17:244-248. This randomized trial showed that finasteride was more effective at reducing the symptoms of chronic prostatitis than saw palmetto.
33. Reissigl A, Djavan B, Pointner J. Prospective placebo-controlled multicenter trial on safety and efficacy of phytotherapy in the treatment of chronic prostatitis/chronic pelvic pain syndrome. J Urol 2004; 171:61 (Abstract 233). This randomized, placebo-controlled trial suggested that saw palmetto was potentially effective in ameliorating the symptoms associated with chronic prostatitis.
34. MacDonald R, Ishani A, Rutks I, Wilt TJ. A systematic review of Cernilton for the treatment of benign prostatic hyperplasia. BJU Int 2000; 85:836-841.
35. Rugendorff EW, Weidner W, Ebeling L. Results of treatment with pollen extract (Cernilton N) in chronic prostatitis and prostatodynia. Br J Urol 1993; 71:433-438.
36. McConnell JD, Roehrborn CG, Bautista OM, et al. Medical Therapy of Prostatic Symptoms (MTOPS) Research Group. The long-term effect of doxazosin, finasteride, and combination therapy on the clinical progression of benign prostatic hyperplasia. N Engl J Med 2003; 349:2387-2398.
37. Nickel JC, Downey J, Ardern D, et al. Failure of a monotherapy strategy for difficult chronic prostatitis/chronic pelvic pain syndrome. J Urol 2004; 172:551-554. Monotherapy does not appear to be a successful treatment strategy in patients with long prostatitis symptoms.
38. Shoskes DA, Hakim L, Ghoniem G, et al. Long-term results of multimodal therapy for chronic prostatitis/chronic pelvic pain syndrome. J Urol 2003; 169:1406-1410.