RESUMEN

BACKGROUND: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is still a challenge to manage for all physicians. We feel that a summary of the current literature and a systematic review to evaluate the therapeutic efficacy of flower pollen extract would be helpful for physicians who are considering a phytotherapeutic approach to treating patients with CP/CPPS. METHODS: A comprehensive search of the PubMed and Embase databases up to June 2016 was performed. This comprehensive analysis included both pre-clinical and clinical trials on the role of flower pollen extract in CP/CPPS patients. Moreover, a meta-analysis of available randomized controlled trials (RCTs) was performed. The NIH Chronic Prostatitis Symptom Index (NIH-CPSI) and Quality of Life related questionnaires (QoL) were the most commonly used tools to evaluate the therapeutic efficacy of pollen extract. RESULTS: Pre-clinical studies demonstrated the anti-inflammatory and anti-proliferative role of pollen extract. 6 clinical, non-controlled studies including 206 patients, and 4 RCTs including 384 patients were conducted. The mean response rate in non-controlled studies was 83.6% (62.2%-96.0%). The meta-analysis revealed that flower pollen extract could significantly improve patients' quality of life [OR 0.52 (0.34-.0.81); p = 0.02]. No significant adverse events were reported. CONCLUSION: Most of these studies presented encouraging results in terms of variations in NIH-CPSI and QoL scores. These studies suggest that the use of flower pollen extract for the management of CP/CPPS patients is beneficial. Future publications of robust evidence from additional RCTs and longer-term follow-up would provide more support encouraging the use of flower pollen extracts for CP/CPPS patients.

Asunto(s)

RESUMEN

The therapeutic efficacy for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is currently unsatisfactory. The aim of the present study was to assess the safety and efficacy of pollen extract in association with vitamins (DEPROX 500®) in males with CP/CPPS. All patients with a diagnosis of CP/CPPS attending the same urologic centre between March and October 2012 were enrolled in this randomised controlled phase III study. Participants were randomised to receive oral capsules of DEPROX 500® (two capsules every 24 h) or ibuprofen (600 mg, one tablet three times a day) for four weeks. The National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI), International Prostate Symptom Score and Quality of Well-Being (QoL) questionnaires were used. In the intention-to-treat analysis, 87 males (25 class IIIa and 62 class IIIb) with a mean age of 33.6±5.9 years were randomly allocated to the DEPROX 500® (n=41) or ibuprofen (n=46) treatment groups. At the follow-up examination (following one month of treatment), in the DEPROX 500® group, 31/41 patients (75.6%) reported an improvement in quality of life, defined as a reduction of the NIH-CPSI total score by ≥25%, compared with 19/46 (41.3%) in the control group (P=0.002). The greater improvement in the DEPROX 500® group compared with the ibuprofen group was statistically significant (treatment difference in the NIH-CPSI pain domain, -2.14±0.51, P<0.001; QoL scores, P=0.002). All patients were negative at the Meares-Stamey test evaluation. Adverse events were less frequent in the DEPROX 500® group than in the ibuprofen group. The DEPROX 500® treatment significantly improved total symptoms, pain and quality of life compared with ibuprofen in patients with CP/CPPS, without severe side-effects.

RESUMEN

Objective: To evaluate the correlation between severity of symptom and SPL amounts in expressed prostatic secretion(EPS).Methods: A total of 164 men enrolled in the study.Scores of CPSI and Chinese medicine syndrome were used to assess the severity of symptom.SPL acounts in EPS were also measured.The correlation between scores of CPSI,Chinese medicine syndrome and SPL acounts in EPS were analyzed.Results: There was no linear correlation between scores of CPSI,Chinese medicine syndrome and SPL amounts in EPS(P

RESUMEN

PURPOSE: To evaluate the specific metabolic patterns of the prostatic tissue with prostatitis syndrome 1H-magnetic resonance spectroscopy was performed on the patients with prostatitis syndrome. MATERIALS AND METHODS: Between 1996 and 2001, 24 men aged 19-59 (mean 36.9) were evaluated for the impression of prostatitis syndome. Image and spectrum were obtained with GE Signa 1.5T MRI/MRS unit using a GP flexible surface coils. Scout images were obtained at axial plane with T2-weighted fast spin echo sequence, and 1H spectra were acquired in the localized single-voxel elements of the prostatic tissue with stimulated echo-acquisition mode sequence before and after therapy. RESULTS: Elevated levels of amino acids and decreased citrate were detected in the prostatic tissue with prostatitis syndrome in comparison with normal tissue. Spectral variations of amino acids metabolic signal were found between different patient groups, and recovery of spectral pattern after 1 month or 3 months of antimicrobials therapy was found. In chronic noninflammatory pelvic pain syndrome, amino acids levels were elevated as in other prostatitis, but patterns were different. CONCLUSIONS: 1H-magnetic resonance spectroscopy using external body surface coil can be a useful and non-invasive method to evaluate and to monitor therapeutic efficacy of prostate diseases including the prostatitis syndrome.

Asunto(s)

RESUMEN

PURPOSE: Recently, urine reflux into prostate during abnormal micturition has been proved and suggested to be an important pathogenetic factor that evoked the symptoms of prostatitis syndrome. The evaluation of voiding dysfunction in these patients may give the useful information to select the treatment methods or the next step of study. The objectives of this study was to evaluate the usefulness of voiding symptom score and uroflowmetry as the screening methods for patients with nonbacterial prostatitis syndrome. MATERIALS AND METHODS: For patients with prostatitis syndrome, evaluations of urine, prostatic secretion, voiding symptom scores(IPSS: international prostate symptoms score), and uroflowmetry were performed. Patients were divided into 3 groups according to the patterns of uroflow curve[type N; normal bell shape with Qmax(maximal flow rate) > 20ml/sec, type I; irregular shape, regardless of Qmax, type P; plateau shape with Qmaxf15ml/sec]. For patients with cutie patterns of type I and p, G-blockers were tried initially for 1-2 months and the effectiveness of o-blockers according to the changes of IPSS, Qmax and patterns of uroflow cutie was estimated. Patients with the pattern of type N and non-responders to o-blockers were further investigated to rule out any other cause. RESULTS: Among total 64 patients, 55 patients(86%) showed the abnormal uroflow cuties(Type I or P). 34(61.8%) of these 55 patients responded to alpha-blockers with changes of IPSS from 18.3 to 8.1(p<0.001) and of Qmax from 13.gm1/sec to 20.0ml/sec(p<0.001). The response to o-blockers was expected highly in group of type I with more than 10m1/sec of Qmax and less than 20points of IPSS(14.7folds). Of the 9 of type N patients, 6 were revealed to have idiopathic detrusor instability and 18 of 21 non-responders to alpha-blockers were diagnosed to have the bladder neck obstruction. CONCLUSIONS: The results that the effectiveness to o-blockers and the possibility of other disease could be characterized by IPSS and uroflowmetry suggest IPSS and uroflowmetry may be the useful screening methods for patients with prostatitis syndrome.

Asunto(s)