Prostate state under varicosis of the pelvis (experimental study)

BACKGROUND: Chronic pelvic pain syndrome / chronic abacterial prostatitis is one of the most common diseases in urological practice. Despite its frequency the pathogenesis of the disease remains poorly understood. It is known that the morphological manifestation of chronic inflammation is sclerosis, in the development of which the venous congestion of the prostate is also important. AIM: To evaluate the effect of chronic venous congestion of the pelvis on the prostate in a chronic experiment. MATERIALS AND METHODS: An original model of persistent chronic varicose of the pelvis has been created. The experiment was carried out on 35 mature rabbits weighing 2.63.2 kg. Animals were divided into 3 groups. Control (n = 5) study of the normal anatomy of animals. In group 2 (n = 15), the creation of a model: ligation of the v. sacralis mediana, in combination with administration of progesterone solution. In group 3 (n = 15), false surgery and progesterone administration. Duplex scanning of the pelvic veins was performed at 1, 3 and 6 months, the diameter of the veins and the reflux after manual compression was assessed. After removing the animals from the experiment histological examination and morphometry of the prostate tissue were carried out. In prostate samples the concentration of hydroxyproline was investigated as a marker of connective tissue development. RESULTS: Venous congestion of the pelvic organs in animals in the second group negatively affected the structure of the prostate gland. Histological examination of the samples showed infiltration of the prostate tissue, edema of the stroma, a sharp expansion of the veins at the beginning of the experiment, later noted the proliferation of connective tissue, compression of the acini and a decrease in the secretory activity of the prostate gland. The results of morphometry showed an increase in the area of the stromal component to a greater extent due to an increase in the volume of connective tissue. There was a tendency to an increase in the concentration of hydroxyproline in the prostate tissue in animals of the 2nd group with the achievement of maximum values by the 6th month of the experiment. In animals of the 3rd group no significant changes in the structure of the prostate gland were revealed. CONCLUSIONS: The morphological manifestation of chronic venous hyperemia is infiltration of the prostate stroma and sclerogenesis.

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Treatment of patients with chronic pelvic pain syndrome: result of single-center follow up study

Herald Urology ◽

10.21886/2308-6424-2018-6-4-27-35 ◽

2019 ◽

Vol 6 (4) ◽

pp. 27-35

Author(s):

V. A. Kruglov ◽

F. R. Asfandiyarov ◽

S. N. Vybornov ◽

K. S. Seyidov

Keyword(s):

Neuropathic Pain ◽

Pelvic Pain ◽

Chronic Pelvic Pain ◽

Pain Therapy ◽

Prostate Gland ◽

Chronic Pelvic Pain Syndrome ◽

Pain Syndrome ◽

Pelvic Pain Syndrome ◽

Perineal Region ◽

Inflammatory Changes

Introduction. Chronic pelvic pain syndrome is an urgent and widely discussed problem in the medical community. Despite the efforts made by a wide range of specialists, there is currently no universally accepted universal approach to the diagnosis and treatment of this condition. The article provides a description and results of applying its own approach to the management of patients with chronic pelvic pain syndrome.Purpose of research. The aim of the work was to improve the practical results of treatment of patients suffering from chronic pelvic pain syndrome.Materials and methods. The results of the examination and treatment of 46 men aged from 26 to 57 years are presented. The leading complaint of the patients was the long-term pain in the pelvic and / or perineal region. According to the survey results, 43.5% of patients showed signs of inflammation in the prostate gland, 56.5% showed no symptoms. Patients with proven inflammatory changes in the prostate gland were divided into two groups: the first group received the “standard” therapy of chronic prostatitis (antibiotics, prostate-tropic drugs, microcirculation and immunocorrection enhancers, physiotherapy), in the second group the patients received the “standard” treatment in combination with myofascial blockades and neuropathic pain therapy. Patients without inflammatory changes in the prostate were combined into a third group and received only myofascial blockade and neuropathic pain therapy.Results. Pain in chronic pelvic pain syndrome is most often localized in the perineal region and in the inguinal zones, while the presence or absence of a proven inflammatory component in the prostate gland does not significantly affect the localization and degree of pain, nor the assessment of quality of life. The pelvic myofascial syndromes are detected in the majority of patients with CPPS and their targeted correction in the framework of complex therapy has a positive effect on the results of patient treatment.Conclusions. Correction of musculo-tonic disorders in chronic pelvic pain syndrome was accompanied by a statistically significant reduction in pain on a 10-point numerical rating scale for pain, a decrease in the I-PSS index.

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Influence of myofascial therapy on painful erection – case study

Ból ◽

10.5604/01.3001.0014.6060 ◽

2020 ◽

Vol 21 (3) ◽

pp. 1-6

Author(s):

Adrian Rogala ◽

Grażyna Brzuszkiewicz-Kuźmicka

Keyword(s):

Pain Relief ◽

Connective Tissue ◽

Muscle Tone ◽

Chronic Pelvic Pain Syndrome ◽

Pain Syndrome ◽

Trigger Points ◽

Pelvic Pain Syndrome ◽

Beneficial Effects ◽

The Many

Pain during sexual intercourse in men is a well-recognized symptom that is considered in the context of sexual dysfunction. Because there is no clear definition, it can be a joint feature of chronic prostatitis, chronic pelvic pain syndrome (CPPS), or come from connective tissue. Because of the many possible causes of genitourinary pain, a multimodal approach is necessary. The aim of this study is to present the effect of myofascial therapy on chronic, unpleasant, dull pain at the level of VAS = 9, occurring during erection and ejaculation, as well as during touch of the testicle in a 35-year-old man. The patient did not have erection problems, which was confirmed by an accurate and reliable tool in the form of the International Index of Erectile Function (IIEF-5). The man received two myofascial therapies, 45 min. each, 7 days apart followed by significant improvement in pain relief (VAS = 0). The manual techniques were used to find and remove changes manifested by increased muscle tone and fascia, lack of displacement of structures relative to each other, maximum painful points, and trigger points. In the follow-up examination performed after 1, 3 and 6 months, the patient confirmed that the effects of therapy were maintained. Connective tissue may play an important role in the occurrence of genitourinary pain. Physiotherapeutic examination and usage of myofascial techniques can bring beneficial effects in the form of pain relief in the relevant region.

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UropathogenicEscherichia coliInduces Chronic Pelvic Pain

Infection and Immunity ◽

10.1128/iai.00910-10 ◽

2010 ◽

Vol 79 (2) ◽

pp. 628-635 ◽

Cited By ~ 60

Author(s):

Charles N. Rudick ◽

Ruth E. Berry ◽

James R. Johnson ◽

Brian Johnston ◽

David J. Klumpp ◽

...

Keyword(s):

Pelvic Pain ◽

Chronic Pelvic Pain ◽

Prostate Gland ◽

Chronic Pelvic Pain Syndrome ◽

Nod Mice ◽

Pain Syndrome ◽

Unknown Etiology ◽

Pelvic Pain Syndrome ◽

Microbial Infection ◽

Microbial Infections

ABSTRACTChronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a debilitating syndrome of unknown etiology often postulated, but not proven, to be associated with microbial infection of the prostate gland. We hypothesized that infection of the prostate by clinically relevant uropathogenicEscherichia coli(UPEC) can initiate and establish chronic pain. We utilized anE. colistrain newly isolated from a patient with CP/CPPS (strain CP1) and examined its molecular pathogenesis in cell culture and in a murine model of bacterial prostatitis. We found that CP1 is an atypical isolate distinct from most UPEC in its phylotype and virulence factor profile. CP1 adhered to, invaded, and proliferated within prostate epithelia and colonized the prostate and bladder of NOD and C57BL/6J mice. Using behavioral measures of pelvic pain, we showed that CP1 induced and sustained chronic pelvic pain in NOD mice, an attribute not exhibited by a clinical cystitis strain. Furthermore, pain was observed to persist even after bacterial clearance from genitourinary tissues. CP1 induced pelvic pain behavior exclusively in NOD mice and not in C57BL/6J mice, despite comparable levels of colonization and inflammation. Microbial infections can thus serve as initiating agents for chronic pelvic pain through mechanisms that are dependent on both the virulence of the bacterial strain and the genetic background of the host.

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Features of the morphological structure of endometrial infiltrates in women with chronic pelvic pain syndrome

Journal of obstetrics and women s diseases ◽

10.17816/jowd65126-33 ◽

2016 ◽

Vol 65 (1) ◽

pp. 26-33

Author(s):

Tatyana O Efimenko ◽

Igor Yu Kogan ◽

Tatyana G Tral ◽

Arseniy S Molotkov ◽

Gulrukhsor Kh Tolibova

Keyword(s):

Chronic Pelvic Pain ◽

Chronic Pelvic Pain Syndrome ◽

Morphological Structure ◽

Pain Syndrome ◽

Inflammatory Cells ◽

Pelvic Pain Syndrome ◽

Stromal Component ◽

Vascular Component ◽

Severe Degree ◽

The Relationship

Background. There is no clear idea of what factors determine the characteristics of pain in endometriosis. Scientific data on the relationship between morphological and functional features of heterotopic tissue, and the intensity of the pain syndrome is extremely small. Purposes and tasks. To determine the features of the morphological structure of endometrial infiltrates in women with chronic pelvic pain syndrome. Materials and methods. We examined 32 patients with infiltrative endometriosis. Pain intensity was determined in accordance with a 10-point visual analog scale (VAS). Preparation of material for histological study was carried out during the execution of the operating laparoscopy. Histological sections stained with hematoxylin and eosin. The study was conducted with increasing ×100. Histological examination was carried out a descriptive and semi-quantitative assessment of glandular-stromal component biopsy, infiltration of inflammatory cells number, as well as the presence of blood vessels (arterioles, venules). Statistical analysis of the material was carried out using the Microsoft Excel 2013 and Stastistica 10.0 for Windows. Results. During the correlation analysis of the relationship between the intensity of pain and the severity of the vascular component revealed a strong correlation (Rs = 0.71, p < 0.05). With the severity of glandular-stromal component biopsy revealed moderate correlation (Rs = 0.49, p < 0.05). With the severity of the inflammatory infiltration of a number of cells revealed that there is no correlation (Rs = -0.1, p > 0.05). Conclusions. In severe degree of pain severity predominated infiltrates a lot of glands and stroma expressed vascular component, multiple foci of hemorrhage and severe degree of infiltration of inflammatory cells number. When pain syndrome of moderate severity, as in mild, was found mostly poorly and moderately pronounced glandular-stromal component, and infiltration of inflammatory cells number.

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IL-1β-primed mesenchymal stromal cells exert enhanced therapeutic effects to alleviate Chronic Prostatitis/Chronic Pelvic Pain Syndrome through systemic immunity

Stem Cell Research & Therapy ◽

10.1186/s13287-021-02579-0 ◽

2021 ◽

Vol 12 (1) ◽

Author(s):

Hanchao Liu ◽

Xinning Zhu ◽

Xiaohui Cao ◽

Ani Chi ◽

Jian Dai ◽

...

Keyword(s):

Stromal Cells ◽

Chronic Prostatitis ◽

Chronic Pelvic Pain ◽

Chronic Pelvic Pain Syndrome ◽

Pain Syndrome ◽

Prostate Tissue ◽

Pelvic Pain Syndrome ◽

Therapeutic Effects ◽

Systemic Immunity

Abstract Background Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) seriously affects patient health. Despite the elusiveness of innate therapeutic effects, mesenchymal stromal cells (MSCs) hold great promise for inflammation-related diseases. Recent evidence indicates that disease-specific inflammatory cytokines could enhance the therapeutic effects of MSCs. Methods By establishing a CP/CPPS mouse model and pretreating MSCs with the cytokine interleukin-1β (IL-1β), we studied the IL-1β-primed MSC immunoregulatory ability and targeted migration ability in vitro and in CP/CPPS mice. Results IL-1β levels significantly increased in the prostate tissue and serum of experimental autoimmune prostatitis (EAP) mice. Pretreatment with IL-1β enhanced the immunomodulatory potential and targeted migration of MSCs in vitro. Furthermore, intravenous infusion of IL-1β-primed MSCs dampened inflammation in prostate tissues and alleviated hyperalgesia in EAP mice. The infused MSCs inhibited monocyte infiltration and promoted regulatory T lymphocyte formation in prostate tissue, thus remodeling the local environment. Surprisingly, IL-1β-primed MSCs exhibited improved accumulation in the spleen but not in prostate tissue. Accordingly, infused MSCs reshaped systemic immunity by reducing the proportion of Ly6ChighCD11b+ monocytes and boosting the proportion of CD4+Foxp3+ regulatory T lymphocytes in the spleen and lung. Inflammatory chemokine (C–C motif) ligand 2 (CCL2) decreased through the downregulation of the NF-κB and JNK/MAPK pathways by inflammatory resolution via MSCs infusion to alleviate pain. Conclusion In summary, IL-1β-primed MSCs restored systemic immunologic homeostasis to alleviate CP/CPPS by modulating systemic immunity. These findings provide a novel strategy to boost the therapeutic effects of MSC-based therapy for CP/CPPS and reveal the essential role of systematic immunity in the treatment of CP/CPPS with MSC infusion.

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