Advancements in the Management of Urologic Chronic Pelvic Pain: What is New and What Do We Know?

Parker, Justin; Buga, Sorin; Sarria, Jose E.; Spiess, Philippe E.

doi:10.1007/s11934-010-0121-9

Cited by 17 publications

(13 citation statements)

References 43 publications

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“…A symptomatic improvement has been observed in BoNTtreated patients [2,4,65,67,81,82,[85][86][87][88]. BoNT benefit was evident within one month after the treatment, and it continued throughout the follow up period [65,66,71,72].…”

Section: Discussionmentioning

confidence: 81%

Treating Benign Prostatic Hyperplasia with Botulinum Neurotoxin

Brisinda

Vanella²,

Marniga³

et al. 2011

CMC

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Botulinum toxin (BoNT) has been increasingly used in the interventional treatment of several disorders; the use of this agent has extended to a plethora of conditions including focal dystonia, spasticity, inappropriate contraction in most gastrointestinal sphincters, eye movement disorders, hyperhidrosis, genitourinary disorders and aesthetically undesirable hyperfunctional facial lines. In addition, BoNT is being investigated for the control of pain, and for the management of tension or migraine headaches and myofascial pain syndrome. Benign prostatic hyperplasia (BPH) is a common condition in ageing men; the goal of therapy is to reduce the lower urinary tract symptoms (LUTS) associated with BPH and to improve the quality of life. However, medical treatment, including drugs that relax smooth muscle within the prostate and drugs that shrink the gland are not totally effective or without complications. The standard surgical treatment for BPH is progressively changing to minimally invasive therapies, but none of them has provided clear results. The use of BoNT-A to inhibit the autonomic efferent effects on prostate growth and contraction, and inhibit the abnormal afferent effects on prostate sensation, might be an alternative treatment for BPH. BoNT injections have several advantages over drugs and surgical therapies in the management of intractable or chronic disease; systemic pharmacologic effects are rare, permanent destruction of tissue does not occur, and graded degrees of relaxation may be achieved by varying the dose injected. In this paper, clinical experience over the last years with BoNT in BPH impaired patients will be illustrated.

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Section: Discussionmentioning

confidence: 81%

Treating Benign Prostatic Hyperplasia with Botulinum Neurotoxin

Brisinda

Vanella²,

Marniga³

et al. 2011

CMC

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“…• Category IV-Asymptomatic inflammatory prostatitis: asymptomatic and is often an incidental finding during evaluation for infertility or prostate cancer. [33][34][35][36] Historically, it was thought that CP/PD was simply the result of inflammation; a hypothesis supported by the fact that symptomatic relief was often obtained with the administration of anti-inflammatory medications. 37 With further investigation, however, the disease process was also found to be associated with hypertrophy of smooth muscle, periurethral edema, and pelvic floor dysfunction resulting from increased tone in local musculature.…”

Section: S Iiia: Inflammatory-white Blood Cells Present In Prostatic mentioning

confidence: 99%

Neuromodulation of Pelvic Visceral Pain: Review of the Literature and Case Series of Potential Novel Targets for Treatment

et al. 2012

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Chronic pelvic pain (CPP) is complex and often resistant to treatment. While the exact pathophysiology is unknown, the pain states resultant from conditions such as interstitial cystitis and the like yield patients with a presentation that bears a striking similarity to neuropathic syndromes that are known to respond to neuromodulation. While there has been past success using the sacral region as a target for spinal cord stimulation (SCS) to treat these patients, there remains to be a consensus on the optimal location for lead placement. In this article, the authors discuss the potential etiology of CPP, examine the current literature on lead placement for SCS as a method of treatment, as well as present several cases where novel lead placement was successfully employed. n

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“…Pharmacologic agents commonly used are saw palmetto, pollen extracts, pentosan polysulfate, antibiotics, NSAIDs, α-antagonists, and antidepressants. Surgical interventions include intraprostatic botulinum toxin-A injections, TURP, prostatectomy, transurethral needle ablation, transurethral microwave thermotherapy, and extracorporeal shock wave therapy [21]. To date, no single treatment has been effective in providing symptom relief in all affected patients.…”

Section: Evaluation and Treatmentmentioning

confidence: 99%

Lower Urinary Tract Symptoms: Defining Syndromes in Urology

Kanagarajah¹,

Ayyathurai

Gousse³

2010

Curr Bladder Dysfunct Rep

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Lower urinary tract symptoms (LUTS) comprise a complex network of interrelated symptoms affecting different stages of the micturition cycle. With the prevalence of LUTS steadily increasing, there is great emphasis on the need for appropriate diagnosis and treatment. The current classification of LUTS into various urologic syndromes is controversial and poses a diagnostic and treatment dilemma. In this review, we present a comprehensive overview of four frequently encountered syndromes associated with LUTS-overactive bladder, interstitial cystitis/painful bladder syndrome, benign prostatic obstruction, and chronic prostatitis/chronic pelvic pain syndrome-and also discuss the current trend in the management of these symptoms and syndromes.

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Advancements in the Management of Urologic Chronic Pelvic Pain: What is New and What Do We Know?

Cited by 17 publications

References 43 publications

Treating Benign Prostatic Hyperplasia with Botulinum Neurotoxin

Treating Benign Prostatic Hyperplasia with Botulinum Neurotoxin

Neuromodulation of Pelvic Visceral Pain: Review of the Literature and Case Series of Potential Novel Targets for Treatment

Lower Urinary Tract Symptoms: Defining Syndromes in Urology

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