Etiologic theories of chronic prostatitis/chronic pelvic pain syndrome

Abstract

The etiology of chronic prostatitis/chronic pelvic pain syndrome is unknown. Whereas infection causes category I and II prostatitis, the evidence for an ongoing infection in category III patients is lacking. Immunologic, neurologic, and psychologic factors likely play a role in the development and maintenance of symptoms in these men. The traditional concept of pain as a simple response to a noxious stimulus has some merit, but modern research indicates that the response is much more complex, and we must look at a patient's physiology and psychology to be able to interpret each individual's pain response. It is some advance in the field to realize that we probably need to look beyond the prostate and address the entire biopsychosocial problem to be able to offer successful treatment to these men.

2 General Concepts

“…NGF is one of the few factors that correlate with pelvic pain. 41,42,43,44 Cfiber sensitization, as a result of neurogenic inflammation, is a product of this NGF being released. NGF is also responsible for the increased production of neuropeptides such as substance P and calcitonin related gene-related peptide when it binds to the receptors on sensory neurons.…”

“…NGF is also responsible for the increased production of neuropeptides such as substance P and calcitonin related gene-related peptide when it binds to the receptors on sensory neurons. 41,42,43,44 Persistent activation of silent C-fibers from the viscera of the pelvis results in an increase in noxious input to the dorsal horn. The resulting biochemical changes that result in allodynia and a state of greater neuropathic output.…”

“…Central sensitization is due to plastic deformation of General Concepts the dorsal horn as a response to the repetitive or sustained noxious stimulus. 34,36,40,42,43,44,47 Clinical Note…”

Ejaculatory Duct Dysfunction and Lower Urinary Tract Symptoms: Chronic Prostatitis

“…There have been many different etiologies proposed for CPPS including immunologic, neurologic, endocrine, psychologic, and combinations of these [2]. In this article we discuss a potentially curable cause of prostatitis due to EDO, which we have termed chronic obstructive prostatitis (COP).…”

Ejaculatory duct dysfunction and chronic pelvic pain syndrome in men

“…It has been suggested that CPPS can be caused by many factors, some of which lie beyond the prostate [2]. This article examines one such factor-ejaculatory duct obstruction (EDO).…”