Prostatitis

Abstract

Sol'!cover reprint of the hardcover 1 st edition 1994The use of general descriptive names, registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use.Typesetting: VII PrefaceProstatitis syndromes continue to be a major problem in urology. About every second man will experience symptoms of prostatitis during his lifetime. A study by the U.S. National Center for Health Statistics showed that approximately 25% of the men seen for urogenital problems suffer from prostatitis.What is the intention of this book? Although investigations in recent years, including microbiologic and immunologic ones, have focused on the correct diagnosis of prostatitis, much confusion still remains regarding its correct classification, its etiology, and the evaluation of diagnostic results. Many clinicians, therefore, tend to lump together several diseases of variable type and sequela as prostatitis.The term "prostatitis" implies an inflammatory disease, but true bacterial infection is detected in only 5 %-1 0% of patients. In fact, most patients reveal no significant bacterial counts in the prostatic fluid. Nonetheless, 40%-60% of these patients suffer from non bacterial prostatitis, as shown by the fact that the prostatic fluid contains elevated leukocyte counts while common uropathogens are not detected.Essentially, three clinical types of real inflammatory prostatitis are widely accepted: acute and chronic bacterial and nonbacterial prostatitis. There remains a condition denoted as prostatodynia, covering patients in whom signs of neither inflammation nor infection are found. Multiple extraprostatic disorders are suspected causes of these complaints, e.g., bladder outlet disorders, detrusor hyperreflexia, pelvic floor tension myalgia, interstitial cystitis, urolithiasis, ostitis pubis, and anogenital disorders. Proven data concerning these special problems are rare, and their association to prostatodynia is unclear. The intention of this book is to provide the reader with a clarification of the etiopathogenesis of prostatitis and the competence to exclude the patient with complaints and symptoms of prostatitis but without true prostatic inflammation, i.e., to identify the man suffering from prostatodynia, thus preventing multiple and useless antibiotic trials. Instead, if the diagnosis prostatodynia is clarified, there may be an indication for, among other things, psychodynamic investigation and therapy.This book concentrates on clinical prostatitis strictu sensu and does not treat the various types of histologically detected inflammation of the prostate, e.g., "prostatitis" associated with benign prostatic hypertrophy. Very rarely, prostatectomy specimens of younger patients or autopsy samples of prostates x Preface without evidence of hyperplasia demonstrate inflammatory infiltrates. In men up to the age of 40, prostatitis is mainly located in the peripheral gland, no...

A Classic Herbal Formula Danggui Beimu Kushen Wan for Chronic Prostatitis: From Traditional Knowledge to Scientific Exploration

“…Six clinical studies were included in the review, involving four RCTs [12, 15, 43, 44] and two case series [45, 46]. Characteristics of six identified clinical studies were summarized in Table 1.…”

“…Among six included studies, one RCT focused on the treatment of CBP [15], one RCT [12] and one case series [45] for CP/CPPS, two studies for both CBP and CP/CPPS (one RCT [43] and one case series [46]), and one RCT for CP without any specified category [44]. In terms of herbal intervention, five studies applied modified DBKW decoction as an intervention [15, 43–46] and the other one utilized original DBKW decoction [12].…”

“…In terms of herbal intervention, five studies applied modified DBKW decoction as an intervention [15, 43–46] and the other one utilized original DBKW decoction [12]. Three RCTs compared modified DBKW with western drugs [15, 43, 44] and one RCT compared original DBKW plus α -blocker with the same α -blocker only [12]. Details of herb ingredients in the included clinical studies are presented in Table 2.…”

“…All of them utilized conventional medicines (antibiotic or α -blocker drugs) as the comparators [12, 15, 43, 44]. Both Guo [43] and Wu [15] claimed that the total effectiveness rate of modified DBKW was superior to antibiotic drugs; however, detailed data are not available for further synthesis.…”

“…Within all records of formulas, Danggui Beimu Kushen Wan (Chinese Angelica, Fritillaria and Flavescent Sophora Pill; DBKW) is one of the formulas that are indicated for difficult urination in pregnant women or male patients. In the modern era, this formula has been widely utilized for a range of prostate disorders involving CP [15], benign prostatic hyperplasia [16], and PCa [17]. This formula containing Angelicae Sinensis Radix (Dang gui), Fritillariae Thunbergii Bulbus (Zhe bei mu), Sophorae Flavescentis Radix (Ku shen), and Talcum (Hua shi) was initially created by ZHANG Zhong-jing (150-219 AD), the Chinese medical sage, detailed in Jin Gui Yao Lue (Synopsis of Prescriptions of the Golden Chamber; JGYL), approximately 1800 years ago [18].…”