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Muscle Tenderness in Men With Chronic Prostatitis/Chronic Pelvic Pain Syndrome: The Chronic Prostatitis Cohort Study

2007; Lippincott Williams & Wilkins; Volume: 179; Issue: 2 Linguagem: Inglês

10.1016/j.juro.2007.09.088

1527-3792

Daniel A. Shoskes, Richard E. Berger, Angelo Elmi, J. Richard Landis, Kathleen J. Propert, Scott I. Zeitlin,

Prostate Cancer Diagnosis and Treatment

No AccessJournal of UrologyAdult urology1 Feb 2008Muscle Tenderness in Men With Chronic Prostatitis/Chronic Pelvic Pain Syndrome: The Chronic Prostatitis Cohort Studyis accompanied byBacterial Cystitis is Accompanied by Increased Peripheral Thermal Sensitivity in Mice Daniel A. Shoskes, Richard Berger, Angelo Elmi, J. Richard Landis, Kathleen J. Propert, Scott Zeitlin, and Chronic Prostatitis Collaborative Research Network Study Group Daniel A. ShoskesDaniel A. Shoskes Cleveland Clinic, Cleveland, Ohio , Richard BergerRichard Berger University of Washington, Seattle, Washington , Angelo ElmiAngelo Elmi Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania , J. Richard LandisJ. Richard Landis Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania , Kathleen J. PropertKathleen J. Propert Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania , Scott ZeitlinScott Zeitlin David Geffen School of Medicine at University of California and VA Greater Los Angeles Healthcare System, Los Angeles, California , and Chronic Prostatitis Collaborative Research Network Study Group View All Author Informationhttps://doi.org/10.1016/j.juro.2007.09.088AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Myofascial pain is a possible etiology for category III chronic prostatitis/chronic pelvic pain syndrome, either secondary to infection/inflammation or as the primary cause. We documented tenderness on physical examination in a large multicenter cohort of patients with chronic pelvic pain syndrome and compared to controls. Materials and Methods: Data were reviewed from the National Institutes of Health Chronic Prostatitis Cohort study on 384 men with chronic pelvic pain syndrome and 121 asymptomatic controls who had complete unblinded physical examination data from 7 clinical centers between October 1998 and August 2001. Tenderness in 11 sites including prostate, genitals, abdomen and pelvic floor together with prostate size and consistency was evaluated. Data were correlated with cultures and symptoms. Results: Overall 51% of patients with chronic pelvic pain syndrome and 7% of controls had any tenderness. The most common site was prostate (41% chronic pelvic pain syndrome, 5% controls), followed by external and internal pelvic floor (13% and 14% chronic pelvic pain syndrome, 0 controls) and suprapubic area (9% chronic pelvic pain syndrome, 0 controls). Of patients with chronic pelvic pain syndrome 25% had 1 tender site, 11% had 2 and 6% had 3 tender sites. Tenderness did not correlate with inflammation or infection in the prostate fluid. Prostate consistency was normal in 79% of patients with chronic pelvic pain syndrome and in 95% of controls, and did not correlate with symptom severity. Patients with chronic pelvic pain syndrome with any tenderness had significantly higher Chronic Prostatitis Symptom Index scores at baseline and at 1 year (24.1 vs 21.2 and 20.2 vs 17.5, p <0.0001) compared to patients without tenderness. Conclusions: Abdominal/pelvic tenderness is present in half of the patients with chronic pelvic pain syndrome but only 7% of controls. Extraprostatic tenderness may identify a cohort of patients with a neuromuscular source of pain. References 1 : Clinical practice: Chronic prostatitis and the chronic pelvic pain syndrome. N Engl J Med2006; 355: 1690. Google Scholar 2 : Integration of myofascial trigger point release and paradoxical relaxation training treatment of chronic pelvic pain in men. J Urol2005; 174: 155. 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Google Scholar © 2008 by American Urological AssociationFiguresReferencesRelatedDetailsCited byGupta P, Gallop R, Spitznagle T, Lai H, Tu F, Krieger J, Clemens J, Bradley C, Yang C, Sutcliffe S, Moldwin R, Kreder K, Kutch J and Rodriguez L (2022) Is Pelvic Floor Muscle Tenderness a Distinct Urologic Chronic Pelvic Pain Syndrome Phenotype? Findings from the Multidisciplinary Approach to the Study of Chronic Pelvic Pain Research Network Symptom Pattern StudyJournal of Urology, VOL. 208, NO. 2, (341-349), Online publication date: 1-Aug-2022.Gill B and Shoskes D (2020) Editorial CommentJournal of Urology, VOL. 204, NO. 6, (1282-1283), Online publication date: 1-Dec-2020.Polackwich A, Li J and Shoskes D (2015) Patients with Pelvic Floor Muscle Spasm Have a Superior Response to Pelvic Floor Physical Therapy at Specialized CentersJournal of Urology, VOL. 194, NO. 4, (1002-1006), Online publication date: 1-Oct-2015.FitzGerald M, Anderson R, Potts J, Payne C, Peters K, Clemens J, Kotarinos R, Fraser L, Cosby A, Fortman C, Neville C, Badillo S, Odabachian L, Sanfield A, O'Dougherty B, Halle-Podell R, Cen L, Chuai S, Landis J, Mickelberg K, Barrell T, Kusek J and Nyberg L (2018) Randomized Multicenter Feasibility Trial of Myofascial Physical Therapy for the Treatment of Urological Chronic Pelvic Pain SyndromesJournal of Urology, VOL. 189, NO. 1S, (S75-S85), Online publication date: 1-Jan-2013.Davis S, Binik Y, Amsel R and Carrier S (2013) A Subtype Based Analysis of Urological Chronic Pelvic Pain Syndrome in MenJournal of Urology, VOL. 190, NO. 1, (118-123), Online publication date: 1-Jul-2013.FitzGerald M, Payne C, Lukacz E, Yang C, Peters K, Chai T, Nickel J, Hanno P, Kreder K, Burks D, Mayer R, Kotarinos R, Fortman C, Allen T, Fraser L, Mason-Cover M, Furey C, Odabachian L, Sanfield A, Chu J, Huestis K, Tata G, Dugan N, Sheth H, Bewyer K, Anaeme A, Newton K, Featherstone W, Halle-Podell R, Cen L, Landis J, Propert K, Foster H, Kusek J and Nyberg L (2012) Randomized Multicenter Clinical Trial of Myofascial Physical Therapy in Women With Interstitial Cystitis/Painful Bladder Syndrome and Pelvic Floor TendernessJournal of Urology, VOL. 187, NO. 6, (2113-2118), Online publication date: 1-Jun-2012.Anderson R, Wise D, Sawyer T, Glowe P and Orenberg E (2011) 6-Day Intensive Treatment Protocol for Refractory Chronic Prostatitis/Chronic Pelvic Pain Syndrome Using Myofascial Release and Paradoxical Relaxation TrainingJournal of Urology, VOL. 185, NO. 4, (1294-1299), Online publication date: 1-Apr-2011.Shoskes D, Prots D, Karns J, Horhn J and Shoskes A (2011) Greater Endothelial Dysfunction and Arterial Stiffness in Men With Chronic Prostatitis/Chronic Pelvic Pain Syndrome—A Possible Link to Cardiovascular DiseaseJournal of Urology, VOL. 186, NO. 3, (907-910), Online publication date: 1-Sep-2011.FitzGerald M, Anderson R, Potts J, Payne C, Peters K, Clemens J, Kotarinos R, Fraser L, Cosby A, Fortman C, Neville C, Badillo S, Odabachian L, Sanfield A, O'Dougherty B, Halle-Podell R, Cen L, Chuai S, Landis J, Mickelberg K, Barrell T, Kusek J and Nyberg L (2009) Randomized Multicenter Feasibility Trial of Myofascial Physical Therapy for the Treatment of Urological Chronic Pelvic Pain SyndromesJournal of Urology, VOL. 182, NO. 2, (570-580), Online publication date: 1-Aug-2009.Anderson R, Sawyer T, Wise D, Morey A and Nathanson B (2009) Painful Myofascial Trigger Points and Pain Sites in Men With Chronic Prostatitis/Chronic Pelvic Pain SyndromeJournal of Urology, VOL. 182, NO. 6, (2753-2758), Online publication date: 1-Dec-2009.Related articlesJournal of Urology14 Dec 2007Bacterial Cystitis is Accompanied by Increased Peripheral Thermal Sensitivity in Mice Volume 179Issue 2February 2008Page: 556-560 Advertisement Copyright & Permissions© 2008 by American Urological AssociationKeywordspelvic painprostatitisMetricsAuthor Information Daniel A. Shoskes Cleveland Clinic, Cleveland, Ohio Financial interest and/or other relationship with Farr Labs and Triurol. More articles by this author Richard Berger University of Washington, Seattle, Washington Nothing to disclose. More articles by this author Angelo Elmi Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania Nothing to disclose. More articles by this author J. Richard Landis Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania Nothing to disclose. More articles by this author Kathleen J. Propert Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania Nothing to disclose. More articles by this author Scott Zeitlin David Geffen School of Medicine at University of California and VA Greater Los Angeles Healthcare System, Los Angeles, California Financial interest and/or other relationship with Boehringer Ingelheim. More articles by this author Chronic Prostatitis Collaborative Research Network Study Group More articles by this author Expand All Advertisement PDF downloadLoading ...