Diagnosis and treatment of chronic bacterial prostatitis and chronic prostatitis/chronic pelvic pain syndrome: a consensus guideline.
Diagnosis and treatment of chronic bacterial prostatitis and chronic prostatitis/chronic pelvic pain syndrome: a consensus guideline.
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DOI：
10.1111/bju.13101
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发表时间：
2015-10
影响因子：
4.5
通讯作者：
Prostatitis Expert Reference Group (PERG)
中科院分区：
文献类型：
--
作者：
Rees J;Abrahams M;Doble A;Cooper A;Prostatitis Expert Reference Group (PERG)
目的提高非专科医生和患者对慢性细菌性前列腺炎（CBP）和慢性前列腺炎/慢性盆腔疼痛综合征（CP/CPPS）的认识和认识。为医疗保健专业人员在非专科和专科环境中治疗CBP和CP/CPPS患者提供指导。促进非专家和专家之间的有效转诊以及多学科团队（MDT）的参与。指南人群是患有CBP或CP/CPPS的男性（持续或复发症状，且在过去6个月中至少3个月没有其他泌尿生殖器病理）。该指南的共识建议是基于对CBP和CP/CPPS的诊断和管理文献的检索（发表于1999年至2014年2月）。在缺乏高质量、已发表证据的情况下，采用德尔菲面板法。CBP和CP/CPPS可表现为广泛的临床表现。四个主要症状领域是泌尿生殖系统疼痛，下尿路症状（LUTS -排尿或储存症状），心理问题和性功能障碍。患者应根据其个体症状模式进行管理。一线治疗的选择包括抗生素、α -肾上腺素能拮抗剂（如果存在排尿LUTS）和简单的镇痛药。如果感染控制没有明显的症状改善，或者培养不支持感染原因，应避免重复使用抗生素，如喹诺酮类药物。早期使用针对神经性疼痛的治疗和/或转诊到专科服务，应该考虑对最初的措施没有反应的患者。建议采用MDT方法（泌尿科医生、疼痛专家、护士专家、专业物理治疗师、全科医生、认知行为治疗师/心理学家和性健康专家）。患者应充分了解可能的潜在原因和治疗方案，包括对慢性疼痛周期的解释。慢性前列腺炎可以表现出各种各样的体征和症状。建议识别个体症状模式和基于症状的治疗方法。需要进一步的研究来评估CBP和CP/CPPS的管理方案。
To improve awareness and recognition of chronic bacterial prostatitis (CBP) and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) among non‐specialists and patients. To provide guidance to healthcare professionals treating patients with CBP and CP/CPPS, in both non‐specialist and specialist settings. To promote efficient referral of care between non‐specialists and specialists and the involvement of the multidisciplinary team (MDT). The guideline population were men with CBP or CP/CPPS (persistent or recurrent symptoms and no other urogenital pathology for ≥3 of the previous 6 months). Consensus recommendations for the guidelines were based on a search to identify literature on the diagnosis and management of CBP and CP/CPPS (published between 1999 and February 2014). A Delphi panel process was used where high‐quality, published evidence was lacking. CBP and CP/CPPS can present with a wide range of clinical manifestations. The four main symptom domains are urogenital pain, lower urinary tract symptoms (LUTS – voiding or storage symptoms), psychological issues and sexual dysfunction. Patients should be managed according to their individual symptom pattern. Options for first‐line treatment include antibiotics, α‐adrenergic antagonists (if voiding LUTS are present) and simple analgesics. Repeated use of antibiotics, such as quinolones, should be avoided if there is no obvious symptomatic benefit from infection control or cultures do not support an infectious cause. Early use of treatments targeting neuropathic pain and/or referral to specialist services should be considered for patients who do not respond to initial measures. An MDT approach (urologists, pain specialists, nurse specialists, specialist physiotherapists, general practitioners, cognitive behavioural therapists/psychologists, and sexual health specialists) is recommended. Patients should be fully informed about the possible underlying causes and treatment options, including an explanation of the chronic pain cycle. Chronic prostatitis can present with a wide variety of signs and symptoms. Identification of individual symptom patterns and a symptom‐based treatment approach are recommended. Further research is required to evaluate management options for CBP and CP/CPPS.
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影响因子：
3.7
作者：
Cohen JM;Fagin AP;Hariton E;Niska JR;Pierce MW;Kuriyama A;Whelan JS;Jackson JL;Dimitrakoff JD
通讯作者：
Dimitrakoff JD
影响因子：
6.6
作者：
Clemens, JQ;Meenan, RT;Calhoun, EA
通讯作者：
Calhoun, EA
影响因子：
2.1
作者：
Bundrick, W;Heron, SP;Kahn, JB
通讯作者：
Kahn, JB
影响因子：
3.5
作者：
Davis, Seth N.;Morin, Melanie;Carrier, Serge
通讯作者：
Carrier, Serge
影响因子：
6.6
作者：
Anderson, Rodney U.;Wise, David;Orenberg, Elaine K.
通讯作者：
Orenberg, Elaine K.