Impaired Ability to Relax Pelvic Floor Muscles in Men With Chronic Prostatitis/Chronic Pelvic Pain Syndrome.
Impaired Ability to Relax Pelvic Floor Muscles in Men With Chronic Prostatitis/Chronic Pelvic Pain Syndrome.
复制标题
患有慢性前列腺炎/慢性盆腔疼痛综合症的男性放松盆底肌肉的能力受损。
DOI：
10.1093/ptj/pzac059
复制
发表时间：
2022
期刊：
影响因子：
3.2
通讯作者：
Kutch,JasonJ
中科院分区：
文献类型：
--
作者：
Yani,MohebS;Eckel,SandrahP;Kirages,DanielJ;Rodriguez,LarissaV;Corcos,DanielM;Kutch,JasonJ
目的过度盆底肌肉活动被认为是慢性前列腺炎/慢性盆腔疼痛综合征（CP/CPPS）疼痛的根源。我们的目的是确定患有 CP/CPPS 的男性是否存在神经驱动变化，从而损害他们放松盆底肌肉的能力。方法我们招募了 90 名男性（42 名患有 CP/CPPS 的男性，48 名属于对照组[无盆腔疼痛史]）。全部完成了美国国立卫生研究院慢性前列腺炎症状指数 (NIH-CPSI)。我们通过比较两种条件下的静息盆底肌肉活动来量化放松的能力：“仅休息”条件，其中参与者被指示简单地放松，以及“收缩之间休息”条件，其中参与者被指示在自愿盆底肌肉收缩之间休息几秒钟。我们使用多变量混合效应模型来检查各组之间的差异（患有 CP/CPPS 的男性和对照组男性）以及 NIH-CPSI 捕获的 6 种症状的影响：与位置（会阴、睾丸、阴茎、耻骨上区域）和活动（排尿、射精）相关的疼痛。患有 CP/CPPS 的男性在收缩间休息条件下的静息活动高于仅休息条件下的静息活动，而对照组男性在两种条件下的静息活动相似。这种效果在报告有射精相关疼痛的男性中最为明显，占 CP/CPPS 组的 70%。结论没有盆腔疼痛史的男性在进行自愿盆底肌肉收缩后能够将盆底肌肉放松回到基线。相比之下，患有 CP/CPPS 的男性，尤其是那些患有射精相关疼痛的男性，其盆底肌肉的放松能力受损。影响这项研究可能支持针对 CP/CPPS 的更个性化的物理治疗师方法的研究，这些方法可增强放松盆底肌肉的能力，作为减轻疼痛的机制。
ObjectiveExcessive pelvic floor muscle activity has been suggested as a source of pain in chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). Our objective was to determine whether men with CP/CPPS have changes in neural drive that impair their ability to relax pelvic floor muscles.MethodsWe recruited 90 men (42 with CP/CPPS and 48 in the control group [without a history of pelvic pain]). All completed the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI). We quantified the ability to relax by comparing resting pelvic floor muscle activity under 2 conditions: a “rest-only” condition, in which participants were instructed to simply relax, and a “rest-between-contraction” condition, in which participants were instructed to rest for several seconds between voluntary pelvic floor muscle contractions. We used multivariate mixed-effects models to examine differences between the groups (men with CP/CPPS and men in the control group) as well as the effect of 6 symptoms captured by the NIH-CPSI: pain related to location (perineum, testicles, penis, suprapubic region) and activity (urination, ejaculation).ResultsMen with CP/CPPS were significantly different from men in the control group; men with CP/CPPS had higher resting activity in the rest-between-contraction condition than in the rest-only condition, whereas men in the control group had similar resting activities in both conditions. This effect was strongest in men who reported ejaculation-related pain, which was 70% of the CP/CPPS group.ConclusionMen without a history of pelvic pain were able to relax their pelvic floor muscles back to baseline after performing voluntary pelvic floor muscle contractions. In contrast, men with CP/CPPS, particularly those with ejaculation-related pain, had an impaired ability to relax their pelvic floor muscles.ImpactThis study may support the investigation of more personalized physical therapist approaches for CP/CPPS that enhance the ability to relax pelvic floor muscles as a mechanism for pain reduction.