背景:慢性盆腔疼痛综合征(CPPS)是一种常见的泌尿系统疾病,可导致患病个体严重残疾。慢性疼痛的生理解释通常是不完整的;CPPS的适当管理包括对生物,心理,和社会因素,被称为生物心理社会模型。
目的:这篇叙述性综述的目的是研究男性CPPS的治疗方法,特别关注那些利用生物心理社会护理模式的人。
方法:在电子数据库PubMed上进行了全面的文献检索,Embase,和Cochrane图书馆,使用与CPPS治疗相关的相关医学主题标题术语和关键词。搜索仅限于从开始到2023年1月以英文发表的研究。此外,我们对选定研究的参考列表进行了手动审核,以查找初始搜索中未确定的研究.如果他们调查了患有CPPS的男性的药物或非药物治疗,则包括研究。
结果:共有30项研究符合纳入标准。抗生素,α-阻断剂,非甾体抗炎药,gabapentinoids,抗抑郁药,和5型磷酸二酯酶抑制剂是试图减轻男性CPPS症状的试验中包括的药物。专注于不使用药物治疗CPPS的研究包括冲击波疗法等干预措施,针灸,物理治疗,肉毒杆菌毒素,冷冻疗法,电疗,锻炼,和认知行为疗法。
结论:α-阻滞剂和非甾体类抗炎药在治疗男性CPPS方面显示出了有希望的结果,而抗生素的有效性仍然存在争议。抗抑郁药和5型磷酸二酯酶抑制剂也可用于减轻CPPS患者的症状。治疗如盆底肌肉疗法,针灸,冲击波疗法,认知行为疗法必须被认为是男性CPPS患者医疗管理的有效补充。虽然这些干预措施显示出作为单一疗法的益处,个体化和治疗方式的组合可能会减轻疼痛并提高生活质量.
Chronic pelvic pain syndrome (
CPPS) is a common urologic condition that can cause significant disability in affected individuals. Physiologic explanations of chronic pain are often incomplete; appropriate management of
CPPS includes recognition of biological, psychological, and social elements, known as the biopsychosocial model.
The aim of this narrative review is to investigate treatments for men with
CPPS, with a special focus on those utilizing the biopsychosocial model of care.
A comprehensive literature search was conducted on the electronic databases PubMed, Embase, and Cochrane Library, using relevant Medical Subject Heading terms and keywords related to
CPPS treatments. The search was limited to studies published in English from inception to January 2023. Additionally, reference lists of selected studies were manually reviewed to find studies not identified by the initial search. Studies were included if they investigated pharmacologic or nonpharmacologic treatments for men with CPPS.
A total of 30 studies met the inclusion criteria. Antibiotics, α-blockers, nonsteroidal anti-inflammatory drugs, gabapentinoids, antidepressants, and phosphodiesterase type 5 inhibitors were among the pharmacologic agents included in trials attempting to reduce symptoms of male CPPS. Studies that focused on treating CPPS without medication included interventions such as shockwave therapy, acupuncture, physical therapy, botulinum toxin, cryotherapy, electrotherapy, exercise, and cognitive behavioral therapy.
α-Blockers and nonsteroidal anti-inflammatory drugs have shown promising results in treating
CPPS in men, while the effectiveness of antibiotics remains controversial. Antidepressants and phosphodiesterase type 5 inhibitors may also be useful in decreasing symptoms in patients with CPPS. Treatments such as pelvic floor muscle therapy, acupuncture, shockwave therapy, and cognitive behavioral therapy must be considered effective complements to medical management in men with CPPS. While these interventions demonstrate benefits as monotherapies, the individualization and combination of treatment modalities are likely to result in reduced pain and improved quality of life.