Pelvic tenderness

A study has shown that men with CPPS have more tenderness in the pelvic-pubic area. Internal and external "tender points" were examined.(1) How the tender points were selected and/or identified was not clear. The tender points bore no correlation to the fibromyalgia tender points.

Andra bloggar om CPPS, kroniskt bäckenbottensmärtsyndrom, kronisk abakteriell prostatit, NIHIIIb, tender points
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(1) Berger RE, Ciol MA, Rothman I, Turner JA. Pelvic tenderness is not limited to the prostate in CPPS… comparison of men with and without CPPS. BMC Urol 7:17-24, 2007.

Urinary nitrites

Urinary nitrites are higher in patients with enuresis (1) indicating a connection between nitric oxide (NO) regulation and enuresis ("over-active bladder"). "NO plays an important role in the micturition process and disorders [IC, cystitits, enuresis] of the lower urinary tract."(2) Some IC patients show significant improvement with decreasing bladder NO.(3)
Nitric oxide (NO) has been shown to be significantly higher in the prostatic urethra of NIH-IIIa patients, but not in NIH-IIIb patients.(4)

Andra bloggar om CPPS, kroniskt bäckenbottensmärtsyndrom, kronisk abakteriell prostatit, NIHIIIb
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(1) Al-Waili NS Increased urinary nitrite excretion in primary enuresis: effects of indomethacin treatment on urinary and serum osmolality and electrolytes, urinary volumes and nitrite excretion. BJU Int 90:294-301, 2002.
(2) Ho MH, Bhatia NN, Khorram O. Physiologic role of nitric oxide and nitric oxide synthase in female lower urinary tract. Curr Opin Obstet Gynecol 16(5):423-429, 2004.
(3) Hosseini A, Ehren I, Wiklund NP. Nitric oxide as an objective marker for evaluation of treatment response in patients with classic interstitial cystitis. J Urol 172(6 Pt 1):2261-2265, 2004.
(4) Hosseini A, Herulf M, Ehren I. Measurement of nitric oxide may differentiate between inflammatory and non-inflammatory prostatitis. Scand J Urol Nephrol 40(2):125-130, 2006.

Bladder lining findings

Many CPPS sufferers react with pain/discomfort on potassium instillations (a potassium ion containing fluid is injected into the bladder) in a manner similar to IC patients, but the so called potassium sensitivity test is not wholly reliable as both false negatives and positives are common. It is believed that the potassium sensitivity is caused by impaired “barrier function” of the bladder urothelium to irritants or cytotoxic substances in the urinary fluid. It is assumed that potassium influx into nerve and muscular cells causes abnormal nerve firing and muscular relaxation.

Sulfated polysaccharides, like heparin, are thought to lower adherence to the bladder and urethral etc mucosal wall, which would also improve urine flow dynamics. If adherence increases bacteria, molecules etc can attach to the surface, as well as flow become more turbulent.

Other research has shown that instillation with resinifera-toxin modulates nerve firing in such a way as to (permanently?) alleviate bladder related symptoms. See additional discussion under treatment.

Andra bloggar om CPPS, kroniskt bäckenbottensmärtsyndrom, kronisk abakteriell prostatit, urinblåsa

The female prostate

As mentioned in passing in an earlier post some women have a vestigial prostate (and some men a vestigial uterus: the utriculum). The organ is more known as Skene's or the paraurethral gland. Oddly enough it is semifunctional in some cases and may eject a fluid and be stimulated. A popular overview was recently published in the may 30 issue of New Scientist.

Andra bloggar om prostata