Molecular Effects of Low-Intensity Shock Wave Therapy on L6 Dorsal Root Ganglion/Spinal Cord and Blood Oxygenation Level-Dependent (BOLD) Functional Magnetic Resonance Imaging (fMRI) Changes in Capsaicin-Induced Prostatitis Rat Models.

Neurogenic inflammation and central sensitization play a role in chronic prostatitis/chronic pelvic pain syndrome. We explore the molecular effects of low-intensity shock wave therapy (Li-ESWT) on central sensitization in a capsaicin-induced prostatitis rat model. Male Sprague-Dawley rats underwent intraprostatic capsaicin (10 mM, 0.1 cm3) injections. After injection, the prostate received Li-ESWT twice, one day apart. The L6 dorsal root ganglion (DRG)/spinal cord was harvested for histology and Western blotting on days 3 and 7. The brain blood oxygenation level-dependent (BOLD) functional images were evaluated using 9.4 T fMRI before the Li-ESWT and one day after. Intraprostatic capsaicin injection induced increased NGF-, BDNF-, and COX-2-positive neurons in the L6 DRG and increased COX-2, NGF, BDNF, receptor Trk-A, and TRPV1 protein expression in the L6 DRG and the dorsal horn of the L6 spinal cord, whose effects were significantly downregulated after Li-ESWT on the prostate. Intraprostatic capsaicin injection increased activity of BOLD fMRI responses in brain regions associated with pain-related responses, such as the caudate putamen, periaqueductal gray, and thalamus, whose BOLD signals were reduced after Li-ESWT. These findings suggest a potential mechanism of Li-ESWT on modulation of peripheral and central sensitization for treating CP/CPPS.

Diagnosis of Prostate Cancer and Prostatitis Using near Infra-Red Fluorescent AgInSe/ZnS Quantum Dots.

The link between the microbiome and cancer has led researchers to search for a potential probe for intracellular targeting of bacteria and cancer. Herein, we developed near infrared-emitting ternary AgInSe/ZnS quantum dots (QDs) for dual bacterial and cancer imaging. Briefly, water-soluble AgInSe/ZnS QDs were synthesized in a commercial kitchen pressure cooker. The as-synthesized QDs exhibited a spherical shape with a particle diameter of 4.5 ± 0.5 nm, and they were brightly fluorescent with a photoluminescence maximum at 705 nm. The QDs showed low toxicity against mouse mammary carcinoma (FM3A-Luc), mouse colon carcinoma (C26), malignant fibrous histiocytoma-like (KM-Luc/GFP) and prostate cancer cells, a greater number of accumulations in Staphylococcus aureus, and good cellular uptake in prostate cancer cells. This work is an excellent step towards using ternary QDs for diagnostic and guided therapy for prostate cancer.

Alterations in regional homogeneity of resting-state cerebral activity in patients with chronic prostatitis/chronic pelvic pain syndrome.

The purpose of this study was to explore the neural mechanism in Chronic prostatitis/Chronic pelvic pain syndrome (CP/CPPS) using resting-state functional magnetic resonance imaging. The functional magnetic resonance imaging was performed on 31 male CP/CPPS-patients and 31 age and education matched male healthy controls on a 3-T magnetic resonance imaging unit. A two-sample t-test was adopted to reveal the regional homogeneity between the patients and healthy controls. The mean regional homogeneity values in the alerted brain regions of patients were correlated with the clinical measurements by using Pearson's correlation analyses. The CP/CPPS-patients had significantly decreased regional homogeneity in the bilateral anterior cingulate cortices, insular cortices and right medial prefrontal cortex, while significantly increased regional homogeneity in the brainstem and right thalamus compared with the healthy controls. In the CP/CPPS-patients, the mean regional homogeneity value in the left anterior cingulate cortex, bilateral insular cortices and brainstem were respectively correlated with the National Institutes of Health Chronic Prostatitis Symptom Index total score and pain subscale. These brain regions are important in the pain modulation process. Therefore, an impaired pain modulatory system, either by decreased descending pain inhibition or enhanced pain facilitation, may explain the pain symptoms in CP/CPPS.

[DIETARY SUPPLEMENT REKECEN IMPROVES SAFETY AND EFFICACY OF CHRONIC PROSTATITIS ANTIBACTERIAL THERAPY].

This randomized comparative study was carried out to estimate efficacy and safety of the natural complex of fermented food fibers and short chain fatty acids (dietary supplement rekicen-RD®) in antibacterial therapy of 64 patients with chronic infectious prostatitis. 32 patients of the treatment group received 8 week standard antibacterial therapy for chronic prostatitis in combination with dietary supplement rekicen-RD® and 32 patients of the control group were treated only with antibacterial therapy. Short-term and long-term results were estimated after 8 weeks and 6 months follow-up, respectively. It was found, that addition of dietary supplement rekicen- RD® to antibacterial therapy resulted in statistically significant improvement of the treatment efficacy. Compared to patients of the control group, patients of the treatment group had more pronounced positive changes of all indicators of treatment efficacy (NIH-CPSI total score, quality of life, echo-structure of prostate, the number of leukocytes in prostatic secretions). Long-term (after 6 months) clinical efficacy of the combination of antibacterial therapy with dietary supplement rekicen-RD® was 96,9%, bacteriological efficacy after 8 weeks - 87,5%, after 6 months - 81%. Notably, there was 4,5-fold reduction in the rate of antibiotics adverse side effects in the treatment group patients without a single gastro-intestinal side effect.

Effectiveness on urinary symptoms and erectile function of Prostamev Plus® vs only extract Serenoa repens.

Prostatic inflammation is widespread in the male population. Two groups of 50 patients each with symptoms of prostatic inflammation and ecocolorDoppler indicative of prostatitis were identified. Both groups were further subdivided into two subgroups (respectively A1, A2, B1, and B2). Group A1 underwent therapy with oral levofloxacin 500 mg daily for 10 days plus co-treatment with oral Serenoa repens (320 mg) plus Bromeline plus Nettle (Prostamev Plus®) daily for two months; Group A2 with oral levofloxacin 500 mg daily for 10 days plus oral Serenoa repens extract 320 mg/day for two months; Group B1 specific antibiotic treatment for 10 days (included levofloxacin if sensitive) plus co-treatment with oral Serenoa repens (320 mg) plus Bromeline plus Nettle (Prostamev Plus®) daily for two months; Group B2 with specific antibiotic treatment for 10 days plus Serenoa repens 320 mg/day for two months. The groups treated with Prostamev Plus® in comparison to the groups treated with Serenoa repens extract (saw palmetto) achieved better improvements of both IPSS score, urinary flow and sexual life.

Prostatic abscess in a pediatric patient with chronic granulomatous disease: report of a unique case and review of the literature.

Chronic granulomatous disease (CGD) is a rare hereditary disease in which phagocytes have difficulty forming the superoxide radical required to kill certain pathogens. Individuals with CGD are susceptible to a specific set of infections and granulomatous lesions. We present the case of a 15-year-old boy with X-linked CGD who presented with unremitting cough and fevers. He had a left-sided pneumonia that persisted despite home intravenous antibiotics. He was admitted to an outside facility for bronchoalveolar lavage to obtain cultures and polymerase chain reaction. Computed tomography of chest, abdomen, and pelvis was done for baseline evaluation of extent of disease. Computed tomography revealed a fluid collection in the prostatic fossa, later determined to be a prostatic abscess. To our knowledge, this is the first reported case of a prostatic abscess in a pediatric patient with CGD.

[Combined therapy using phytopreparation prostagutt forte in patients with acute prostatitis].

The results of study on evaluation of efficacy of combined treatment of patients with acute prostatitis are presented. The study included 34 patients with acute prostatitis aged 19 to 51 years. 13 patients in Group 1 received only basic therapy: fluoroquinolones (ciprofloxacin, 500 mg 2 times daily for 14 days), non-steroidal anti-inflammatory drugs (suppositories voltaren 50 mg at bedtime for 7 days). Along with basic treatments, 21 patients in the Group 2 received phytopreparation prostagutt forte (at a dose 280 mg 2 times a day), which has antiestrogenic, antiproliferative, antiinflammatory, immunomodulatory properties. It was shown that patients receiving prostagutt forte experienced pronounced and significant decrease of white blood count in the prostatic secretion, the decrease of prostate volume according to the data of transrectal ultrasound examination, more rapid relief of the inflammatory process, which was manifested by reduction of hyperthermia and reduction of severity of bladder outlet obstruction associated with swelling of the prostate.

[Efficacy of magnetolaser therapy of patients with an inflammatory form of chronic abacterial prostatitis].

To assess efficacy of magnetolaser therapy (KAP-ELM-01 Andro-Gin unit) in the treatment of inflammatory chronic abacterial prostatitis (ICAP), 68 ICAP patients were divided into 2 groups. Group 1 patients (n = 33) received standard therapy. Group 2 patients received standard therapy plus magnetolaser (ML) therapy. The effect was assessed by the symptoms scale and indices of kallirrein-kinin system. After treatment pain relieved by 36,9%, on the average, in group 1 and by 63.1% in group 2. Lower urinary tract symptoms regressed insignificantly in both groups: by 4.8% and 7.1%, respectively. Quality of life improved by 27.6 and 65.5%, respectively. Kallikrein activity in prostatic secretion remained high in both groups. A 21.7% rise (p < 0.05) of prokallikrein level was seen after treatment only in group 2. Activity of KKS inhibitors (alpha2-MG and alphal-PI) in prostatic secretion normalized in group 2. Total activity of serin proteinases lowered in both groups (p < 0.05). High activity of alphal-PI (8.21 + 1.97 U/ml) persisted in group 1. Thus, standard treatment of ICAP does not result in biochemical normalization of prostatic secretion. ML therapy is more effective.

[Prostamol-Uno treatment in patients with prostatic adenoma and chronic non-infectious prostatitis].

We studied efficacy and safety of prostamol-Uno (PU) monotherapy in patients with prostatic adenoma (PA) comorbid with chronic abacterial prostatitis (CAP) in a clinical open trial including 45-year-old males aged over 45 years with PA comorbid with CAP, having irritative and obstructive symptoms by IPSS above 8 points and duration 6 months or longer, by NIH-CPSI above 10 points and duration 3 months or longer. The patients had Qmax from 5 to 15 ml/s, urine volume 100-350 ml, residual urine volume under 150 ml, prostate size more than 25 cm3, PSA level under 4 ng/ml and no bacterial growth in the third urine portion seeding and/or prostatic secretion. The effect was assessed by the disease history, complaints, digital rectal examination of the prostate, the disease symptoms by IPSS, quality of life (QoL), NIH-CPSI, bacteriological tests of the urine and prostatic secretion, urinalysis, Nechiporenko test in 3 urine portions. Uroflowmetry, ultrasonic investigation of the urinary bladder and prostate, transrectal energy dopplerography of the prostate, PSA assay in the blood serum were made in all the patients. PU safety was evaluated by arterial pressure, heart rate, 6-lead ECG, total and biochemical blood count. Control examination 3 months after the treatment showed no negative changes. PU patients demonstrated reduction in IPSS index from 14 to 6.8 points and NIH-CPSI (from 18.4 to 12.3 points (from 13 to 11.2 and 17.1 to 16.8 points, respectively, in the controls). QoL reduced from 3.9 to 1.9, from 3.6 to 3.3 points, respectively. Qmax rose from 12.4 to 18.2 ml/s and 13.5 to 14.5 ml/s, respectively. PSA changed insignificantly. Side effects were mild. Spectral doppler examination detected improvement in prostatic blood flow after PU treatment in 16 (53.3%) patients. Resistance index as an index of peripheral vascular resistance increased from 0.48-0.54 to 0.7-0.72 (p < 0.05). Thus, PU effectively reduces irritative and obstructive symptoms typical for prostatic adenoma in combination with CAP.

Emphysematous prostatitis caused by Klebsiella pneumoniae.

Emphysematous prostatitis is a rare condition that is characterized by gas and abscess accumulation in the prostate. We report a 60-year-old man with emphysematous prostatitis caused by Klebsiella pneumoniae. He had a history of recently diagnosed diabetes mellitus and a 16-year history of alcoholic liver cirrhosis. He was admitted due to fever, dysuria and difficult urination. Physical examination revealed lower abdominal tenderness and prostatic fluctuance on digital examination. Leukocytosis, pyuria and elevated C-reactive protein were found. Abdominal radiography disclosed a collection of abnormal air pockets in the lower pelvic cavity and computed tomography scans corroborated the existence of extensive air collection in the prostate. Under the impression of emphysematous prostatitis, the patient was successfully treated with transurethral incision of the prostate and antibiotics for 6 weeks; there were no urinary sequelae during 6 months of follow-up.

[Use of Intramag devices with Intraterm and LAST-02 attachments in complex therapy of chronic prostatitis].

The examination of the patients exposed to physical factors (magnetotherapy, laser therapy and thermotherapy) has demonstrated that Intramag unit with attachments Intraterm and LAST-02 for local physiotherapy is effective in patients with chronic prostatitis and can be used in urological hospitals and outpatient clinics.

[Using AELTIS-synchro-02 device in the therapy of chronic bacterial prostatitis].

The treatment of chronic bacterial prostatitis combined antibacterial drugs and physiotherapy (low-energy laser radiation, electrostimulation of the prostate). Treatment of chronic bacterial prostatitis with medication and complex two-channel bio-synchronized electrolaser therapy with application of the unit AELTIS-synchro-02 raises efficacy of treatment with chronic bacterial prostatitis due to combined effect of antibacterial drugs and bacteriostatic and immunomodulating actions of the physical factors applied. These normalize microcirculation in the region of the prostatic gland, improve a draining function of the prostatic ducts, allows achievement of good results in 88.2% patients.

[Efficiency and safety of prostamol-Uno in patients with chronic abacterial prostatitis].

In this open label prospective study in patients with category III prostatitis we assessed efficacy and safety of Sabal serrulata plant extract (prostamol Uno 320 mg) (group I, n=30) as compared to watchful waiting (group II, n=24). Efficacy was evaluated by means of NIH-CPSI, IPSS-QoL questionnaires, patients' general subjective assessment of treatment outcome, uroflowmetry and transrectal Doppler mapping (colour doppler and spectral doppler) of the prostate. Patients receiving prostamol Uno in comparison with watchful waiting group had significant improvement of mean NIH-CPSI (from 17.8 to 11.4 vs 17.1 to 16.5) and IPSS (from 13.0 to 6.3 vs 13.2 to 11.6) scores, Qmax values (from 12.9 ml/s to 17.8 ml/s vs 13.3 ml/s to 14.4 ml/s) and Doppler parameters of vascular resistance in the prostate. According to the patients' subjective assessment, moderate and significant improvement was reported by 76.7% patients in prostamol Uno group vs 23.3% in the watchful waiting group. There were no severe side effects. In prostamol Uno group one patient (3.3%) had moderate dyspepsia that resolved without termination of the drug administration. Prostamol Uno showed good efficacy and safety profile in patients with category III prostatitis.

Clinical studies on treatment of chronic prostatitis with acupuncture and mild moxibustion.

To observe the therapeutic effect of acupuncture and mild moxibustion on chronic prostatitis and to probe into the mechanism of the therapy. Two hundred patients with chronic prostatitis were randomly divided into two groups so as to observe respectively the changes in clinical symptoms, count of WBC and lecithin corpuscles in succus prostaticus, prostatic capcules and internal echo, tenderness and elasticity of prostate by palpation before and after treatment. After treatment, a remarkable improvement was found in clinical symptoms, succus prostaticus test and ultrasonic examination in the treatment group with a statistically significant difference (P < 0.05) as compared to the control group. The treatment of chronic prostatitis with acupuncture and mild moxibustion can remove the stagnation of succus prostaticus, improve the blood circulation in prostate, inhibit or kill the pathogenic micro-organisms, strengthen or regulate the immune function of the patients, improve local blood circulation, eliminate the accumulation of secretion and relieve the obstruction of the prostatic ducts.

[Treatment with non-steroidal anti-inflammatory drugs in patients with amicrobial chronic prostato-vesiculitis: transrectal ultrasound and seminal findings]. / Trattamento con FANS nella prostato-vesciculite cronica amicrobica: effetti su quadro ecografico e spermatico (parametri citologici e chimico-fisici).

AIM: The aim of this paper was to evaluate the efficacy (0= none; 3= fully) of the treatment with nonsteroidal anti-inflammatory (NSAI) drugs on (a) gland post-inflammatory echopattern, by transrectal ultrasound (TRUS); (b) seminal cytologic (WBC concentration and spermiophagies) and (c) >2 physicochemical inflammatory parameters in patients with chronic amicrobial prostato-vesiculitis (PV). METHODS: Thirty-five patients with PV received NSAI drugs in the following intermittently steps (over a 3-month period): 1) Pygeum 100 mg twice a day for 14 consecutive days per month; 2) flavoxate-propyphenazone 400 mg twice a day plus Serratiopeptidase 10 000 U twice a day for the subsequent 14 days per month. All patients underwent semen analysis and TRUS scans in the pre-treatment and after 3 months of therapy. RESULTS: The fully (a+b+c) efficacy rate, through an improvement of TRUS prostatic or vesicular echopattern in 37.1% and 22.8% respectively, was higher than that registered with an improvement of only 1 or 2 endpoints. Altogether, the following TRUS findings showed reductions (range 25-40%): prostate volume and hypochogenicity (51.4%); vesicular antero-posterior diameter (APD) in the 43.5% and 28.6% of the uni- and bilateral PV respectively; vesicular wall tickness (25%); unilateral vesicular honeycomb aspect (36%). No efficacy, mainly related to immodified TRUS prostatic or vesicular echopattern in 51.4% and 65.7% respectively, was observed on: areas of prostatic hyperechogenicity; peri-prostatic venous congestion; vesicular APD <7 mm or >21 mm (with honeycomb aspect). CONCLUSIONS: In PV patients, the treatment with NSAI compounds was effective when it was enable to produce multiple positive effects, mainly through TRUS changes.

[Rehabilitation of patients with chronic prostatitis in combination with reflex syndromes of lumbar osteochondrosis]. / Vosstanovitel'noe lechenie bol'nykh khronicheskim prostatitom v sochetanii s reflektornymi sindromami poiasnichnogo osteokhondroza.

A combined treatment is proposed for patients with chronic prostatitis attended by reflex syndromes of lumbar osteochondrosis. The treatment consists in postisometric relaxation, massage of the prostate and transrectal mobilization of the pelvic ligaments. The results achieved in 106 patients proved that the proposed combined treatment is effective in compound pathology of the pelvic region.

High serum prostate-specific antigen levels in the absence of prostate cancer in Middle-Eastern men: the clinician's dilemma.

OBJECTIVE: To investigate the common causes of total serum prostate-specific antigen (PSA) values of> 10 ng/mL in an Arab population, as in the USA and Europe the risk of prostate cancer is considered high in men with such PSA levels. PATIENTS AND METHODS: Serum total PSA was measured in men presenting to our hospital as part of the investigation for prostate cancer screening and/or in elderly men with prostatism. Men with a serum PSA level of> 10 ng/mL were further investigated by transrectal ultrasonography (TRUS) of the prostate and biopsy of suspicious lesions for histological diagnosis. In addition, the percentage of free PSA, PSA velocity and PSA density were determined. All the patients included in this study were men of Arab origin residing in Kuwait. RESULTS: In all, 1700 men (mean age 55.6 years, range 35-94) were assessed; of these, 161 had a serum PSA of> 10 ng/mL, attributable to benign prostatic hyperplasia (BPH) in 110 (68%), BPH with histological features of prostatitis in 33 (21%) and prostate cancer in 18 (11%). TRUS of the prostate in 143 of the 161 men with either BPH or BPH with prostatitis showed varying grades of intraprostatic calcifications in 22 (15%). Both PSA density and percentage free PSA did not contribute to determining the causes of total PSA levels of> 10 ng/mL. There was a progressive decline in PSA in all patients with BPH and prostatitis, except one who at re-biopsy had prostate cancer (T1N0M0, G1). CONCLUSION: Total PSA values of> 10 ng/mL in Arab men may be a result of BPH, BPH with prostatitis or prostate cancer, in that order. A gradual decline in total PSA (decreased PSA velocity) with time to < 4 ng/mL often confirms the diagnosis of BPH with prostatitis. The percentage of free PSA and PSA density may not be helpful in diagnosing prostate cancer with certainty in these patients. Compared with Caucasians in the USA and Europe, BPH and BPH with prostatitis appear to be more frequent causes of serum PSA levels of> 10 ng/mL in Arab men.

A case of imported melioidosis presenting as prostatitis.

We report a case of melioidosis in a previously healthy Belgian man. He presented with septicemia and prostatic abscesses 1 week after a trip to Vietnam. Burkholderia pseudomallei was isolated from multiple hemocultures. He was treated successfully with intravenous ceftazidime and trimethoprim-sulfamethoxazole, followed by a per-oral maintenance therapy of amoxicillin-clavulanate with supplementary amoxicillin. There was no need for surgical drainage. This is the second reported case of melioidosis in Belgium.

[Comparative analysis of various techniques of prostatic drainage in patients with chronic obstructive prostatitis]. / Sravnitel'nyi analiz éffektivnosti razlichnykh tekhnologii drenirovaniia predstatel'noi zhelezy u bol'nykh khronicheskim obstruktivnym prostatitom.

The efficacy of prostatic drainage using transurethral vacuum aspiration (Introl-4 unit) and transrectal pneumovibromassage (PVM-R-01) was compared in 1511 patients with chronic obstructive prostatitis. The drainage was accompanied by local (urethral, rectal and urethral-rectal tripsin or chimotripsin electrophoresis) or systemic enzymic therapy (vobenzim). The highest effect of the drainage was achieved in patients pretreated for 5-7 days with systemic enzymes. Transrectal pneumovibromassage proved more effective and safe but the transurethral technique if indicated can be also used in the combined treatment.

[Prostatic drainage technique in obstructive chronic prostatitis using rectal pneumovibromassager PVM-R-01]. / Tekhnologiia drenirovaniia predstatel'noi zhelezy pri obstruktivnom khronicheskom prostatite posredstvom rektal'nogo pnevmovibromassazhera PVM-R-01.

The author presents theoretical and clinical grounds for application of pneumovibromassager PVM-P-01 in the treatment of patients with obstructive chronic prostatitis and compares its efficiency with that of transurethral drainage; describes treatment regimens and mechanisms of action; presents results of rectal pneumovibromassage in patients with benign prostatic hyperplasia complicated by chronic prostatitis.