OBJECTIVE: To compare the therapeutic effect between acupuncture combined with ibuprofen sustained-release capsule and simple ibuprofen sustained-release capsule on chronic pelvic pain (CPP) after pelvic inflammatory disease (PID). METHODS: A total of 144 patients were randomized into an observation group (72 cases, 10 cases dropped off) and a control group (72 cases, 9 cases dropped off). Ibuprofen sustained-release capsule was given orally in the control group, one capsule a time. On the basis of the treatment in the control group, acupuncture was applied at Guanyuan (CV 4), Shuidao (ST 28), Guilai (ST 29), Shenshu (BL 23) and Ciliao (BL 32), and Shuidao (ST 28), Guilai (ST 29), Shenshu (BL 23) and Ciliao (BL 32) were connected to electroacupuncture in the observation group. The treatment was given 10 days before menstruation, once a day for 3 menstrual cycles in both groups, and the follow-up was adopted 3 menstrual cycles after treatment. The visual analogue scale (VAS) scores of hypogastrium and lumbosacral region before treatment, after treatment, and at the follow-up, the score of local signs and the score of World Health Organization quality of life questionnaire-brief version (WHOQOL-BREF) before and after treatment were observed in the both groups. RESULTS: After treatment and at the follow-up, the VAS scores of hypogastrium and lumbosacral region were decreased compared before treatment in both groups ( CONCLUSION Acupuncture combined with ibuprofen sustained-release capsule can effectively improve the symptoms, signs and quality of life in patients with CPP after PID, the therapeutic effect is superior to simple ibuprofen sustained-release capsule.
Acupuncture Points ; Acupuncture Therapy ; Female ; Humans ; Pelvic Inflammatory Disease/etiology* ; Pelvic Pain/etiology* ; Quality of Life ; Treatment Outcome

Chronic Pain ; Humans ; May-Thurner Syndrome/diagnostic imaging* ; Pelvic Pain/etiology*

Animals ; Chronic Pain ; Freund's Adjuvant/adverse effects* ; Humans ; Inflammation ; Male ; Pelvic Pain/etiology* ; Prostatitis ; Rats

OBJECTIVETo characterize the symptoms of neurogenic intrapelvic syndrome and the pathogenic mechanisms.

METHODSA total of 537 patients with neurogenic intrapelvic syndrome were treated in the Takano Hospital between 2001 and 2005. Clinical data were analyzed retrospectively.

RESULTSThe mean age was 58.5 years old. There were 205 males and 332 females. There were 80 patients(14.9%) who presented with only one symptom with anorectal pain being the most common one (43.8%, 35/80). One hundred and fifty-six(29.1%) patients had two symptoms with anorectal pain and difficult evacuation being the most common combination (26.3%, 41/156). There were 144 patients (26.8%) complained of 3 symptoms and the most common combination was anorectal pain, difficult evacuation, and abdominal discomfort (30.0%, 43/144). A combination of 4 symptoms was reported in 105 patients(19.6%) with the combination of anorectal pain, incontinence, abdominal discomfort, and lumbar discomfort being the most often(65.7%, 69/105). In addition, there were 52 patients(9.7%) who had above 5 symptoms simultaneously. The frequencies of the 5 symptoms were 73.6% for anorectal pain, 27.9% for incontinence, 69.6% for difficult evacuation, 55.3% for abdominal discomfort, and 53.6% for lumbar discomfort.

CONCLUSIONSSymptomatology of neurogenic intrapelvic syndrome is complicated. The pathogenic mechanism may be related to concurrent dysfunction of sacral nerve and pelvic splanchnic nerve.

Encopresis ; etiology ; Female ; Humans ; Male ; Middle Aged ; Pelvic Pain ; etiology ; Retrospective Studies ; Syndrome

So far the etiology of chronic prostatitis(CP), particularly chronic nonbacterial prostatitis(NBP) or chronic pelvic pain syndrome (CPPS), remains to be elucidated. According to recent epidemiologic data, the prevalence of CP ranged from 2.5% to 16% of the world population, affecting men of all ages and all ethnic origins. Since 1990s researchers of many countries have carried out largerscaled, deeper and more extensive studies than ever before on the etiology, diagnosis and treatment of the disease, with the sponsorship and coordination of such international institutions as the International Prostatitis Collaborative Network(IPCN), the Chronic Prostatitis Collaborative Research Network of the National Institute of Health (NIH-CPCRN) and so on. The main achievements of recent years include: the etiology of CP/CPPS being a complicated multi-step and multi-factor course, the establishment of the new clinical classification system, the introduction of the National Institute of Health chronic prostatitis symptom index, the new criteria of diagnosis and standardized clinical evaluation, the primary explorations of new treatment methods and medicines, etc. Further investigations suggested are the optimization of clinical classification, the screening and verification of treatment methods and medicines for CP/CPPS, etc.
Chronic Disease ; Combined Modality Therapy ; Humans ; Male ; Pelvic Pain ; diagnosis ; etiology ; therapy ; Prostatitis ; diagnosis ; etiology ; therapy

Chronic prostatitis (CP)/chronic pelvic pain syndrome (CPPS) is a common problem of medically controversial condition that causes considerable morbidity and impact on life. Although there are many competing causes proposed, the etiology and pathogenesis of CP/CPPS remain unclear. The causative factors underlying the CPPS are not fully understood. The optimal management of CP/CPPS is still unknown. The guideline of diagnosis and management of CP/CPPS based on evidence base medicine is not yet established. Many problems are still not resolved, such as the significance of leukocytes and the role of inflammation in CP/CPPS, the significance of bacteria presence and the role of infection in CP/CPPS, the correlation between leukocytes/bacteria and severity of symptoms, how to divide the subgroups of CP/CPPS, the role of antimicrobial therapy in the treatment of men with CP/CPPS, why patients with category IIIb complain of symptoms, while those with category IV complain of none. Although CP/CPPS is now achieving greater recognition, well-designed studies with large sample size should be performed.
Chronic Disease ; Humans ; Male ; Pelvic Pain ; etiology ; microbiology ; therapy ; Prostatitis ; etiology ; microbiology ; therapy

Lumbar disc herniation is a common male disease. In the past, More academic attention was directed to its relationship with lumbago and leg pain than to its association with andrological diseases. Studies show that central lumber intervertebral disc herniation may cause cauda equina injury and result in premature ejaculation, erectile dysfunction, chronic pelvic pain syndrome, priapism, and emission. This article presents an overview on the correlation between central lumbar intervertebral disc herniation and andrological diseases, focusing on the aspects of etiology, pathology, and clinical progress, hoping to invite more attention from andrological and osteological clinicians.
Chronic Pain ; etiology ; Erectile Dysfunction ; etiology ; Humans ; Intervertebral Disc Displacement ; complications ; Lumbar Vertebrae ; Male ; Pelvic Pain ; etiology ; Polyradiculopathy ; etiology ; Premature Ejaculation ; etiology ; Priapism ; etiology

Endometriosis (EMs) is a common gynecologic disease that affects women's physical and mental health seriously. The pathogenesis is still unknown and the mechanism of endometriosis-associated pain remains unclear. Mast cells (MC) are known to be multifunctional players in the immune system. Recent studies have shown that nerve fibers in EMs lesions can release neural peptides such as nerve growth factor and substance P to induce MC degranulating and releasing histamine, proteases, cytokines, chemokines etc., which contributes to the development of pain and hyperalgesia in patients with endometriosis.
Endometriosis ; complications ; metabolism ; pathology ; Female ; Humans ; Mast Cells ; metabolism ; Nerve Growth Factor ; metabolism ; Pelvic Pain ; etiology ; pathology

Objective: To investigate the role of mast cells in chronic prostatitis / chronic pelvic pain syndrome (CP/CPPS). METHODS: Forty-five male SD rats were equally randomized into a control, an experimental autoimmune prostatitis (EAP) model, and an intervention group. The EAP model was made in the latter two groups by subcutaneous injection of mixed suspension of complete Freund's adjuvant and prostate tissue, while the controls were treated subcutaneously with 0.9% sodium chloride. Tactile allodynia was quantified in the pelvic region of the control and EAP animals using Von-Frey filaments at 5, 10, 20, 30 and 40 days. After successful establishment of the EAP model, the rats of the intervention group were injected intraperitonieally with cromolyn sodium for 10 days, and meanwhile tactile allodynia was detected in the rats of the intervention and EAP model groups every other day. Then the prostates of the rats were harvested for HE and toluidine blue staining and measurement of the expression of mast cell tryptase by immunohistochemistry and Western blot. RESULTS: Von-Frey assessment showed a more severe pelvic pain in the EAP model than in the control rats, but milder in the intervention group than in the EAP models. HE staining revealed infiltration of lymphocytes and neutrophils in the prostate and congestion surrounding the gland in the EAP model rats, but none in the controls. However, both the infiltration and congestion were significantly alleviated in the intervention group. Toluidine blue staining shown that. Compared with the control group, the total count of mast cells and the number degranulated mast cells were markedly increased in the EAP models (P <0.01) but decreased in the intervention group (P <0.05). Both immunohistochemistry and Western blot manifested that the expression of tryptase in the mast cells was remarkably upregulated in the EAP (both P <0.01) but down-regulated in the intervention group (P <0.05 and P <0.01). CONCLUSIONS Both the total count of mast cells and the number of degranulated mast cells are significantly increased in the prostate of EAP rats. Mast cells are one of the most important mediators of type Ⅲ prostatitis-induced chronic pelvic pain, which can be used as a target for the intervention and treatment of type Ⅲ prostatitis.
Adjuvants, Immunologic ; Animals ; Autoimmune Diseases ; etiology ; pathology ; Cell Degranulation ; Chronic Disease ; Chronic Pain ; etiology ; Disease Models, Animal ; Freund's Adjuvant ; Male ; Mast Cells ; enzymology ; physiology ; Pelvic Pain ; etiology ; Prostatitis ; etiology ; pathology ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Tryptases ; metabolism

Lymphangioleiomyomatosis (LAM) is a rare disease usually occurring in young women of child-bearing age. It is characterized by a distinctive proliferation of lymphatic smooth muscle cells, especially occurring in the pulmonary parenchyme. The majority of primary LAM occurs in the lung, but there are a few reports of extrapulmonary cases. We report a case of a 21-yr-old female who first complained of low abdominal pain and was referred from a local clinic with the impression of an ovarian cyst. Gynecologic ultrasonography revealed a large posterior pelvic mass with an irregular echogenicity measuring 9.7x4.2 cm in size. Pelviscopy showed a large, thin walled, partly cystic, pelvic mass. The mass was partly removed. Microscopically, the mass was characterized by a haphazard proliferation of smooth muscle cells arranged in fascicular, trabecular, and papillary patterns around a ramifying network of endothelium-lined spaces. The cells were plump or epithelioid with abundant eosinophilic cytoplasm and showed a positive reaction for both alpha-smooth muscle actin and HMB-45 antigen. Surgical and pathological findings were consistent with pelvic retroperitoneal LAM. Despite the numerous treatment attempts, the patient suffered from intractable chylous ascites and developed pulmonary LAM and died due to severe respiratory distress.
Abdominal Pain/diagnosis/etiology ; Adult ; Diagnosis, Differential ; Female ; Humans ; Lung Neoplasms/complications/*diagnosis ; Lymphangioleiomyomatosis/complications/*diagnosis ; Pelvic Neoplasms/complications/*diagnosis ; Rare Diseases/complications/diagnosis