The paper introduces Professor FANG Yigong 's experience in treating pelvic congestion syndrome with acupuncture. Professor FANG believes that the stagnation in the thoroughfare and conception vessels, retarded circulation of qi and blood, and the obstruction of blood flow in the uterus are implicated in the pathogenesis of pelvic congestion syndrome. In clinical practice, according to the pathogenesis, focusing on regulating the functions of the thoroughfare and conception vessels, the thinking of treatment is summarized as "resolving the stasis and stopping pain by regulating the thoroughfare and conception vessels", "selecting the points based on their indications" and "tranquilizing the mind and harmonizing the physical and mental states". The main points are Baihui (GV20), Shenting (GV24), Benshen (GB13), Zhongwan (CV12), Tianshu (ST25), Guanyuan (CV4), Dahe (KI12), and Zigong (EX-CA1). The supplementary points are used in terms of the etiology and symptoms. During acupuncture, attention should be paid to the application of Xiaoyao Tiaoshen technique of acupuncture and mutual harmonization of the mind in acupuncture operator and patient. This summary may provide a new approach to the treatment of pelvic congestion syndrome.
Female ; Humans ; Acupuncture Points ; Acupuncture Therapy ; History, 21st Century ; Pelvic Pain/therapy* ; Pelvis/pathology*

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a complex disease that is often accompanied by mental health disorders. However, the potential mechanisms underlying the heterogeneous clinical presentation of CP/CPPS remain uncertain. This study analyzed widely targeted metabolomic data of expressed prostatic secretions (EPS) and plasma to reveal the underlying pathological mechanisms of CP/CPPS. A total of 24 CP/CPPS patients from The Second Nanning People's Hospital (Nanning, China), and 35 asymptomatic control individuals from First Affiliated Hospital of Guangxi Medical University (Nanning, China) were enrolled. The indicators related to CP/CPPS and psychiatric symptoms were recorded. Differential analysis, coexpression network analysis, and correlation analysis were performed to identify metabolites that were specifically altered in patients and associated with various phenotypes of CP/CPPS. The crucial links between EPS and plasma were further investigated. The metabolomic data of EPS from CP/CPPS patients were significantly different from those from control individuals. Pathway analysis revealed dysregulation of amino acid metabolism, lipid metabolism, and the citrate cycle in EPS. The tryptophan metabolic pathway was found to be the most significantly altered pathway associated with distinct CP/CPPS phenotypes. Moreover, the dysregulation of tryptophan and tyrosine metabolism and elevation of oxidative stress-related metabolites in plasma were found to effectively elucidate the development of depression in CP/CPPS. Overall, metabolomic alterations in the EPS and plasma of patients were primarily associated with oxidative damage, energy metabolism abnormalities, neurological impairment, and immune dysregulation. These alterations may be associated with chronic pain, voiding symptoms, reduced fertility, and depression in CP/CPPS. This study provides a local-global perspective for understanding the pathological mechanisms of CP/CPPS and offers potential diagnostic and therapeutic targets.
Humans ; Male ; Prostatitis/blood* ; Adult ; Pelvic Pain/blood* ; Metabolomics ; Prostate/metabolism* ; Middle Aged ; Chronic Pain/blood* ; Metabolome ; Case-Control Studies ; Tryptophan/blood* ; Depression/blood* ; Oxidative Stress/physiology* ; Chronic Disease ; Lipid Metabolism/physiology*

Male ; Humans ; Genital Diseases, Male ; Scrotum ; Cysts ; Pelvic Pain ; Retrospective Studies

This study aimed to investigate the impact of the coronavirus disease 2019 (COVID-19) pandemic on erectile function in Chinese patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). A retrospective study was conducted on 657 CP/CPPS patients who visited The Third Xiangya Hospital of Central South University (Changsha, China) from November 2018 to November 2022. Patients were divided into two groups based on the timeline before and after the COVID-19 outbreak in China. The severity of CP/CPPS, penile erection status, anxiety, and depression was evaluated using the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI), International Index of Erectile Function-5 (IIEF-5), Generalized Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-9 (PHQ-9) scales, respectively. Compared with patients before the COVID-19 outbreak, more CP/CPPS patients developed severe erectile dysfunction (ED) due to depression and anxiety caused by the pandemic. After developing moderate-to-severe ED, mild and moderate-to-severe CP/CPPS patients exhibited more apparent symptoms of anxiety and depression ( P < 0.001 and P = 0.001, respectively), forming a vicious cycle. The COVID-19 pandemic has adversely affected the psychological status of CP/CPPS patients, exacerbating their clinical symptoms and complicating ED. The exacerbation of clinical symptoms further worsens the anxiety and depression status of patients, forming a vicious cycle. During the COVID-19 pandemic, paying more attention to the mental health of CP/CPPS patients, strengthening psychological interventions, and achieving better treatment outcomes are necessary.
Male ; Humans ; Erectile Dysfunction/etiology* ; Pandemics ; Penile Erection ; Prostatitis/complications* ; Retrospective Studies ; East Asian People ; COVID-19/complications* ; Chronic Disease ; Pelvic Pain/complications*

Objective: To determine the impact of endometriosis on the quality of life, risk of anxiety and depression among Filipino women in a tertiary hospital. Methods: A cross-sectional study was conducted among 210 patients aged 18-50 diagnosed clinically and sonographically with pelvic endometriosis. Verbal and written consent were secured. Descriptive statistical analysis was used to describe the baseline characteristics of the population. Short Form McGill Pain Questionnaire (SF-MPQ) was used to assess the degree of pain symptoms of the patients. WHO Quality of Life Tool (WHOQOL-BREF), Hamilton Anxiety Scale (HAM-A) and Hamilton Depression Scale (HAM-D) in Filipino version were used to evaluate the quality of life, anxiety and depression of the respondents. Series of paired t-tests were performed to determine the differences in the average outcomes (i.e. level of depression, anxiety, quality of life and subscales, pain scores and types of pain). McNemar’s chi-square test was utilized to determine the differences in the frequency of mild to severe anxiety and depression before and after treatment. Spearman’s rho rank correlation was performed to determine the relationship of the level of pain to the outcome measures. One-way analysis of variance was performed to determine differences in the current mean levels of depression, anxiety, quality of life and its subscales across disease conditions (i.e. endometriosis alone, myoma uteri, adenomyosis, other gynecologic conditions, infertility). The level of significance was set at a p-value < 0.05 using two-tailed comparison. Results: The most common symptoms reported were the presence of dysmenorrhea (90.95%) and pelvic pain (88.57%), which were both rated at pain scale 8/10. Majority (73.8%) of patients have some form of depression (mild-28.57%, moderate-27.13%, severe-13.33%, very severe-4.76%) with an average level of depression at 12.39 ± 6.5. Majority (54.76%) of patients likewise have some form of anxiety (mild-15.24%, moderate-20.95%, severe-18.57%) with an average level of anxiety at 15.44 ± 10.38. Depression and anxiety scores significantly decreased after medical treatment. In terms of overall quality of life and perceived level of health, respondents demonstrated an average score of 3.25 ± 0.91 and 2.86 ± 0.96, respectively. These post-treatment scores showed significant improvement from baseline. The sub-domains (i.e. physical, psychological, social and environmental) also have relatively high scores ranging from 13.44 ± 2.39 to 15.60 ± 2.63. These are indicative of very satisfactory quality of life.Other gynecologic conditions, such as infertility, myoma uteri, and adenomyosis, do not contribute significantly to the outcomes measured. Conclusion Pelvic endometriosis is a chronic, life-long, inflammatory disease that presents mainly as pelvic pain. This debilitating pain can significantly affect patients’ psychological well-being and mental health, which is manifested by the very high incidence of anxiety and depression among Filipino women with endometriosis. Management of endometriosis is complex, hence a multi-disciplinary approach that includes psychiatric counseling may be necessary.
Anxiety ; Depression ; Pelvic Pain ; Quality of Life

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

OBJECTIVE: To observe the clinical therapeutic effect of CO₂ laser moxibustion on endometriosis related pelvic pain of cold coagulation and blood stasis. METHODS: A total of 76 patients with endometriosis related pelvic pain of cold coagulation and blood stasis were randomized into a laser moxibustion group and a sham laser moxibustion group, 38 cases in each group. In the laser moxibustion group, moxibustion was applied at bilateral Zigong (EX-CA 1) using CO₂ laser moxibustion instrument. In the sham laser moxibustion group, the manipulation of moxibustion was same as the laser moxibustion group, without laser output. The treatment was given once every other day, 30 min each time, 3 times a week for 4 weeks in both groups. Before and after treatment and follow-up of 3 months after treatment, the scores of Gracely box scale (GBS) and visual analogue scale (VAS) were observed, the usage of non-steroidal anti-inflammatory drug for the duration of the treatment and the average days of taking drugs were recorded in both groups. RESULTS: Compared before treatment, the GBS and VAS scores were decreased after treatment and during follow-up in the laser moxibustion group (P<0.05), while those in the sham moxibustion group had no significant differences (P>0.05). Compared with the sham moxibustion group, the GBS and VAS scores were decreased after treatment and during follow-up (P<0.05), the cases and average days of taking drugs were less in the laser moxibustion group (P<0.05). CONCLUSION CO₂ laser moxibustion can improve the pain symptom in patients with endometriosis related pelvic pain of cold coagulation and blood stasis, and reduce the use of analgesic drugs.
Acupuncture Points ; Carbon Dioxide ; Endometriosis/complications* ; Female ; Humans ; Moxibustion ; Pelvic Pain/therapy* ; Treatment Outcome

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

We investigated the therapeutic effects of superoxide dismutase (SOD) from thermophilic bacterium HB27 on chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and its underlying mechanisms. A Sprague-Dawley rat model of CP/CPPS was prepared and then administered saline or Thermus thermophilic (Tt)-SOD intragastrically for 4 weeks. Prostate inflammation and fibrosis were analyzed by hematoxylin and eosin staining, and Masson staining. Alanine transaminase (ALT), aspartate transaminase (AST), serum creatinine (CR), and blood urea nitrogen (BUN) levels were assayed for all animals. Enzyme-linked immunosorbent assays (ELISA) were performed to analyze serum cytokine concentrations and tissue levels of malondialdehyde, nitric oxide, SOD, catalase, and glutathione peroxidase. Reactive oxygen species levels were detected using dichlorofluorescein diacetate. The messenger ribonucleic acid (mRNA) expression of tissue cytokines was analyzed by reverse transcription polymerase chain reaction (RT-PCR), and infiltrating inflammatory cells were examined using immunohistochemistry. Nuclear factor-κB (NF-κB) P65, P38, and inhibitor of nuclear factor-κBα (I-κBα) protein levels were determined using western blot. Tt-SOD significantly improved histopathological changes in CP/CPPS, reduced inflammatory cell infiltration and fibrosis, increased pain threshold, and reduced the prostate index. Tt-SOD treatment showed no significant effect on ALT, AST, CR, or BUN levels. Furthermore, Tt-SOD reduced inflammatory cytokine expression in prostate tissue and increased antioxidant capacity. This anti-inflammatory activity correlated with decreases in the abundance of cluster of differentiation 3 (CD3), cluster of differentiation 45 (CD45), and macrophage inflammatory protein 1α (MIP1α) cells. Tt-SOD alleviated inflammation and oxidative stress by reducing NF-κB P65 and P38 protein levels and increasing I-κBα protein levels. These findings support Tt-SOD as a potential drug for CP/CPPS.
Animals ; Chronic Pain ; Cytokines/metabolism* ; Fibrosis ; Humans ; Inflammation/metabolism* ; Male ; NF-kappa B/metabolism* ; Pelvic Pain/pathology* ; Prostatitis/metabolism* ; Rats ; Rats, Sprague-Dawley ; Superoxide Dismutase ; Syndrome

General recommendations regarding surgical techniques are not always appropriate for all Peyronie's disease (PD) patients. Therefore, the purpose of this study was to investigate the effects of plication procedures in PD patients with severe penile curvature and the effects of early surgical correction in patients who no longer have progressive deformities. The clinical data from 72 patients who underwent plication procedures were analyzed in this study. Patients were divided into Groups A and B according to the curvature severity (≤60° or >60°) and Groups 1 and 2 according to the duration of disease stabilization (≥3 months or <3 months). At the 1-year follow-up, 90.0% (36/40) and 90.6% (29/32) patients reported complete penile straightening, and 60.0% (24/40) and 100.0% (32/32) patients reported penile shortening in Groups A and B, respectively. No curvature recurrence occurred in any patient, and no significant differences were observed in postoperative International Index of Erectile Function-Erectile Function domain (IIEF-EF), erectile pain, sensitivity, or suture knots on the penis whether such outcomes were grouped according to the curvature severity or the duration of stabilization. However, the duration from symptom onset to surgical management in Group 1 was significantly longer than that in Group 2 (mean ± standard deviation [s.d.]: 20.9 ± 2.0 months and 14.3 ± 1.2 months, respectively, P < 0.001). The present study showed that the plication procedures seemed to be an effective choice for the surgical treatment of PD patients with severe penile curvature. In addition, the early surgical treatment seemed to benefit those patients who already had no erectile pain and no longer exhibited progressive deformity.
Erectile Dysfunction/surgery* ; Humans ; Male ; Patient Satisfaction ; Pelvic Pain ; Penile Induration/surgery* ; Penis/surgery* ; Retrospective Studies ; Treatment Outcome