Kronik prostatit/kronik pelvik ağrı sendromuna klinik yaklaşım: Literatür taraması

Prostatit; prostat bezinin enfekte olması ve ödemlenmesi olarak tanımlanır. Pelvik ağrı, rahatsızlık, işeme ve boşalma semptomları eşlik edebilir. Her yaş grubundan erkeği etkileyebilir ve hastaların yaşam kalitesi üzerinde önemli etkileri vardır. Ulusal Sağlık Enstitüleri’nin (National Institutes of Health) prostatit için oluşturduğu sınıflama sistemine göre dört gruba ayrılır. Bunlar; akut bakteriyel prostatit (grup 1), kronik bakteriyel prostatit (grup 2), kronik prostatit/kronik pelvik ağrı sendromu (inflamatuvar: grup 3A, non-inflamatuvar: grup 3B) ve asemptomatik prostatittir (grup 4). Prostatit benzeri şikayetleri olan hastaların >%90’ını kronik prostatit/kronik pelvik ağrı sendromu grubu oluşturur. Bu tanım heterojen bir hasta grubunu temsil eder ve bir dışlama tanısıdır. Tedavisinde antibiyotikler, anti-inflamatuvarlar, alfa blokerler, hormonal tedaviler, nöromodülatör tedaviler, bitkisel tedaviler, fizik tedaviler, akupunktur tedavileri gibi çok farklı tedavi çeşitleri uygulanmış ancak monoterapilerin yeterince etkinlik sağlamadığı gösterilmiştir. Hastalığın tedavisinde multimodal yaklaşım umut vadetmektedir.

Anahtar Kelimeler:

Prostatit, pelvik ağrı, tanı, tedavi

Clinical management of chronic prostatitis/chronic pelvic pain syndrome: Literature review

Prostatitis; it is defined as the infection and edema of the prostate gland. It may be accompanied by pelvic pain, discomfort, voiding and ejaculation dysfunction. It can affect men of all age groups and has a significant impact on patients' quality of life. It is divided into four groups according to the classification system established by the National Institutes of Health for prostatitis. These groups are; acute bacterial prostatitis (group 1), chronic bacterial prostatitis (group 2), chronic prostatitis/chronic pelvic pain syndrome (inflammatory: group 3A, non-inflammatory: group 3B) and asymptomatic prostatitis (group 4). Chronic prostatitis/chronic pelvic pain syndrome group constitutes >90% of all patients with prostatitis-like complaints. This definition represents a heterogeneous patient group and is an exclusion diagnosis. Many different types of treatment have been used for chronic prostatitis/chronic pelvic pain syndrome, such as antibiotics, anti-inflammatories, alpha blockers, hormonal treatments, neuromodulatory treatments, herbal treatments, physical therapies, acupuncture treatments. However, it has been shown that monotherapies are not effective enough. The multimodal approach to the treatment of the disease holds promise.

Keywords:

Prostatitis, pelvic pain, diagnose, treatment,

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