ACUPUNCTURE MAY BE PROSTATITIS ANSWER
Anonymous User
ACUPUNCTURE MAY BE PROSTATITIS ANSWER
New trend is to think of condition as
neuropathic pain syndrome
By Andrew Skelly
ORLANDO, FLA. - Acupuncture may offer hope to chronic prostatitis patients.
The study, conducted by two Canadian urologists, is part of a new trend
toward regarding the condition as a neuropathic pain syndrome rather than a
consequence of prostate infection.
Chronic nonbacterial prostatitis -- also known as chronic pelvic pain
syndrome (CPPS) -- is a common but stubborn condition that frustrates
physicians and patients alike, said study co-author Dr. Curtis Nickel,
professor of urology and director of the Prostatitis Clinical Research
Centre at Queen's University in Kingston, Ont.
"For most other things, especially in urology, we are reasonably successful
in the majority of patients. Not in prostatitis," he said in an interview at
the AUA meeting. "We do well if we get a 40% to 50% reduction in symptoms."
The researchers aren't even sure what causes CPPS, or how to evaluate it. In
another study, for example, Dr. Nickel and colleagues showed there were no
clinically useful differences in leukocyte counts or bacterial cultures in
urine, expressed prostatic secretion or semen in men with prostatitis
compared with controls.
"We are questioning now whether the standard evaluation -- very
uncomfortable and expensive and cumbersome -- of looking at
prostate-specific specimens after prostate massage is really indicated in
clinical practice," Dr. Nickel said.
Instead, the latest thinking on CPPS is that although the problem may
originate in the prostate, over the long-term it is a neurogenically
mediated condition.
"Patients have neuropathic pain which is reflected in voiding and sexual
disturbances and musculoskeletal pain. And that's why instead of using
prostate-centric treatment, we should probably be using something a little
more broad (such as acupuncture)."
He first observed the use of acupuncture in prostatitis patients on a
lecture tour of China and was later approached by Dr. Richard Chen, a
urologist and certified acupuncturist in Mississauga, Ont., who said he'd
had some success with the technique.
Dr. Nickel tested that claim by sending him some of his most difficult
patients, men who had failed antibiotics, alpha-blockers,
anti-inflammatories and phytotherapy.
"I was more than pleasantly surprised. I was amazed at the results we got,"
he said. "My experience with acupuncture turned me from a skeptic to almost
a believer."
But to confirm the results, researchers must conduct a randomized,
multicentre trial using a standardized acupuncture technique and a sham
acupuncture procedure.
The pilot study involved just 12 men (age 31 to 57 years). Treatment
involved three sets of acupuncture points (a total of 30, eight of them
electrically stimulated) and was given twice weekly for six weeks.
At six and 12 weeks following treatment, 11 patients had a greater than 50%
decrease in the U.S. National Institutes of Health chronic prostatitis
symptom index, and 10 patients perceived at least a 75% improvement in
subjective symptoms from baseline.
Those initial improvements have held up over 24 to 52 weeks of followup.
Researchers are also looking at other ways of treating CPPS as a neuropathic
pain syndrome. They are, for example, testing thermal therapy and
electrostimulation, and are continuing to search for effective drug
therapies.
A large trial is underway comparing tamsulosin (Flomax) plus ciprofloxacin
(Cipro) to placebo, Dr. Nickel said, "because those are the two standard
treatments almost everybody gets treated with in North America . . . and
there's never been a clinical trial comparing them to placebo."
At the meeting, he also presented a small randomized, placebo-controlled
trial of finasteride (Proscar) that showed a trend toward improved symptoms
versus placebo. Subgroups of patients, including older men or those with
larger prostates, might benefit more, he said.
Another multicentre trial showed pentosan polysulfate (Elmiron) produced
modest but statistically significant improvements in quality of life and
symptoms. The glycosaminoglycan substitute is approved for interstitial
cystitis, which Dr. Nickel said is similar to CPPS.
Dr. Nickel, whose clinic is supported by the U.S. National Institutes of
Health, said treatment of CPPS -- a time-consuming condition not amenable to
surgery -- is not adequately remunerated by medicare.
"Physicians don't encourage prostatitis patients to come back," he said.
On top of that, there is a stigma associated with the condition, perhaps due
in part to a misperception it's a sexually transmitted disease.
While prostate cancer and erectile dysfunction have prominent spokesmen, Dr.
Nickel said no one has volunteered to champion the cause of prostatitis
patients, despite the fact many politicians (and in one survey, 14% of
health-care professionals) suffer from the condition.
"We always ask, would you mind being like the Guy Lafleur of Viagra for us
in prostatitis?
"But none of the politicians we treat are willing to even let out a
whisper -- not a whisper -- that they've been down to our treatment clinic."
Anonymous User
> . . . .. there is a stigma associated with the
> condition, perhaps due in part to a
> misperception it's a sexually transmitted
> disease. "But none of the politicians we treat
> are willing to even let out a whisper -- not a
> whisper -- that they've been down to our
> treatment clinic."
NOW maybe the 20-watt lightbulbs in this group will understand why I have so
assiduously and persistently (for how many years now?) attacked those who
would portray this syndrome as a SEXUALLY TRANSMITTED DISEASE, which it so
clearly is not. When I arrived on this newsgroup all anyone talked about,
just about, was bugs and sex and female-vectored infections. There was an
evil, very evil, doctor here called Antonio Feliciano, who ruthlessly and
heartlessly posted here *every day* claiming that he could cure CP/CPPS
patients with a mere 14 days of antibiotic treatment. He grew rich on the
ill-gotten gains, living in a huge house in Manila, and driving several
Mercedes Benzes, including the newest, largest 600-series model. I GOT RID
OF HIM!
And I'm DAMNED proud of it too!
-------
I read http://www.chronicprostatitis.com/wwwboard
Jim
Anonymous User wrote:
I have one word for you and that is TROLL.
Anonymous User
>
> I have one word for you and that is TROLL.
>
Why should I? I'll leave the trolling to you. You're so good at it. So
keeping on trollin'.
Derek
"Anonymous User" wrote......
> "Anonymous User" quoted:
>
> > . . . .. there is a stigma associated with the
> > condition, perhaps due in part to a
> > misperception it's a sexually transmitted
> > disease. "But none of the politicians we treat
> > are willing to even let out a whisper -- not a
> > whisper -- that they've been down to our
> > treatment clinic."
>
> NOW maybe the 20-watt lightbulbs in this group will understand why I have
so
> assiduously and persistently (for how many years now?) attacked those who
> would portray this syndrome as a SEXUALLY TRANSMITTED DISEASE, which it so
> clearly is not. When I arrived on this newsgroup all anyone talked about,
> just about, was bugs and sex and female-vectored infections.
I don't fully agree with all that, as I feel there is a bacterial entity
with certain individuals, but I do agree that the stigma associated with
this condition, namely the misperception it's a sexually transmitted disease
must be changed in order for well known people in society to step forward
and raise awareness. For example, people must know that many men have been
married for years or have have been in an exclusive monogomous relationship
and come down with this. We've heard reports from doctors that virgins have
been afflicted as well. We really do need a spokesman leading the way and
getting this message to the masses without the stereotypical perception of
the past. I suspect one of the reasons no one has stepped forward is that
they are hesitant to discuss the symptoms associated with the CP/CPPS, which
can be of a very personal nature. Interestingly though, if we look at AIDS
and the stigma attached to that disease....it really hasn't stopped the rich
and famous from coming forward to lobby for their funds. Maybe it's because
in time, that disease is a little more hard to hide and the outcome is
almost inevitable so speaking up may not be a choice in all cases.
Nonetheless, the suffering and pain resulting from CP/CPPS could most
definitely be compared with some of the most terrible afflictions and I am
amazed that no one recognizable has yet shown the fortitude to get that
message out to the public.