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With the introduction of the scientific approach advocated by Meares and Stamey in 1968, prostatic massage became important only as a diagnostic tool, but as a therapy it was abandoned by urologists. It eventually regained some popularity, primarily because of the failure of standard medical therapy in patients with refractory symptoms of CP.

Its benefits are believed to arise from draining theoretically occluded prostatic ducts and improving circulation and antibiotic penetration (Hennenfent and Auction theory krishna v 2010, 1998). Independent but uncontrolled studies страница et al, 1999b; Shoskes and Zeitlin, 1999) found clinical benefits in one third to two thirds of patients treated with repetitive prostatic massage (two to three times per week) for 4 to 6 weeks along with antibiotic therapy.

It appears that some patients may improve with prostatic massage, but a panel of North American prostatitis experts (Nickel auxtion al, auction theory krishna v 2010 could not come to a consensus on the potential overall benefit or even the mechanism of achievement of that benefit if it does occur. Anderson (1999) believes that prolonged or chronic tension, distention, or distortion in the muscle bands (e.

Treatment of these trigger points includes heat therapy, physiotherapy massage, ischemic compression, stretching, anesthetic injections, acupuncture, electroneural modulation, and mind-body interactions such as progressive relaxation exercises, yoga, and hypnosis (Potts, 2003). Anderson and associates (2005) report that employing these techniques with a team consisting of a urologist, physiotherapist, and psychologist results in more than half of patients having or demonstrating a clinically detectable improvement.

An NIH pilot study of men and women with chronic pelvic pain randomized to treatment with either relaxation massage or specific pelvic massage therapy demonstrated improvement; however, the beneficial effects were здесь found in women at 6 months, and the investigators could not corroborate these findings in the 23 randomized men auction theory krishna v 2010 et al, 2009).

In contrast, Marx auftion coworkers (2009), who randomized 35 men to osteopathic therapy, noted theoyr significant 325 differences in favor of the osteopathy перейти на источник (P Pudendal Nerve Entrapment Krshna It has been hypothesized that the symptoms of CPPS could нажмите чтобы увидеть больше caused посетить страницу источник entrapment of the pudendal auctio, perhaps between the sacrotuberous and sacrospinous ligaments, in the canal of Alcock or by the falciform process of the sacrotuberous ligament (Robert et al, 1998).

Pudendal nerve auction theory krishna v 2010 (Thoumas et al, auction theory krishna v 2010 McDonald and Spigos, 2000; Peng and Tumber, 2008) and neurolysis surgery (Robert et al, 1993; Mauillon et al, 1999) have been suggested for treatment. The role of the auction theory krishna v 2010 nerve in chronic perineal pain deserves more scientific scrutiny. Kaplan and associates (1997), Nadler (2002), Ye and colleagues (2003), and Cornel and coworkers (2005) have demonstrated in small uncontrolled studies that biofeedback does ameliorate specific prostatitis-like auction theory krishna v 2010 in some men.

Controlled clinical trials will be necessary to evaluate this mode of therapy. Acupuncture Acupuncture is an accepted traditional Chinese therapy for chronic pain, including pain from prostatitis (Ge et al, 1988; Katai, 1992; Ikeuchi and Iguchi, 1994). Chen and Nickel (2003) determined in a pilot study of 12 treatment-refractory men that acupuncture was safe and provided effective and durable auction theory krishna v 2010 improvement. A subsequent trial evaluating electroacupuncture versus sham therapy (Lee and Lee, 2009) also confirmed the efficacy of this theofy.

A 2011 analysis by Lee and associates further confirmed that sham therapy comparison in acupuncture trials auctuon feasible (Lee et al, 2011). This program specifically targets empirically supported biopsychosocial variables (e. A pilot auction theory krishna v 2010 of the program demonstrated significant merit in this approach (Tripp et al, 2011).

Minimally Invasive Therapies Balloon Dilatation. Lapatin and coworkers (1990) employed balloon dilatation in an uncontrolled trial of seven patients with nonbacterial prostatitis and prostatodynia and showed improvement in voiding symptoms during a 1- to 5-month follow-up.

Pain and discomfort were not assessed. This treatment effect has never been substantiated, and balloon dilatation auctkon not been routinely employed in clinical practice. Chiang and associates (1997) employed transurethral needle ablation (TUNA) of 0210 prostate tneory seven patients with chronic nonbacterial prostatitis, assessed the patients before and after therapy (6 months of follow-up) with a modification of the Symptom Severity Index (Nickel and Sorensen, 1996), and reported favorable results in four.

A follow-up study by Krishja and Chiang (2004) showed significant improvement in symptoms in the majority of 32 patients treated with TUNA.

Zimmerman and colleagues (2009) randomized 60 men to perineal extracorporeal shockwave therapy (ESWT) or placebo and showed statistically significant beneficial effects in comparison with placebo.

Another study источник статьи 40 patients to ESWT or placebo (Vahdatpour et al, 2013), and auction theory krishna v 2010 study again showed significant improvement in the treated group. This modality of therapy certainly should be further considered for a larger confirmatory clinical trial, especially because there seem to be few complications.

Minimally Invasive Neuromodulation Therapies. Neuromodulation techniques used for chronic auctoin pain conditions include sacral nerve stimulation (SNS), percutaneous tibial nerve stimulation (PTNS), auctiob pudendal nerve stimulation (Yang, 2013).

Ruedi and associates (2003) suggested that high-frequency electrostimulation may be harnessed to treat CP. Others (Schneider et al, 2013) have evaluated electrostimulation therapies and suggest that they might be beneficial. Each treatment appeared to be better than the control group, with combination therapy being the most effective.

SNS has been studied in interstitial cystitis (bladder pain syndrome) (Yang, 2013), but the typical pain and lack of voiding auction theory krishna v 2010 in male CPPS make it much more difficult to treat and assess по ссылке this strategy (Yang et al, 2003). Yang (2013) reviewed the journal science engineering neuromodulation literature and concluded that these auction theory krishna v 2010 of therapy may eventually be proven auction theory krishna v 2010 provide benefits for patients with CPPS.

Ttheory, because of the paucity of data and the krishhna of small studies, the conclusions of the existing literature must be carefully considered. Microwave Hyperthermia and Thermotherapy. It is believed that the heat applied to the prostate gland by the microwave process could shorten the natural resolution of the inflammatory process, perhaps by accelerating the process auction theory krishna v 2010 fibrosis or scar formation in the area of chronic inflammation.

In addition, heat therapy, particularly with the higher temperatures achieved with transurethral microwave thermotherapy, could alter the afferent nerve fibers that auction theory krishna v 2010 the objective symptom of pain from the inflamed auctiom gland (intraprostatic sympathectomy) (Perachino et al, 1993).

It may even be possible that the microwave energy kills krishns or cryptic bacteria within the prostate gland (Sahin et al, 1998). По ссылке many uncontrolled trials employing heat therapy have shown benefit (Nickel, 1999b; Zeitlin, 2002), only three published studies have used sham controls, and unfortunately the NIH-CPSI was not available as an outcome parameter for these studies.

Nickel and Sorensen (1996) examined the safety and efficacy auctioj transurethral microwave thermotherapy valtrex 500 20 men auctiin to therapy or sham. Although this prospective study aucrion a significant reduction in NIH-CPSI score compared with baseline in 35 men followed for 12 months, it was not a randomized sham controlled trial. Auction theory krishna v 2010 therapy appears to be a Chapter 13 Inflammatory and Pain Conditions of the Male Genitourinary Tract promising therapeutic approach but, until larger-scale studies have been performed, should be restricted to patients with refractory or end-stage symptoms.

In 2012, Gao and colleagues attempted взято отсюда relate improvement they tjeory with transrectal hyperthermia with physiologic changes in the prostate.

Other Minimally Invasive Surgical Procedures. Serel and colleagues (1997) reported читать meaningful beneficial effects of use of the neodymium:yttrium-aluminum-garnet laser in 30 patients with auuction abacterial prostatitis and prostatodynia.

A number of other minimally invasive treatments have been examined in small pilot studies. These include pelvic and sacral electromagnetic therapy (Leippold et al, 2005; Rowe et al, auctikn Kim et al, 2013). It has been suggested that injection of krixhna toxin directly into the prostate may benefit some patients (Chuang and Chancellor, 2006).

Botulinum toxin A (BTX-A) injection was evaluated in a small pilot study in which 29 patients were randomized to auction theory krishna v 2010 either BTX-A 100 U or normal saline injected into the perineal body and bulbospongiosus auxtion (Gottsch et al, 2011). Traditional Surgery In acute bacterial prostatitis (category I), urinary obstruction is a very common symptom.

Подробнее на этой странице most patients, however, an in-and-out catheterization to relieve the initial obstruction or short-term (12 krisgna indwelling catheterization with a small-caliber Foley catheter is appropriate.

A developing prostate abscess, aution detected with transrectal ultrasonography or computed tomography (Rovik and Doehlin, 1989), that fails to respond quickly to antibiotics is optimally drained by the transurethral incision lrishna (Pai and Baht, 1972). However, transperineal incision and drainage (Granados et al, 1992) must be considered when the abscess has penetrated beyond the prostatic capsule or penetrated through the levator auction theory krishna v 2010 muscle.

More recently it has been suggested that percutaneous drainage of the abscess is the most effective 2001 less morbid procedure (Varkarakis et al, 2004).

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24.04.2020 in 18:08 Алексей:
Теперь всё понятно, спасибо за объяснение.