Objective: To analyze the clinical features and spinal lesions related to micturitionin of chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS) patients. Methods: Patients with CP/CPPS were enrolled to this study at the outpatient department of Tongji Hospital between January and June 2019. The data of clinical features was collected and analyzed, including lower urinary tract symptoms(LUTS), bowel syndrome and pain over different parts of body, as well as lower urinary tract dysfunction, spinal lesions and pelvic organ morphological changes demonstrated by MRI. The potential role of spinal lesions in the development of CP/CPPS syndrome was investigated. Results: A total of 126 CP/CPPS patients were included, with an age［M（Q1，Q3）］of 41(31,53) years and a course of disease of 2(1,20) years. Among them, 126 (100.0%) were complicated with LUTS, 72(57.1%) with bowel dysfunction and 88(69.8%) with pain. MRI showed the cervical central disc herniation(126 cases, 100.0%), the ischemic changing in the cervical area of visceral efferant pathway(82 cases, 65.1%), the lumbar central disc herniation(65 cases, 51.6%), and the sacral nerve cysts(97 cases, 77.0%) are commonly seen. In addition, the morphological changes in the visceral organs containing smooth muscle were demonstrated, including thickened bladder wall(91 cases, 72.2%), distended seminal vesicles(70 cases, 55.6%) and distended sigmoid colon/rectum(59 cases, 46.8%). Conclusions: CP/CPPS patients were characterized by the co-existence of LUTS, bowel dysfunction and somatic pain in one individual. The presence of multi-organ symptoms, combined with the high prevalence of spinal lesions associated with micturition reflex, suggesting the potential role of the spinal lesions in the development of CP/CPPS.
目的： 分析慢性前列腺炎/慢性盆腔疼痛综合征（CP/CPPS）患者的临床表现、下尿路功能障碍及排尿相关的脊髓神经通路病变特点。 方法： 纳入2019年1至6月在华中科技大学同济医学院附属同济医院泌尿外科就诊的CP/CPPS患者，描述患者下尿路、下消化道和躯体疼痛症状、尿动力学指标及用MRI评估脊髓神经病变和盆腔脏器的形态改变，分析脊髓神经通路病变与下尿路功能障碍、下消化道功能障碍和疼痛的关系。 结果： 共纳入患者126例，年龄［M（Q1，Q3）］为41（31，53）岁，病程2（1，20）年。患者存在下尿路功能障碍症状126例（100.0%），下消化道症状72例（57.1%），合并复杂多变的躯体疼痛症状88例（69.8%）。MRI显示，颈椎椎间盘中央型突出（126例，100.0%）常伴随脊髓内脏传出神经通路区域的缺血性改变（82例，65.1%），腰椎椎间盘中央型突出（65例，51.6%），骶神经根囊肿（97例，77.0%），以及盆腔内含平滑肌脏器的形态改变如膀胱壁增厚（91例，72.2%）、精囊扩张（70例，55.6%）、乙状结肠/直肠异常扩张（59例，46.8%）等。 结论： CP/CPPS患者具有下尿路症状、下消化道症状和躯体疼痛共存的特点。多个系统功能障碍共存，结合排尿相关的脊髓神经通路病变高发等特点，提示脊髓神经通路病变在其发病中可能具有重要作用。.
Zhonghua yi xue za zhi. 2022 Mar 29 [Epub]
X Y Wu, Y Zhang, X Y Tang, Y Cheng, J Chen, L N Li, S F Xu, Q Ling, L Wang, C X Liu, W M Yang, G H Du
Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China., Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China., Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.