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Incont Pelvic Floor Dysfunct 2012; 6(3):69-73 Review!"#$% &'(C!"#$%&'()*+,!"#!!"#$%&'()*+,-./0E1F!"!"#$%E2F!"#$%!&'()*!"E3F!"#C!"#$%&'()*+,!"#$E4F!"!"#$%&'(!"#$%&!"'(Echronic prostatitisf!"#$%&'()!*+,-./01234567!"#$%&'(%)*+,-./0123*4567!"#$2008!"#$%&'()*+,-./0!"#$%&'()*+,-./5αe5α-reductase inhibitor, 5ARIF!"#$%&'()*+,-+./0 1!"# 8,224!x1z!"#$%&'( 9!"#$%&'()*+,-./015.4%!!"#$% 77.6%!"#$%&' 21.6%!!"#$%&'(!)*+,-./97.9% 1.9%!"#$% 0.2%!"#$%&'()!"#$%&'!()89%!"#10.7%! 0.3%!"#$%&'()*+,-./012345!"#$%&'()*+,"-."#$%/01234!"#$%&%'()*+,#-./01 23456!"#$%&'()*+,-./!"#$%&'()*+,%-./'0123*4!"#$%&'()*+,-./E!"#$%& International Prostate Symptom Score, IPSSF!"#$%&' IPSS! IPSS!"#$%&'"#$()*"#!"#$%&'()*+,-./0)123456!"#$%&'()IPSS!"#$%&'()'*!"E 1F!"#$%&'()*+,-./0123IPSS!"#$%&'()*+*,-./01234567!"#$IPSS!"#$%&'()*+,-./0!"#$%&'()*+,Ebody mass index, BMIF!"#!$%&'()*+',-./0123456"!"#$%&'()*+,-./012IPSS!"!"#$%&'()*+,-./0123456#78!"#$%&'()*!+,-./0123!+,4!"#$%&'()!"#$%&'()*+!"#$,-$./012!"#Kramer!"#$%&'()*+,-./!"#EcytokinesF!"Egrowth factorsf!"#!"#$%&'()*+(,-./0%12x2z!!"#$%&'()*+,-./0123456-7/!"#$%&'()*+,-./"0123456!"#$%&'()&*( +,-./0123+,(!"#$%&'()*+,-./012345678!"#$%&'()*+,-./0!12)34567 1K 8%9:;<=>?!"#$%&'()@*+,-./IPSS!"#$%&'(&)*+',-x1z Average acute inflammation Average chronic inflammation N Correlation coefficient N Correlation coefficient Total IPSS score 8151-0.001 0.91 8151 0.057 < 0.0001 Grouped IPSS score 8151-0.002 0.84 8151 0.053 < 0.0001 Irritative subscore 8037 0.002 0.84 8037 0.056 < 0.0001 Obstructive subscore 8014-0.009 0.42 8014 0.046 < 0.0001 Nocturia subscore 8109-0.002 0.87 8109 0.040 0.0003 IPSS=International Prostate Symptom Score!"#$%&'()*+,-./0/12321!"#$%&'(!" E-mail: chungshiudong@gmail.com SV

!"#$%&'()*+,-./01234%5678!"#$%&'(x3z Kramer!"#$%&'()*+,-./01!"#$%&'()*+,-./0)123456'!"#$%&&'()*+,E1F!"#$T!"#$%&'()*+,-!"(.$/T! IL-17 IFN-g IL-2 IL-4 IL-13 FGF-2!!"#$%&'( IL-6 IL-8 IL-15!"#$%!"#$%&'()*+,#-./-(01234!"#$%&'()*+,-#./01234 56% x2z!"#$%!&'()*+,-.!"#$%&'()*&'+,-./012echronic pelvic pain syndrome, CPPSF!"#$%&'()*+,!"#$%&'()*+,-./01234IL-8!"#$%Efibroblast growth factor 2, FGF-2F!"#!"#$%&'()*++,-./0123456IL- 10!"#$%&'()*+,-./012234+5!"#$%&'()*+,-./0123*45#$'!"#$E 2Fx4z!"#$%&'()*+,-./0123456,!"#$%&'()*+,-./0123#4567!"#$%&'()*+,-./01234567!"#$%&'()*+,-./0&1(234567!"#$$%&x5z Primary Injury Genetic predisposition low systemic IL-10 Tissue damage Cytokine PAIN IL8 NOXA WBC FGF2 growth factors Stroma Fibromuscular tissue growth Lumen 2K!"#$%!"&'()*+,-Echronic pelvic pain syndrome, CPPSF!"#$%&'()*+,!"#$%&'()*+,-./012IL-8!"#$%&Efibroblast growth factor 2, FGF-2F!"#$x4z!"#$%&'()*+,-./012+,345!"#$%&'()*%+,-./01'234567!"#$%&'()*+, -./0123456 IFN-γ IL-6 IL-8!"#$%&'()*+ IL-10!"#$"%&'()*+,-./0&'(12)34!"#$%&'()'*+,-./0123"4567!"#$%&'()*+,$-./01234E3Fx6z!"#`!"#$%&'()*+,-./!"#$%&'()*+,-.!"/01234!"#$%&'()*+,-./01234)567!"#$%&'()*+,-./0123'45678 Infection Foreign antigen Cellular injury Exposure to autoantigen Change in hormonal milieu Trauma (Duct rupture due to obstruction) Exaggerated/Misdirected Immune/Autoimmune pesponse Chronic inflammation Degree of prostatic growth Time 1K!"#$%&'()*+,&-./0123456789:+;<5=>?(@A3BCDEF6 0GH(I x2z TM

Mechanisms in Prostatitis/Chronic Pelvic Pain Syndrome Low testosterone: Local inflamation Autoimmune response Endocrine Altered androgen receptors Local inflammation: Inhibits testosterone synthesis Testosterone inhibits effects of NGF Immune response Imbalance of cytokines Proinflammatory: IFN-γ, IL-6, IL-8 (IL-10, TNF-α, IL-1β) Anti-inflammatory: IL-10 Autoimmune process Nervous system Neurogenic inflammation with NGF Low local levels of β-endorphin Reduced stress lowers IL-6, IL-10 levels Stress induced mast cell degranulation Psychological factors Stress Anxiety/Depression 3K!"#$%&'()*+,-./012+,3456789:;<=>?@ABCDE FGH%IJKLMNBCO!"#$%&'()*+,-./012 IFN-γ IL-6 IL-8!"#$%&'()*+ IL-10 x6z!"#$%&'(nhanes III!"C!ECreactive protein, CRPF!"#$%&'()*+,-./0!"#$%&x7z!"#$%&'()*+,-$.!"#$%&C!"#$%&'()*+,-&.!"#$% 0.32 mg/dl!" 3 4!"#$!"#0.35 mg/dlep=0.06f!"#$%&'()*(!"#$%&' C!"#$ 0.36 mg/dlep=0.06f!"#$%&'()*+,-./0123'4,%+,!"#$%&'()*+,-./0x8z!"#$%!"#$%&'()*+,'-./01"23456!"#$%&'()*+,-'./0"12,34c!"#$%&'(&)*+,-./012345678!"#$ %&x9z!"#$%&'()*+,-!"#$%&'(c!"#$%&'()*+,-!"#$%&'()*+,-"./0123456%7!"#$%&'()*+,-./01234567!"#$%&'()*+,-$./0!"#$ %&'()*+,-./012,-. Interleukin-8!"#$%&'()*+,-./0)!"#$%& '( IL-8!"#$x10z IL-8!"#$%&'()*$%&'(+,-./$%& 8!"#$IL-8!"#$%&'()*+,-./" x11z!"#$%&'()*+ IL-8!"#$%&' IL-8!"#$%&'()*+,-./01+,2345!"#$%&'()*+,-./0"12345678!"#$%&'()*+,-./0123,-./!"#$%&'() Silverio! Refecoxib=ECOX-2!"#$%F 5αFinasteride!"#$%!"#$%&'()"*+x12z!"#$COX-2 Finasteride!"#$ Finasteride!" 4!"#$%&'()*+COX-2!Finasteride!"#$%&'()*+,-./012 Finasteride!"#$%&'()*+,-./01!"#$%&'()COX-2!"#$%&'( EDoxazosinF!"#$%&'(x13z!"#$!"#$%COX-2!"#$%&' ()*+!"#$%&'()*+,-./012345Eoveractive bladder symptom score, OABSSFIPSS!IPSS!" 8 TN

!"#$%&'()*+,-.$/0.12)*+34!"#$%x14z!"#$%&'()*+,-./!"#$%&'(ENSAIDF!"#$%&'NSAID!"#$%&'()%*+,-./0123+4!"#$%&=> 30 ml!"#$%&'()=> 1.4 ng/ml!"#$%&'()*+,-./0123!"#$%&'()*"+,-./012345.60!"#$%&'!"#$% &'()*+,-./01!"#$%&'()*+",-./012345678!"#$%&'()*+,-!"./0123!"#$%&'()*+,-./"012*34"5!"#$%&'()*+,-%./0123"45%6!"#$%&'$%()*+#,-./01&()23!x15z!"#$%&'()*+,-./01&*.8!"#$%&'()*+,-./01#$-2%&'3!"#$%&'()!*+,-./(01234!*!"#$%&'()*'+,"-./(0123'4!"#$%&'()*+,-./0123!"#$!"#$%&'!%()*+,-./0120103 12!"#$ 40!"#$%&'()*+,-.-!"#$%&'()*+,-./0!1234 +,-!"#$%!"&'()*+,-./0123*+!"#$%&'()*+,!-.!Epost-void residual, PVRF!"#$%&'()*+,-./0Doxazosin 4 mg Tolterodine 4 mg12!21!"#$%&'102!"#$%&'()*+,!"#$(-./*01!"#$%&"#$'()*+,-./012345!"#$%&'()*+,-./0 123#45/)!"#$%&'()*+,-./012(345678!"#$%&'()*+,-!"#$%&'()*+,21!"#$%&'!"#$%&'()$*+,-."/0123"#$!"#$%&'()*+,-./0!"#1&23,4 E2F!"#$%&'()*!+,-./0(%12()!"#$%&'()*+,-./012345678!"#$%&'()*+,-./0"#$12345!"#$% &'()*+,-./012345678!"#$%&'()"#*+,$(-./012345!"#$%&'()*+,-./01234,5678!"#$%&'()*+,#-./ 012345#6!"#$%&'()*+,$-./012345!"#$%&'()*+,-./0123"456!"#$%& '()*+,-./01 234567!"#$%&'()*+,-./0123!/014!"#$%&'()*+,-./01 23456)!"#$%&'()*+,-./0)*+1/2(34!"#$%&'()*+,-./0"1234%567!"#$%!&'()*+,-.'!/0+123$%!"#$%&'()*+,!!"#$%&'()*+,-./012+345 2K!"#$%&'(")*+,-./01234&'(5*6708 Non-calculi (N=21) Calculi (N=102) PAIR (N=21) Mean (±SD) Mean (±SD) Before After Before After Before After IPSS 16.8±8.23 5.1±6.34 0.000 18.4±7.8 7.4±8.6 0.000 0.940 0.002 TPV 32.8±14.1 35.2±20.4 0.592 40.1±22.4 37.4±21.9 0.053 0.941 0.677 PSA 2.1±1.9 2.7±2.9 0.183 6.2±2.5 2.1±2.3 0.020 0.417 0.551 Volume 286.2±183.9 367.3±191.4 0.023 225.3±144.8 253.3±167.7 0.085 0.613 0.019 Qmax 12.4±5.1 14.6±3.2 0.065 12.6±7.5 14.6±7.4 0.022 0.381 0.837 PVR 41.6±28.6 91.0±72.7 0.570 80.2±104.8 64.2±99.4 0.180 0.255 0.028 IPSS= International Prostate Symptom Score; TPV= total prostatic volume; PSA= prostatic specific antigen; Qmax= maximum flow rate; PVR= post-void residual TO

!"#$%&'()*+,-./0123&45678!"#$%&'()*+,%-./012345678!"#$%&'()*+,-./012()*+345!"#$%&'()*+,-./01'2345*67 C!"#$%&'()*+,-./&'0123456/!"C!"#$%&'()C!"#$%&! C!"#$%&'()*+!"#$%&'()*+,-#./01%&'(5α!"#$%&'()*+,-./012345!"#C!"#$%&'()*+,-./C!"#$%&'() *+,-./01234567-!C!"#$%&'()*+,-./01234!"#$%&!"#'%()*+,C!"!"#$%&'()*+,-"./0123456!! 1. Nickel JC, Roehrborn CG, O'Leary MP, Bostwick DG, Somerville MC, Rittmaster RS: The relationship between prostate inflammation and lower urinary tract symptoms: Examination of baseline data from the REDUCE trial. Eur Urol 2008; 54:1379-1384. 2. Kramer G, Mitteregger D, Marberger M: Is benign prostatic hyperplasia (BPH) an immune inflammatory disease? Eur Urol 2007; 51: 1202-1216. 3. De Marzo AM, Platz EA, Sutcliffe S, et al: Inflammation in prostate carcinogenesis. Nat Rev Cancer 2007; 7:256-269. 4. Dellabella M, Milanese G, Sigala S, et al: The role of the prostatic stroma in chronic prostatitis/chronic pelvic pain syndrome. Inflamm Res 2009; 58:829-836. 5. Rudick CN, Berry RE, Johnson JR, et al: Uropathogenic Escherichia coli induces chronic pelvic pain. Infect Immun 2011; 79:628-635. 6. Pontari MA, Ruggieri MR: Mechanisms in prostatitis/chronic pelvic pain syndrome. J Urol 2008; 179(5 Suppl):S61-S67. 7. Rohrmann S, De Marzo AM, Smit E, Giovannucci E, Platz EA: Serum C-reactive protein concentration and lower urinary tract symptoms in older men in the Third National Health and Nutrition Examination Survey (NHANES III). Prostate 2005; 62:27-33. 8. St Sauver JL, Sarma AV, Jacobson DJ, et al: Associations between C-reactive protein and benign prostatic hyperplasia/lower urinary tract symptom outcomes in a population-based cohort. Am J Epidemiol 2009; 169:1281-1290. 9. Liao CH, Chung SD, Kuo HC: Serum C-reactive protein levels are associated with residual urgency symptoms in patients with benign prostatic hyperplasia after medical treatment. Urology 2011; 78: 1373-1378. 10. Liu L, Li Q, Han P, et al: Evaluation of interleukin-8 in expressed prostatic secretion as a reliable biomarker of inflammation in benign prostatic hyperplasia. Urology 2009; 74:340-344. 11. Penna G, Mondaini N, Amuchastegui S, et al: Seminal plasma cytokines and chemokines in prostate inflammation: Interleukin 8 as a predictive biomarker in chronic prostatitis/chronic pelvic pain syndrome and benign prostatic hyperplasia. Eur Urol 2007; 51:524-533. 12. Di Silverio F, Bosman C, Salvatori M, et al: Combination therapy with rofecoxib and finasteride in the treatment of men with lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia (BPH). Eur Urol 2005; 47:72-79. 13. Ozdemir I, Bozkurt O, Demir O, Aslan G, Esen AA: Combination therapy with doxazosin and tenoxicam for the management of lower urinary tract symptoms. Urology 2009; 74:431-435. 14. St Sauver JL, Jacobson DJ, McGree ME, Lieber MM, Jacobsen SJ: Protective association between nonsteroidal antiinflammatory drug use and measures of benign prostatic hyperplasia. Am J Epidemiol 2006; 164:760-768. 15. Kim WB, Doo SW, Yang WJ, Song YS: Influence of prostatic calculi on lower urinary tract symptoms in middle-aged men. Urology 2011; 78:447-449. TP