Cold associated with CPPS

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Scand J Urol Nephrol. 2007 May 9;:1-6 [Epub ahead of print]

Chronic abacterial prostatitis and cold exposure.
Hedelin H, Jonsson K.
Centre for Research and Development and Department of Urology, Kärnsjukhuset, Skövde, Sweden.


Objective. Chronic abacterial prostatitis/pelvic pain syndrome (CP/CPPS) is characterized by pain, voiding and sexual dysfunction persisting for > 3 months. The symptoms tend to occur in relapses of varying length. To evaluate what causes a relapse and what precautions patients with CP/CPPS undertake to avoid a relapse and/or aggravation of symptoms, individual semi-structured interviews were performed.

Material and methods. Information was obtained from semi-structured in-depth interviews with 10 selected men with CP/CPPS (mean age 44 years; 30-62 years). The interviews were transcribed and analysed according to Girorgi's phenomenological method as modified by Malterud.

Results. CP/CPPS tended to start in connection with a specific event involving cold exposure, suggesting cold as an initiating stimulus for CP/CPPS. The informants also reported that cold exposure caused aggravation of symptoms and provoked their relapse. Sitting on cold objects, spending time in cold, damp or windy surroundings and walking on a cold floor were provocative and thus were avoided. The exposure did not have to be either prolonged or intense. Heat applied to the perineum, as well as spending time in a warmer climate, gave relief from symptoms.

Conclusions. It appears that cold is one of the factors that can trigger a process resulting in CP/CPPS. The fact that cold also causes aggravation of symptoms and can initiate a relapse was evident, as was the fact that symptoms could be relieved by heat. The connection between cold and symptom aggravation is well known among clinicians but has not previously been studied in a systematic way. The fact that cold, in a susceptible man, can initiate a process resulting in CP/CPSS has not been reported before. Studies aimed at elucidating the mechanisms behind this phenomenon are warranted. Reflex vasoconstriction in a susceptible individual is a possible cause.

PMID: 17853032 [PubMed - as supplied by publisher]

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Scand J Urol Nephrol. 2007 Jun 21;:1-5 [Epub ahead of print]

Chronic prostatitis/chronic pelvic pain syndrome: Symptoms are aggravated by cold and become less distressing with age and time.
Hedelin H, Jonsson K.
Research and Development Centre and the Department of Urology, Kärnsjukhuset, Skövde, Sweden.

Objectives. To evaluate how age and the duration of the condition influence the distress caused by the chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and to study how heat and cold influence the symptoms associated with CP/CPPS as reported by patients afflicted with the condition.

Material and methods. Forty-eight men (median age 50 years; age range 27-70 years) who had suffered from CP/CPPS for a duration ranging from 18 months to 40 years were included in the study. The evaluation included determination of the serum prostate-specific antigen level, the National Institutes of Health's Chronic Prostatitis Symptom Index (NIH-CPSI) and the International Prostate Symptom Score (IPSS).

Results. The mean NIH-CPSI score was 23.0+/-4.8. The mean IPSS was 14.3+/-7.2. Dysuria was reported by 30 men (63%) and ejaculatory pain by 22 (48%). Men with dysuria had painful ejaculations more often (60%) than men without (22%) (p<0.01). There was a strong negative correlation between age and the NIH-CPSI quality of life (QOL) score (correlation coefficient -0.646; p<0.001). Independent of age, the duration of the disease also correlated with the NIH-CPSI QOL score (correlation coefficient -0.48; p<0.02). The total NIH-CPSI score did not correlate with either age or the duration of the disease. Nearly every other man stated that the disease had started in association with a specific event, which for 15 men (31%) included exposure to cold. Forty men (83%) reported that cold caused symptom aggravation and/or induced a relapse. Thirty men (63%) stated that taking a hot bath and 22 (46%) reported that spending time in a hot climate decreased the symptoms.

Conclusions. Age, as well as the duration of the condition, influenced the distress induced by CP/CPPS, suggesting an improved coping ability with time as well as age. The ambient temperature appears to play a role as cold was frequently reported as causing symptom aggravation and heat was often reported to be ameliorating. The mechanisms behind this association between CP/CPPS and temperature as well as the correlation between ejaculatory pain and dysuria require further study.

PMID: 17853027 [PubMed - as supplied by publisher]