Complex Regional Pain Syndrome

[webslave]

With Dr Janicki's permission we have a new page on this:

https://ucpps.men

[webslave]

A researching urologist commented to me that this is an interesting but unproven hypothesis. He commented that he has not seen the increased prostatic blood flow noticed in doppler imaging in the Krieger study when he uses the same instrument on CPPS pts, and that he has not noticed any signs of "autonomic dysreflexia" in these patients. What is autonomic dysreflexia? It's quite interesting:
http://www.northeastrehab.com/Articles/dysreflexia.htm

I actually think some of the symptoms of autonomic dysreflexia are common to CPPS patients (but are perhaps not reported). What do you think?

[Ralph]

Autonomic dysreflexia is reflex sympathetic dystrophy (RSD). A post traumatic syndrome causing hyperemia (increased blood flow) and severe pain for no apparent reason. Basically, is an autonomic (which means related to the nerves) dysfunction causing pain and increased blood flow. The nerves regulate blood flow and the sensation of pain. This is commonly seen by orthopedic surgeons in patients complaining of a painful extremety long after a traumatic event (foot, wrist ect). It has a very typical appearence on bone scans and MRI. This is one of my favorite theories for CPPS along with an allergic cause. I think abnormal or damaged nerves are a large cause of the pelvic and referred pain many of us feel, but this is just my personal belief which is supported by some studies.

[J Dimitrakov]

A researching urologist commented to me that this is an interesting but unproven hypothesis. He commented that he has not seen the increased prostatic blood flow noticed in doppler imaging in the Krieger study when he uses the same instrument on CPPS pts, and that he has not noticed any signs of "autonomic dysreflexia" in these patients. What is autonomic dysreflexia? It's quite interesting:
http://www.northeastrehab.com/Articles/dysreflexia.htm

I actually think some of the symptoms of autonomic dysreflexia are common to CPPS patients (but are perhaps not reported). What do you think?

Maybe he is looking at a different subpopulation of patients. Remember that within the large CPPS group there are different subgroups (subpopulations). There are patients with inflammation and people without inflammation (but still with CPPS Symptoms). The latter would not show increased blood flow on TRUS Doppler but still have symptoms, which, by itself is sufficient evidence that we need to look for other markers for pain (I know some research urologists would disagree with that). However, if Doppler (positive or negative findings) was sufficient to select for a homogeneous group of CPPS patients that would have been enough and we need not look further(unfortunately, as everyone knows, this is not the case).

[webslave]

Remember that within the large CPPS group there are different subgroups (subpopulations). There are patients with inflammation and people without inflammation (but still with CPPS Symptoms).

But that's still controversial, with recent studies showing inflammation in all patients, even those that have "no inflammation" using the old techniques.

I did a quick survey of the research available on doppler and CPPS, and it is very contradictory, with wildly different results. We need more studies to refute or confirm Krieger's study, IMO.