Multidisciplinary Approach Recommended for Pelvic Pain

University of Wisconsin urologist says multidisciplinary network offers hope for progress

22 july 2009 -- In a commentary on three diverse studies in the August Journal of Urology, a leading urologist advocates a multidisciplinary approach to unravel the complex pathologies of pelvic pain, prostatitis, painful bladder syndrome, and interstitial cystitis.

Timothy D. Moon, M.D., of the University of Wisconsin in Madison, takes issue with Ali Tekin, M.D., of Duzce University School of Medicine in Turkey, and colleagues who studied 161 asymptomatic patients with elevated prostate-specific antigen tests. The researchers compared the efficacy of biopsy versus voided bladder 3 urine samples to detect prostatitis, benign prostatic hyperplasia, and prostate cancer in the study group. Relying on urine samples alone would result in 13 percent of cancers not being diagnosed, Moon argues. He also comments on studies by Chao-Zhao Liang, M.D., of Anhui Medical University in Hefei, China, on the incidence of prostatitis in China, and by Mary P. FitzGerald, M.D., of Loyola University Medical Center in Maywood, Ill., on myofascial physical therapy versus global therapeutic massage for pelvic pain linked to pelvic floor muscle abnormalities.

Moon applauds the funding of the Multidisciplinary Approach to Chronic Pelvic Pain Network, a multidisciplinary group of investigators planning diverse studies of the complex of pelvic pain diseases, including studies in epidemiology, neurobiology, urological and non-urological phenotyping, disease biomarkers, and organ cross-talk pathways.

"In conclusion, progress is being made but perhaps bladder and prostate are words that should be omitted from the current diagnostic label if we are to truly understand the pathophysiological process," Moon writes.

Authors of the FitzGerald study reported financial relationships with the pharmaceutical industry.

Commentary - Moon (subscription or payment may be required)
Abstract - Tekin
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Abstract - Liang
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Abstract - FitzGerald
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