Features of the neuro-vegetative reactivity of men with chronic pelvic pain syndrome

Shormanov I.S., Mozhanov I.I., Sokolova H.A.

Aim is to study features of autonomic reactivity and its possible relationship with a neuropathic component of chronic pain with the use of simple and valid diagnostic tests in routine urological practice in CPPS-IIIB patients.

Material and methods. The study included 90 men diagnosed with CPPS-IIIB aged 22-48 years (mean age - 40,6 ± 4,6 years) (core group) and 30 clinically healthy men of the same age (control group). In both groups, the study was carried out the same type of autonomic reactivity on the basis of the calculation of the initial autonomic tone (ICT) (Wayne Table), evaluated pain index (PI) and the Quality of Life Index (QL) (International scale assessment of symptoms of chronic prostatitis NIH-CPSI-QL), studied neuropathic component of pain (neuropathic pain diagnostic questionnaire (DN4)), followed by statistical data processing.

Results. Clinical manifestations of autonomic reactivity disorders were diagnosed in 75.5% of CPPS-III B patients. Analysis of ICT has revealed significant differences in the distribution of types of autonomic reactivity (eutony, vagotony, sympathotony) between the control and the main groups with a predominance in the last sympathotony (57.8%) and in 2 times lower incidence of eutony (p<0.05). These findings reflect the high frequency of system autonomic sympathetic hyperactivity in CPPS-IIIB patients. At the same time one in three patients with CPPS-IIIB showed signs of neuropathic pain, and its overall incidence was significantly higher in 2.7 times compared control group (p <0.05).

Conclusion. Autonomic dysfunction (systemic autonomic sympathetic hyperactivity) associated with a high incidence of chronic neuropathic pain play important role in multifactorial pathogenesis of CPPS -IIIB.

Authors declare lack of the possible conflicts of interests.

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chronic pelvic pain syndrome IIIB (CPPS-IIIB), vegetative reactivity, systemic autonomic sympathetic hyperactivity, neuropathic pain, diagnostics, pathogenetic link