madman
Super Moderator
* Potts outlines a thorough differential diagnosis for LUTS in CPPS, including pseudo-dyssynergia, pelvic floor dysfunction, pudendal neuralgia, underactive bladder, overactive bladder, benign prostatic enlargement, bladder neck dyssynergia, and interstitial cystitis.
Jeannette Potts, MD, Co-founder of Vista Urology and Pelvic Pain Partners, delivers a comprehensive 27-minute presentation on lower urinary tract symptoms (LUTS) associated with chronic pelvic pain syndrome (CPPS). She asserts that chronic prostatitis and CPPS are often mischaracterized–prostatitis is rare, and CPPS is a broad, symptom-based syndrome, rather than a diagnosis.
Dr. Potts critiques the generalized use of alpha-blockers for CPPS, citing a well-conducted NIH study in which alpha-blockers failed to show benefit over placebo in treatment-naïve men. However, she emphasizes that poor phenotyping and overly broad inclusion criteria limit the study’s applicability. Phenotyping patients allows for the targeted use of alpha-blockers in those with clear bladder outlet obstruction or neck dysfunction.
Dr. Potts outlines a thorough differential diagnosis for LUTS in CPPS, including pseudo-dyssynergia, pelvic floor dysfunction, pudendal neuralgia, underactive bladder, overactive bladder, benign prostatic enlargement, bladder neck dyssynergia, and interstitial cystitis. She strongly advocates for non-invasive diagnostic approaches, prioritizing voiding diaries and post-void residual ultrasounds over invasive urodynamics or cystoscopy. Through multiple case studies, she illustrates misdiagnoses stemming from overhydration, unrecognized functional disorders, and overlooked obstructive pathology.
Dr. Potts stresses that interstitial cystitis is rare and distinct from bladder pain syndrome. She urges the abandonment of CPPS, IC/BPS, and similar terms as diagnostic labels, noting their nonspecificity. She underscores that many cases are resolved with basic tools, clinical mindfulness, and careful phenotyping.
Conclusion
Jeannette Potts, MD, Co-founder of Vista Urology and Pelvic Pain Partners, delivers a comprehensive 27-minute presentation on lower urinary tract symptoms (LUTS) associated with chronic pelvic pain syndrome (CPPS). She asserts that chronic prostatitis and CPPS are often mischaracterized–prostatitis is rare, and CPPS is a broad, symptom-based syndrome, rather than a diagnosis.
Dr. Potts critiques the generalized use of alpha-blockers for CPPS, citing a well-conducted NIH study in which alpha-blockers failed to show benefit over placebo in treatment-naïve men. However, she emphasizes that poor phenotyping and overly broad inclusion criteria limit the study’s applicability. Phenotyping patients allows for the targeted use of alpha-blockers in those with clear bladder outlet obstruction or neck dysfunction.
Dr. Potts outlines a thorough differential diagnosis for LUTS in CPPS, including pseudo-dyssynergia, pelvic floor dysfunction, pudendal neuralgia, underactive bladder, overactive bladder, benign prostatic enlargement, bladder neck dyssynergia, and interstitial cystitis. She strongly advocates for non-invasive diagnostic approaches, prioritizing voiding diaries and post-void residual ultrasounds over invasive urodynamics or cystoscopy. Through multiple case studies, she illustrates misdiagnoses stemming from overhydration, unrecognized functional disorders, and overlooked obstructive pathology.
Dr. Potts stresses that interstitial cystitis is rare and distinct from bladder pain syndrome. She urges the abandonment of CPPS, IC/BPS, and similar terms as diagnostic labels, noting their nonspecificity. She underscores that many cases are resolved with basic tools, clinical mindfulness, and careful phenotyping.
Conclusion
