REVIEW – February 2012

Can neural oxidative stress cause prostatitis?


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Introduction. Unless prostatitis symptoms are displayed due to an uroinfection, then prostatitis is due to an unknown mechanism. Different pathogenetic mechanisms are suggested to be responsible for such prostatitis (urine ref lux, neuromuscular disorder, dysfunction of urothelium) but clear links between these mechanisms are missing. Oxidative stress (OxS) may be such a linking mechanism.

Aim. To review a new hypothesis about chronic prostatitis / chronic pelvic pain syndrome.

Hypothesis. Systemic OxS causes excretion of 8-isoprostanes with urine, which cause lower urinary tract symptoms because of their ability to induce contractions of the bladder and the urethra. Excitation of primary sensory afferents’ peripheral processes is sufficient to cause spinal OxS due to mitochondrial overactivation. Spinal OxS can send a signal towards periphery through the very same sensory afferents because the OxS metabolites from the spinal cord can affect the pain receptors on the central processes of the primary sensory afferents. This component of pathogenesis may serve as a relevant link between the symptoms and peripheral biochemical changes in the pelvic organs.