World Congress of Endourology, Oct. 2009, Germany
ABSTRACT
Chronic Abacterial Prostatitis / Chronic Pelvic Pain Syndrome (CPPS) is a clinical entity not easy to diagnose and treat. Inflammation / infection of the Prostate may be present and hence the rationale to use a Thermotherapy Treatment. We have used a Bipolar Radio Frequency Treatment (Tempro-by Direx Group) and report here the results of the first 60 Patients after 1 year follow up. Patients in categories NIH II and III A benefited from the treatment whereas patients in NIH category III B failed. Considering that CPPS is a very challenging illness, even a 43% success rate should be cconsidered very encouraging and justifies additional larger, in depth studies to evaluate the potential of this treatment.
TABLE 1 Patients Demographics
|
Characteristics
|
Value |
| # of the patients |
60 |
| Mean age (range) |
42 years(range 28-57) |
| Mean prostate size(cc) |
40 cc |
| NIH classification (%) |
|
| Category II |
20 (33.33%) |
| Category IIIA |
40 (66.66%) |
| Category III B |
Stopped treating |
| Most bothersome symptoms |
|
| Pelvic pain (%) |
20 (33.33%) |
| 20 (33.33%) |
|
| Perineal and/orperianal pain (%) |
18 (30%) |
|
Orchalgia (%)
|
10 (16.66%) |
Table 2
Taking a Criteria of Improvement as a 50% Reduction in Symptoms Score
at 12 Months
|
Baseline CPSI Score |
Post-TEMPRO CPSI Score |
| Mean Total score |
23.1 |
16.3(30%) |
| Mean paindomain score |
11.7 |
6.9(41%) |
| Mean Quality of life domain score |
6.7 |
4.7(30%) |
| Overall result(> = 50%) |
YES = 26(43%) |
NO =34(57%)
|
INTRODUCTION
Introduction Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a major health care burden we find in our daily urological practice. Several conservative types of treatments are available but many patients are not relieved of their painful symptoms for long periods of time. Therefore, we started a trial using the Tempro system (Direx-Initia) to treat Chronic Prostatitis on our patients. We are here reporting our initial results with patients that have completed at least a 12 months follow.
MATERIAL AND METHODS
We used the Radiofrequency Thermal Treatment with a treatment protocol of 53.5 degrees Celsius for 60 minutes. All patients had symptoms at least 3 to 6 months, and have tried different drugs, such as Ciprofloxacin, Tamsulosine and NSAID, without success. The way to analyze quantitatively the potential improvement, was using the NIH Symptoms Score. Patient demographics and most bothersome symptoms can be seen in Table 1.
RESULTS
The results after 12 months are seen in Table Acute complications were: 4 UTI treated with Antibiotics, 2 ''de novo'' voiding symptoms with Conservative management and 3 Urinary retentions, treated with indwelling catheters for 3-5 days.
CONCLUSION
Considering that Chronic Prostatitis is a challenging illness, these initial results, with an overall success rate of 43% are very encouraging. Perineal and/or perianal pain, as well as orchalgia, are substantially improved in the majority of the patients.
The Tempro treatments it is a simple, safe and effective procedure with minimal side effects. Longer follow up and a larger trial is required to explore in depth the potential of this treatment.
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