Gangman Zaii Urology Hospital, Seoul
Introduction and Objectives:
Abacterial Chronic Prostatitis is a challenging illness in our day to day urology practice. Patients undergo several type of treatments and many of them are nor relieved of their pain.We have recently started a clinical trial using Bipolar Radiofrequency Thermal Treatment (Direx–Initia’s Tempro device) to treat Abacterial Chronic Prostatitis with our patients both young and old (27 to 72 years).We are here reporting our initial results with patients that have completed at least a three months follow up.
Material and Methods
We used the Tempro system (from Direx-Initia) with a treatment protocol of 55 degrees Celsius for 50 minutes, medium heating rate. All patients had tried different drugs, such as Ciproxin ,Tamsulosine and NSAID, without success.We utilized the NIH Symptoms Score in order to evaluate quantitatively patient improvements.
Table 1. Patients demographics
| Characteristics |
Value |
| Numbers of the patients |
41 |
| Mean age (range) |
42.6 ± 11.4 (28 – 72) |
| Mean prostate size (cc) |
25.3 ± 6.1 |
| NIH classification (%) |
| Category II |
13 (31.8%) |
| Category IIIA |
14 (34.1%) |
| Category IIIB |
14 (34.1%) |
| Most bothersome symptoms |
| Pelvic pain (%) |
14 (34.1%) |
| Perineal and/or perianal pain (%) |
12 (29.2%) |
| Orchalgia (%) |
7 (17.1%) |
| Urinary Symptoms (%) |
8 (19.6%) |
NIH : National Institutes of Health, CPSI : Chronic Prostatitis Symptom index
Results
The results after 3 months are as follows;
Table 2. Comparison of Chronic Prostatitis Symptom index scores between pretreatment (baseline) and TEMPRO after 3 months (post TEMPRO) CPSI score
| |
Baseline CPSI score |
Post-TEMPRO CPSI score |
p value |
| Mean Total score |
23.4 ± 7.3 |
16.5 ± 4.9 |
0.072 |
| Mean pain domain score |
11.2 ± 5.4 |
6.5 ± 3.8 |
0.034 |
| Mean Urination domain score |
5.7 ± 3.3 |
5.2 ± 2.3 |
0.872 |
| Mean Quality of life domain score |
6.6 ± 2.4 |
4.6 ± 1.6 |
0.138 |
Taking a criteria of improvement as a 50% reduction in symptoms score the following Table shows the success resultsTable 3. Subgroup analysis according to the decline of CPSI score more than 50 percent at 3 month after TEMPRO. - Group A : CPSI scores decreased more than 50% after TEMPRO (= successful group) - Group B : CPSI scores does not decreased more than 50% after TEMPRO (= unsuccessful group)
| |
Group A |
Group B |
p value |
| |
| Total Success |
19 ( 46 % ) |
22 ( 54 %) |
|
| Age group |
|
|
|
| 50 or Younger than 50 years old |
12 |
17 |
0.638 |
| Older than 50 years old |
7 |
5 |
| NIH classification (%) |
| Category II |
8 |
5 |
0.052 |
| Category IIIA |
9 |
5 |
| Category IIIB |
2 |
12 |
| Most bothersome symptoms (%) |
| Pelvic pain |
5 ( 36 % ) |
9 ( 64 %) |
0.102 |
| Perineal and/or perianal pain |
9 ( 75 % ) |
3 ( 25 % ) |
| Orchalgia |
4 ( 57 % ) |
3 ( 43 % ) |
| Urinary Symptoms |
1 ( 12.5 % ) |
7 ( 87.5%) |
Table 4. Acute complications associated with TU-RF
| Complications |
Numbers of patients |
Management |
| Urinary tract infection |
1 (2.4%) |
Broadspectrum antibiotics |
| de novo voiding symptoms |
3 (7.3%) |
Conservative |
| Urinary retentions |
2 (4.8%) |
Temporary indwelling catheter |
Conclusions
These initial results look very positive with an overall success rate of 46 %. Perineal and/or perianal pain, as well as orchalgia, are substantially improved in the majority of the patients. Considering the complexity of the illness we consider it a simple and effective treatment.Side effects are minimal, therefore the Tempro treatment for prostatitis should be considered as a safe and effective one. We will continue to explore the potential of this treatment.
| 
