The Feasibility of Radical Prostatectomy for Medication Refractory Chronic Prostatitis/Chronic Pelvic Pain Syndrome
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Purpose: The purpose of this study was to compare the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) scores of patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) given pharmacological treatment with those who additionally had prostate cancer and underwent surgical treatment. Materials and Methods: From January 2000 to March 2021, a total of 7,650 patients were diagnosed with chronic prostatitis (N41.1) at our hospital, of which 234 patients were additionally diagnosed with prostate cancer. After excluding patients with severe benign prostatic hyperplasia (＞100 g)-related lower urinary tract symptoms or neurological and psychiatric abnormalities, or advanced prostate cancer, 52 patients undergoing pharmacological treatment with a combination of drugs and 20 patients who underwent radical prostatectomy due to additional prostate cancer were included in the analysis. The NIH-CPSI scores of the two groups were compared at the first outpatient visit, 3 months, and 6 months after the first visit. The p-values were calculated using the Mann-Whitney U test, and the Wilcoxon signed rank test. Results: Patients who underwent radical prostatectomy for prostate cancer showed significant reductions in the voiding and quality of life scores in the NIH-CPSI, but not the pain score at 3 months. After 6 months, there was a significant decrease in the overall NIH-CPSI. On the other hand, in the group on pharmacological therapy, the decrease was statistically significant only in the voiding score at 6 months. However, in the surgery group, 3 patients were found to be suffering from urinary incontinence, and 7 patients from erectile dysfunction. Conclusions: Radical prostatectomy, therefore, appears to be a promising treatment that can be carefully considered for patients with refractory CP/CPPS who do not receive adequate treatment and thus have a poor quality of life.
Abstract
Purpose: The purpose of this study was to compare the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) scores of patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) given pharmacological treatment with those who additionally had prostate cancer and underwent surgical treatment. Materials and Methods: From January 2000 to March 2021, a total of 7,650 patients were diagnosed with chronic prostatitis (N41.1) at our hospital, of which 234 patients were additionally diagnosed with prostate cancer. After excluding patients with severe benign prostatic hyperplasia (＞100 g)-related lower urinary tract symptoms or neurological and psychiatric abnormalities, or advanced prostate cancer, 52 patients undergoing pharmacological treatment with a combination of drugs and 20 patients who underwent radical prostatectomy due to additional prostate cancer were included in the analysis. The NIH-CPSI scores of the two groups were compared at the first outpatient visit, 3 months, and 6 months after the first visit. The p-values were calculated using the Mann-Whitney U test, and the Wilcoxon signed rank test. Results: Patients who underwent radical prostatectomy for prostate cancer showed significant reductions in the voiding and quality of life scores in the NIH-CPSI, but not the pain score at 3 months. After 6 months, there was a significant decrease in the overall NIH-CPSI. On the other hand, in the group on pharmacological therapy, the decrease was statistically significant only in the voiding score at 6 months. However, in the surgery group, 3 patients were found to be suffering from urinary incontinence, and 7 patients from erectile dysfunction. Conclusions: Radical prostatectomy, therefore, appears to be a promising treatment that can be carefully considered for patients with refractory CP/CPPS who do not receive adequate treatment and thus have a poor quality of life.
참고문헌 (8)
- 구자현, "대전충남 지역의 젊은 남성에서 수행된 만성 전립선염 유사증상의 역학 조사: 유병률 및 기후의 영향", Investigative and Clinical Urology, 43(4), pp.318~321 (2002), 대한비뇨의학회
- Shoskes DA, "Impact of post-ejaculatory pain in men with category III chronic prostatitis", chronic pelvic pain syndrome, 2004, pp.172, 542~547
- Schaeffer AJ., "Clinical practice. Chronic prostatitis and the chronic pelvic pain syndrome", N Engl J Med, 355, pp.1690~1698 (2006)
- Barnes RW, "Transurethral resection of the prostate for chronic bacterial prostatitis", Prostate, 3, pp.215~219 (1982)
- 조인창, "대한민국 40-50대 남성에서 만성전립선염 증상점수 (NIH-CPSI)와 국제 발기능 지수 (IIEF-5)의 관계 분석", Urogenital Tract Infection, 7(2), pp.165~172 (2012), 대한요로생식기감염학회
- Chopra S, "Feasibility of robotic radical prostatectomy for medication refractory chronic prostatitis", chronic pelvic pain syndrome : initial results, 2016, pp.32, 238~241
- Krongrad A, "Laparoscopic prostatectomy for severely symptomatic, treatment-refractory chronic prostatitis: preliminary observations from an ongoing phase II clinical trial", Urotoday Int J, 4, pp.art30~ (2011)
- Frazier HA, "Total prostatoseminal vesiculectomy in the treatment of debilitating perineal pain", J Urol, 148(2 Pt 1), pp.409~411 (1992)