Korean J Urol.  2012 Jul;53(7):497-501. 10.4111/kju.2012.53.7.497.

Therapeutic Efficacy of Bipolar Radiofrequency Thermotherapy for Patients with Chronic Prostatitis: A Retrospective Analysis of 26 Cases

Affiliations
  • 1Department of Urology, Kwangju Christian Hospital, Gwangju, Korea. urojh@medimail.co.kr
  • 2Naju Urologic Clinic, Naju, Korea.

Abstract

PURPOSE
Chronic prostatitis (CP) does not yet have a universally successful therapy. Alternative treatments including thermotherapy have been adopted in the multimodal management of pain and voiding dysfunction. We retrospectively analyzed the therapeutic efficacy of bipolar radiofrequency thermotherapy for patients who were unsatisfied with conventional medication for CP.
MATERIALS AND METHODS
A retrospective study between October 2009 and September 2010 of 26 patients who were under 50 years old and diagnosed with CP (National Institutes of Health [NIH]-category III) was performed. Twenty patients were diagnosed with inflammatory CP (NIH-category IIIa) and the rest with noninflammatory CP (NIH-category IIIb). We used the Tempro system at an intraprostatic temperature of 55degrees C for 50 minutes with a medium heating rate. All patients also completed the NIH-Chronic Prostatitis Symptom Index (CPSI) before and after treatment.
RESULTS
In the patients diagnosed with CP, the mean serum prostate-specific antigen (PSA) level was 0.9+/-0.3 ng/ml, the prostate volume was 27.1+/-5.5 g, and the average score for all 3 domains on the NIH-CPSI significantly decreased. The total scores decreased from 19.8+/-7.1 to 11.1+/-7.0, the pain domain decreased from 8.6+/-3.1 to 4.8+/-3.1, the voiding symptom domain decreased from 5.1+/-1.8 to 2.9+/-1.8, and the effect on the quality of life decreased from 6.1+/-2.2 to 3.4+/-2.2 (p<0.05).
CONCLUSIONS
Bipolar radiofrequency thermotherapy for patients with CP intractable to conventional medication can provide significant improvement in the NIH-CPSI. Large, randomized controlled trials will also be required to confirm the efficacy of this therapy.

Keyword

Prostatitis; Thermotherapy

MeSH Terms

Academies and Institutes
Heating
Hot Temperature
Humans
Hyperthermia, Induced
Prostate
Prostate-Specific Antigen
Prostatitis
Quality of Life
Retrospective Studies
Prostate-Specific Antigen

Figure

  • FIG. 1 Mean National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) scores before and after thermotherapy (p<0.05a). QoL, quality of life. a:t-test.

  • FIG. 2 Rate of improvement in National Institutes of Health-Chronic Prostatitis Symptom Index after thermotherapy (n=26).


Reference

1. Collins MM, Stafford RS, O'Leary MP, Barry MJ. How common is prostatitis? A national survey of physician visits. J Urol. 1998. 159:1224–1228.
2. Nickel JC. Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA, editors. Inflammatory conditions of the male genitourinary tract: prostatitis and related conditions, orchitis, and epididymitis. Campbell-Walsh urology. 2007. 9th ed. Philadelphia: Saunders;304–329.
3. Shoskes DA, Hakim L, Ghoniem G, Jackson CL. Long-term results of multimodal therapy for chronic prostatitis/chronic pelvic pain syndrome. J Urol. 2003. 169:1406–1410.
4. Nickel JC. Prostatitis: evolving management strategies. Urol Clin North Am. 1999. 26:737–751.
5. Schappert SM. National Ambulatory Medical Care Survey: 1991 summary. Vital Health Stat 13. 1994. (116):1–110.
6. Yoo YN. Prostatitis. Korean J Urol. 1994. 35:575–585.
7. Moon TD, Hagen L, Heisey DM. Urinary symptomatology in younger men. Urology. 1997. 50:700–703.
8. Nickel JC. The overlapping lower urinary tract symptoms of benign prostatic hyperplasia and prostatitis. Curr Opin Urol. 2006. 16:5–10.
9. Propert KJ, McNaughton-Collins M, Leiby BE, O'Leary MP, Kusek JW, Litwin MS, et al. A prospective study of symptoms and quality of life in men with chronic prostatitis/chronic pelvic pain syndrome: the National Institutes of Health Chronic Prostatitis Cohort study. J Urol. 2006. 175:619–623.
10. Pontari MA, Ruggieri MR. Mechanisms in prostatitis/chronic pelvic pain syndrome. J Urol. 2004. 172:839–845.
11. Nickel JC, Alexander RB, Schaeffer AJ, Landis JR, Knauss JS, Propert KJ, et al. Leukocytes and bacteria in men with chronic prostatitis/chronic pelvic pain syndrome compared to asymptomatic controls. J Urol. 2003. 170:818–822.
12. Yang CC, Lee JC, Kromm BG, Ciol MA, Berger RE. Pain sensitization in male chronic pelvic pain syndrome: why are symptoms so difficult to treat? J Urol. 2003. 170:823–826.
13. Brehmer M, Baba S. Transurethral microwave thermotherapy: how does it work? J Endourol. 2000. 14:611–615.
14. Perachino M, Bozzo W, Puppo P, Vitali A, Ardoino S, Ferro MA. Does transurethral thermotherapy induce a long-term alpha blockade? An immunohistochemical study. Eur Urol. 1993. 23:299–301.
15. Collins MM, Stafford RS, O'Leary MP, Barry MJ. Distinguishing chronic prostatitis and benign prostatic hyperplasia symptoms: results of a national survey of physician visits. Urology. 1999. 53:921–925.
16. Larson TR, Bostwick DG, Corica A. Temperature-correlated histopathologic changes following microwave thermoablation of obstructive tissue in patients with benign prostatic hyperplasia. Urology. 1996. 47:463–469.
17. Schulman CC, Zlotta AR, Rasor JS, Hourriez L, Noel JC, Edwards SD. Transurethral needle ablation (TUNA): safety, feasibility, and tolerance of a new office procedure for treatment of benign prostatic hyperplasia. Eur Urol. 1993. 24:415–423.
18. Zeitlin SI. Heat therapy in the treatment of prostatitis. Urology. 2002. 60:6 Suppl. 38–40.
19. Montorsi F, Guazzoni G, Bergamaschi F, Galli L, Consonni P, Matozzo V, et al. Is there a role for transrectal microwave hyperthermia of the prostate in the treatment of abacterial prostatitis and prostatodynia? Prostate. 1993. 22:139–146.
20. Terai A, Arai Y, Yamamoto I, Onishi H, Oishi K, Yoshida O. Newly developed transurethral radiofrequency thermotherapy device for benign prostatic hyperplasia: a pilot study in canine prostate. Int J Hyperthermia. 1995. 11:627–635.
21. Watson GM, Perlmutter AP, Shah TK, Barnes DG. Heat treatment for severe, symptomatic prostatic outflow obstruction. World J Urol. 1991. 9:7–11.
22. Nickel JC, Sorensen R. Transurethral microwave thermotherapy for nonbacterial prostatitis: a randomized double-blind sham controlled study using new prostatitis specific assessment questionnaires. J Urol. 1996. 155:1950–1954.
23. Aaltomaa S, Ala-Opas M. The effect of transurethral needle ablation on symptoms of chronic pelvic pain syndrome: a pilot study. Scand J Urol Nephrol. 2001. 35:127–131.
24. Kastner C, Hochreiter W, Huidobro C, Cabezas J, Miller P. Cooled transurethral microwave thermotherapy for intractable chronic prostatitis: results of a pilot study after 1 year. Urology. 2004. 64:1149–1154.
25. Nickel JC, Siemens DR, Johnston B. Transurethral radiofrequency hot balloon thermal therapy in chronic nonbacterial prostatitis. Tech Urol. 1998. 4:128–130.
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