Symptomatic Analysis of Men with Chronic Prostatitis/Chronic Pelvic Pain Syndrome

Kim, Hong Kook; Sohng, Inho; Hyun, Young Min; Park, Heung Jae; Joo, Kwan Joong; Kim, Hyung Jee

Abstract

PURPOSE
Prostatitis is an extremely common syndrome that afflicts 2~10% of men and is now classified into NIH category. Of these, NIH category III(Chronic Prostatitis/Chronic Pelvic Pain Syndrome, CP/CPPS) varies widely in clinical presentation and response to treatment. We evaluated the characteristic symptoms of CP/CPPS based on NIH chronic prostatitis symptom index(NIH-CPSI), International Prostate Symptom Score(IPSS) and International Index of Erectile Function-5(IIEF-5) for the exploration of the future prospects of treatment.
MATERIALS AND METHODS
114 subjects agreed to participate in the study. The data from 99 patients were available for evaluation. The candidates with category IIIa and IIIb chronic pelvic pain syndrome were from 3rd decade to 6th decade for exclusion of effect of BPH. The NIH-CPSI, IPSS, IIEF-5 were used to grade symptoms and the quality of life impact at the start of the study. We investigated the correlation of the each domain of the scales categorized by age, location and multiplicity of the pain, and duration of the disease. Pearson's correlation method and ANOVA test were used for statistical analysis.
RESULTS
Mean age of the patients was 41.1+/-8.5(3rd decade; 8 patients, 4th decade; 30, 5th decade 47, 6th decade 14). There were significant correlation between IPSS total score and urinary domain of NIH-CPSI (R=0.82), and irritative domain of IPSS and urinary domain of NIH-CPSI(R=0.76) with pearson's method. Analysis of the scores categorized by age revealed that there were no difference in 2nd, 3rd, 4th decade, but 6th decades had high IPSS total score. Analysis of the scores categorized by location and multiplicity of the pain revealed that the most common site of the pain was perineum(34.3%), and the patients who had 3 or more painful area had higher scores in all domains of CPSI and IPSS except pain domain of NIH-CPSI than the patients who had 1 painful area. Analysis of the scores categorized by duration of the disease revealed that the IPSS scores of the patients suffered during 1 year or more were higher than the patient suffered during 6months or less. There was no significant correlation between IIEF-5 and other scales.
CONCLUSION
In our study there was significant correlation between urinary domain of NIH-CPSI and total score of IPSS. So, urinary domain of NIH-CPSI could be helpful index when alpha-blocker is used for the treatment of CP/CPPS. And alpha-blocker could be more effective in patients who are older and have longer duration of the disease and have multiple painful areas.