Urogenit Tract Infect.  2022 Dec;17(3):76-80. 10.14777/uti.2022.17.3.76.

The Feasibility of Radical Prostatectomy for Medication Refractory Chronic Prostatitis/Chronic Pelvic Pain Syndrome

• Jeong SC

• KMID: 2537604
• DOI: http://doi.org/10.14777/uti.2022.17.3.76

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.

Keyword

Chronic prostatitis/chronic pelvic pain syndrome; Radical prostatectomy; National Institutes of Health-Chronic Prostatitis Symptom Index