Assessment of Efficiency of Transuretral Radio-wave Prostate Thermotherapy in Patients with Chronic Nonbacterial Prostatitis

Abstract

Among men of working age chronic prostatitis is the most frequent urological illness, and characteristic symptoms of it are frequent reason of the urological recourse. Nowadays, there is no single universal successful therapy of chronic prostatitis. Therefore, this excuses a search for new methods of treatment of the patients with this pathology.The objective: was to evaluate the efficiency of transurethral radio wave bipolar thermotherapy (TURF) of the prostate in patients with chronic nonbacterial prostatitis with inflammatory chronic pelvic pain syndrome (CP/CPPS (NIH III A)).Materials and methods. There were 57 patients with chronic nonbacterial prostatitis under supervision, with inflammatory chronic pelvic pain syndrome (NIH IIIA), with a disease duration of more than 4 years, and low treatment efficiency on the background of standard therapy. All patients received standard therapy according to the clinical protocol. Part of the patients (Group 37) received transurethral bipolar prostate radiotherapy using the Tempro apparatus on the background of standard therapy, with subsequent comparative evaluation of clinical results relatively to the control group (20 – I group), which received only standard therapy after 3,6 and 12 months after treatment.Results. It was found that the use of transurethral radio wave bipolar thermotherapy with the Tempro system on the background of standard therapy in patients with chronic nonbacterial prostatitis with inflammatory chronic pelvic pain syndrome (CP/CPPS – NIH III A), facilitated more extended and clinical result, in contrast to the results in the group of patients who received only standard therapy. If, according to the assessment of general condition (S+QoL) in group II of patients, after 3 and 6 months after the standard course of treatment, the indicator improved by 38,9 % and 41,4 %, respectively (p<0,05), after 12 months only by 10,3 %, with no significant statistical difference with an indicator before treatment (p>0,05). Whereas in group II of patients who additionally recieved transurethral radio wave bipolar thermotherapy, the score (S+QoL) after 3 months and 6 months was 64,0 % and 68,2 %, respectively, lower than before treatment (p<0,05). After 12 months after treatment, this result remained without negative dynamics, 68,4 % below the pre-treatment index (p<0,05). Appropriate results were also obtained in a detailed assessment of the dynamics of the main symptoms 3, 6 and 12 months after treatment. Manifestations of pain, discomfort, or discomfort in typical areas returned to patients in group I 12 months after treatment, whereas in group II, such patients had a small percentage, except for discomfort over the womb in 27 % of patients. TURF has also been shown to be highly effective in the severity of the inflammatory process as a result of prostate secretion microscopy. Accordingly, after 12 months, less than 10 leukocytes in the field of view were in 35 % of patients of group I, while in group II it was – 73 %, from 11 to 20 leukocytes were in 60 % of patients – group I, and 37 % – group II. According to the TRUSD of the prostate, the median volume of the prostate 12 months after treatment in group II was 28,1 % lower than the indicator before treatment (p<0,05). If, after 3 and 6 months after treatment, the average prostate volume in group I of patients decreased significantly by 14,1 % and 11,9 % respectively, there was no statistically significant difference after 12 months (p>0,05).Conclusion. The use of transurethral bipolar radiotherapy on the background of standard therapy in patients with inflammatory CP/CPPS who are hardly succumbed to traditional therapy, is safe with long-lasting and sustained clinical effects against standard therapy.