Abstract
Prostatitis is a widespread disease associated with pelvic pain syndrome, which is characterized by pelvic pain, various urinary symptoms, and possible sexual dysfunction. An adequate therapy requires schemes for chronic prostatitis that affects, among other things, the atypical causative agents. We investigate a therapy for prostate inflammation consisting in a combination of macrolides with the usage of men’s pads for underwear during the treatment. We demonstrate the efficacy of this therapy on a group of patients with chronic prostatitis. The group of patients under this combination therapy exhibits better recovery dynamics compared to the group of patients who were treated only by macrolides. We observe a statistically significant (p-value < 0.01) difference between the two groups in the data from three sections of the NIH-CPSI questionnaire, which concerned pain, symptoms of impaired urination, and quality of life. The number of patients with soreness of the prostate, with the presence of bacteria and leukocytes in the prostate gland secretion, and with the presence of microorganisms in the PCR tests after treatment was lower in the combination therapy group compared to the macrolide group. The obtained results demonstrate that the use of macrolides in combination with the use of men’s pads in the treatment of chronic prostate inflammation, including “abacterial” prostatitis, is promising. More generally, our results highlight the importance of flexible and individual approaches to the treatment of chronic prostatitis.
Highlights
Chronic and acute inflammation of the prostate is the most common urological disease in men under the age of 50, while in older patients it ranks third in prevalence after benign prostatic hyperplasia and prostate cancer [1]
The number of patients with soreness of the prostate, with the presence of bacteria and leukocytes in the prostate gland secretion, and with the presence of microorganisms in the PCR tests after treatment was lower in the combination therapy group compared to the macrolide group
In the macrolide therapy group (“no-MPAD” group), the baseline average score of 25 ± 3 decreased to 8 ± 2 after treatment
Summary
Chronic and acute inflammation of the prostate is the most common urological disease in men under the age of 50, while in older patients it ranks third in prevalence after benign prostatic hyperplasia and prostate cancer [1]. According to the recommendations of the European Association of Urology and the Russian Society of Urology, for the treatment of patients with chronic prostatitis and/or chronic pelvic pain syndrome, most urologists prescribe antimicrobial therapy with first-line drugs (fluoroquinolones) for 4 weeks [2]. This is often done empirically, without verifying the primary bacterial agent and determining its sensitivity. Ps. aeruginosa, and coccal flora were detected in 40% of cases [3] Such a comprehensive study of the biomaterial for patients with chronic prostatitis is very rare in outpatient practice, and, an adequate therapy, as a rule, is not carried out. Dissatisfaction with treatment and frequent relapses of the disease often force patients to go out of control or change doctors, which leads to further chronic inflammation with worse prognosis and appearance of complications
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