Syndrome of chronic task pain in patients with calculus prostatitis: search for optimal therapy

Abstract

The objective: to determine the efficacy of the combination of the method of extracorporeal shock wave therapy (ESWT) and non-steroidal anti-inflammatory drugs (NSAIDs) in the correction of pain in chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) in patients with CP of the IIIb category. Patients and methods. Extracorporeal shock wave therapy in 57 men (mean age 38.2 ± 2.1 years) with symptoms of CPPS on the basis of chronic calculous prostatitis (CP category IIIb) was performed in the Department of Sexopathology and Andrology of the Institute of Urology of the NASU of Ukraine. All patients were divided into three groups, in I (n=27) – patients received suppositories Dicloberl 100 mg once a day for 20 days, in II (n=19) – suppositories Dicloberl 100 mg once a day 20 days and Nimesil 100 mg inside the morning after a meal – 5 days; In ІІІ (n=11) tocopherol acetate 400 mg once a day for 30 days inside after eating. The duration of the disease was from 8 months to 5,2 years. All patients underwent a standard urologic examination and pain assessment on the NIH-CPSI scale. The parameters given above were monitored 3 times during the study: before treatment, 1 and 3 months after treatment. At the last visit, the subjective assessment of the efficacy and tolerability of the drug was recorded by patients and treating physicians. It was found that the use of diclofenac sodium in suppositories, in persons with CP / CTPS receiving ESWT, contributed to a significant reduction in pain on the scale of NIH-CPSI for a 30-day period of treatment at 48,4±1,8% (p<0,05) and demonstrated high compliance (according to the patient –77,7%, according to the doctor – 81,4%). Results. It was also found that the use of a combination of diclofenac sodium suppositories with the oral form of nimesulide, in these cases, reduced the NIH-CPSI values by 55,7±2,1% of the initial, and the compliance was 84,1% according to the patient, – 89,3% (р<0,05). Conclusion. Carrying out extracorporeal shock wave therapy in persons with calculous prostatitis and chronic pelvic pain syndrome is an effective measure of pain relief, and NSAIDs (diclofenac sodium and nimesulide) significantly improve the results of treatment.