Use of Acetylcysteine in the Treatment of Patients with Chronic Prostatitis/Chronic Pelvic Pain Syndrome

Abstract

Antioxidants are recommended for the treatment of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). The efficacy and safety of quercetin in the treatment of patients with CP/CPPS have been studied most. To increase the effectiveness of treatment, we propose to use acetylcysteine, which, along with antioxidant properties, has secretolytic properties.The objective: to provide a comparative assessment of the efficacy and safety of quercetin and acetylcysteine in the treatment of patients with CP/CPPS.Materials and methods. The study involved 60 patients with CP/CPPS aged 18–45 years. Patients were randomized into two comparison groups. Patients in group 1 (n=30) were prescribed quercetin1 g per day for 1 month. Patients in group 2 (n=30) received acetylcyteine orally at a dose of 600 mg per day for 1 month. The condition of patients was assessed according to the NIH-CPSI scale, spermogram parameters and dynamics interlekin-10 (IL-10) and tumor necrosis factor α (TNF-α) in ejaculate. The efficiency criterion was considered to be a 25 % decrease in the NIH-CPSI.Results. As a result of the treatment of patients with CP/CPPS with the use of antioxidants in both groups symptoms of the prostatitis were reduced: NIH-CPSI total (group 1 – 22,5±0,5 vs. 15,0±0,8; group 2 – 22,7±0,5 vs. 15,1±1,1); pain (group 1 – 11,5±0,3 vs. 7,1±0,4; group 2 – 10,0±0,5 vs. 6,6±0,6); urinary symptoms (group 1 – 3,4±0,3 vs. 2,1±0,2; group 2 – 4,8±0,4 vs. 2,2±0,4), quality of life (group 1 – 7,7±0,4 vs. 5,8±0,3; group 2 – 7,8±0,3 vs. 6,3±0,4). The fertility was improved significantly (p<0,05): increased sperm concentration, progressive sperm motility, decreased number of pathological sperm, leukocyte TNF-α concentration and increased IL-10 concentration in ejaculate. In group 2 only ejaculate viscosity decreased significantly (p<0,05), improved sperm motility, decreased white blood cell count, decreased TNF-α concentration in ejaculate were significantly greater than in group 1. The clinical efficacy of acetylcysteine and quercetin in the treatment of patients with CP/CPPS was 63,3 % and 60,0 % respectively (subject to the efficacy criterion of reducing the NIH-CPSI score by 25 %).Conclusion. The use of acetylcysteine can be useful for patients with CP/CPPS.