The effectiveness of the integrated approach to the treatment of chronic prostatitis, including in patients with benign prostatic hyperplasia


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Abstract

Introduction. Concurrent chronic prostatitis (CP) plays an important role in the pathogenesis and progression of benign prostatic hyperplasia (BPH), increasing the severity of lower urinary tract symptoms (LUTS), lowering the quality of life, and increasing the risk of acute urinary retention. However, in the management of patients with BPH, the role of CP is not always taken into account. Aim. To evaluate the effectiveness of integrated management of patients with CP and patients with co-occurring BPH and CP using a physiotherapeutic device Mavit for the treatment of inflammatory diseases of the prostate. Materials and methods. Clinical effectiveness of integrated therapy using the Mavit device was studied in 45 patients with CP. The first group (BPH + CP) comprised 25 patients, who were diagnosed with stage I-II BPH co-occurring with CP. The group of CP included 20 patients with an established diagnosis of CP. Clinical outcomes were followed for 12 months after treatment. In 10 CP patients, the tissue effect of the Mavit device on the prostate blood circulation was assessed before and after the physiotherapy session using transrectal ultrasound in the color Doppler mapping mode. We studied the linear peak blood flow velocity, index of peripheral vascular resistance, and vascular density pattern. Results. Clinical outcomes were followed for 3 to 12 months. All patients reported an improvement in dysuria and voiding, a reduction in pain in the genital area. Voiding function improvements were confirmed by IPSS, uroflowmetry, and postvoid residual urine volume. Transrectal color Doppler ultrasound mapping showed positive changes in the prostate microcirculation. In 7 patients, the treatment results were followed for 4 to 9 years. During the entire period of observation, the level of prostate- specific antigen remained below 1.75 ng/ml, which indicates the safety of this method in patients with BPH. Conclusion. In patients with symptomatic BPH with concomitant CP in the conservative stage of the disease, integrated treatment of CP using physiotherapeutic modalities has pathogenetic significance. It significantly reduces the LUTS secondary to BPH, improves IPSS, QoL, urinary flow rate, postvoid residual urine volume. The findings allow us to recommend the Mavit device for the treatment of CP, including in patients with I-II stage BPH.

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About the authors

A. B Zhiborev

I.P. Pavlov Ryazan State Medical University of Minzdrav of Russia

Email: zhiborev@yandex.ru
SPIN-code: 6065-4495
Ph.D., Teaching Assistant at the Department of Urology and Nephrology

A. G Martov

D.D. Pletnev City Clinical Hospital, Moscow Health Department; Institute of Postgraduate Professional Education, A.I. Burnazyan Federal Medical Biophysical Center of FMBA of Russia

SPIN-code: 5680-0899
Dr.Med.Sci., Head of the Department of Urology and Andrology

References

  1. Verhamme K.M.C., Dieleman J.P., Bleumink G.S. et al. Incidence and prevalence of lower urinary tract symptoms suggestive of benign prostatic hyperplasia in primary care - The Triumph Project. Eur. Urol. 2002;42:323-328. doi: 10.1016/S0302-2838(02)00354-8.
  2. Ficarra V., Rossanese M., Zazzara M. et al. The role of inflammation in lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) and its potential impact on medical therapy. Curr. Urol. Rep. 2014;15(12):463. doi: 10.1007/s11934-014-0463-9.
  3. Huang X.H., Qin B., Liang Y.W. et al. LUTS in BPH patients with histological prostatitis before and after transurethral resection of the prostate. Zhonghua Nan Ke Xue. 2013;19(1):35-39.
  4. Urkmez A., Yuksel O.H., Uruc F. et al. The effect of asymptomatic histological prostatitis on sexual function and lower urinary tract symptoms. Arch. Esp. Urol. 2016;69(4):185-191.
  5. Кудрявцев Ю.В., Романова Л.М. Морфологические изменения в ткани предстательной железы при доброкачественной гиперплазии. В. кн.: Доброкачественная гиперплазия предстательной железы. Под ред. Н.А. Лопаткина. М.: Наука. 1999. C. 44
  6. Кирпатовский В.И., Сивков А.В., Федяков Р.П. и др. Роль нарушения кровоснабжения и тканевой гипоксии в развитии дисфункции мочевого пузыря при инфравезикальной обструкции, вызванной аденомой предстательной железы. Урология. 2013;2:123-128
  7. Kogan M.I., Belousov 1.1., Shangichev A.V. Whether dyslipidemia plays the pathogenetic role in the development of noninflammatory chronicprostatitis/chronic pelvic pain syndrome? Urologiia. 2012; (5): 46-52.
  8. Kozlowski R., Kershen R.T., Siroky M.B. et al. Chronic ischemia alters prostate structure and reactivity in rabbits. J. Urol. 2001;165 (3):1019- 1026. doi: 10.1016/S0022-5347(05)66595-0.
  9. Allen S., Aghajanyan I.G. Benign prostatic hyperplasia treatment with new physiotherapeutic device. Urol. J. 2015;12(5):2371-2376.
  10. Kessler T.M., Mordasini L., Weisstanner C. et al. Sono-electro-magnetic therapy for treating chronic pelvic pain syndrome in men: a randomized, placebo-controlled, double-blind trial. PLoS One. 2014;9(12):e113368. doi: 10.1371/journal.pone.0113368.
  11. Лоран О.Б. Диагностика и дифференциальная диагностика доброкачественной гиперплазии предстательной железы. В. кн.: Доброкачественная гиперплазия предстательной железы, Под ред. Н.А. Лопаткина. М.: Наука. 1999. C. 56-70
  12. Kiyatkin V.A., Konchugova T.V., Yakovlev M. Y., Bobkov A.D. The application of the combined resonance-wave therapy for the treatment of the patients presenting with chronic bacterial prostatitis. Vopr. Kurortol. Fizioter. Lech. Fiz. Kult. 2015;92(5):40-44. Doi: 10.17116/ kurort2015540-44.
  13. Аполихин О.И., Сивков А.В., Ощепков В.Н. Термальные неэндоскопические методы лечения ДГПЖ. В. кн.: Доброкачественная гиперплазия предстательной железы.Под ред. Н.А. Лопаткина. М.: Наука. 1999. C. 134-149
  14. Сучкова Ж.Н. Локальная магнитотерапия. Медицинская газета. 2001;62:9-13
  15. Улащик В.С. Новые методы и методики физической теории. Минск: Беларусь. 1986. 176 с.
  16. Гайдуков В.П., Жиборев Б.Н., Жиборев А.Б. и др. Устройство для физиотерапевтического воздействия на ткани полостей организма. Патент № 2291678. Бюлл. № 2 от 20.01.2007. http://www.freepatent.ru/patents/2291678
  17. Системы комплексной электромагнитотерапии. Уч. пособие для вузов. Под ред. А.М. Беркутова, В.И. Жулева, Г.А. Кураева, Е.М. Прошина. М.: Бином. 2000. 376 с.

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