How to help a patient with abacterial prostatitis?

Capa

Citar

Texto integral

Acesso aberto Acesso aberto
Acesso é fechado Acesso está concedido
Acesso é fechado Acesso é pago ou somente para assinantes

Resumo

Introduction. Despite all the achievements of modern medicine, chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) remains a difficult disorder to treat. Patients are often dissatisfied with the treatment outcomes, since the main symptoms, namely pain and urination disorders, usually decrease, but do not completely resolve.

Aim. To study the efficiency of the combined drug Prostatex Plus in the treatment of patients with CPPS (IIIb).

Material and methods. A total of 60 patients with chronic abacterial prostatitis of category IIIb with a severe pain were included in the study. The main group included 37 patients, who received one suppository Prostatex Plus per rectum at night for 20 days. In the control group (n=23), patients received non-steroidal anti-inflammatory drugs and vitamins. The examination was performed at baseline, on the 20th day (upon completion of the Prostatex Plus therapy) to assess the immediate effect and 30 days after completion of cytokine therapy to assess the long-term results.

Results. The average age of patients was 48.3±3.7 years. The duration of the disease ranged from 2 to 16 years, averaging 9.7±3.2 years. The leading symptom was pain in 100% of patients, the pain intensity was higher than 8 points. For all the assessed parameters, more significant positive results were obtained in the Prostatex Plus group, the effect of the treatment lasted for a month.

Conclusion. The combined use of tamsulosin and organ-specific regulatory in patients with CP/CPPS with severe pain syndrome led to a stable effect. A significant decrease in pain intensity and the total score on the CP symptom scale was seen, as well as an improvement in local microcirculation, sexual function, an increase in the maximum and average urine flow rate compared to the control group. Satisfactory treatment outcomes led to an improvement in the quality of life.

Texto integral

Acesso é fechado

Sobre autores

E. Kulchavenya

FGBOU VO Novosibirsk State Medical University of Ministry of Health of Russia; Medical Center “Avicenna”

Autor responsável pela correspondência
Email: urotub@yandex.ru
ORCID ID: 0000-0001-8062-7775

Ph.D., MD, professor, professor at the Department of Phthisiopulmonology of FGBOU VO Novosibirsk State Medical University of Ministry of Health of Russia, Scientific Chief of the Medical Center “Avicenna” of the group of companies "Mother and Child"

Rússia, Novosibirsk; Novosibirsk

D. Kholtobin

Medical Center “Avicenna”; Altai State Medical University of the Ministry of Health of Russia

Email: urology-avicenna@mail.ru
ORCID ID: 0000-0001-6645-6455

Ph.D., MD, Department of Urology and Andrology with a course of Specialized Surgery of Altai State Medical University of the Ministry of Health of Russia, Head of the Urologic Department of the Medical Center “Avicenna” of the group of companies "Mother and Child"

Rússia, Novosibirsk; Barnaul

S. Shevchenko

GNUZ NSO City Hospital No. 3; MC "Zdravitsa"

Email: shevchenko_s@list.ru
ORCID ID: 0000-0001-5013-2667

Ph.D., deputy chief at the GNUZ NSO City Hospital No. 3, urologist at the MC "Zdravitsa"

Rússia, Novosibirsk; Novosibirsk

E. Brizhatyuk

LLC "Family Medicine Center "Almita"

Email: elena.brizhatyuk@yandex.ru
ORCID ID: 0000-0002-2697-4001

Ph.D., urologist

Rússia, Novosibirsk

Bibliografia

  1. Magistro G., Stief C.G., Wagenlehner F.M.E. Chronische Prostatitis/chronisches Beckenschmerzsyndrom [Chronic prostatitis/chronic pelvic pain syndrome]. Urologe A. 2020;59(6):739–748. doi: 10.1007/s00120-020-01226-5.
  2. Stamatiou K., Trinchieri M., Trinchieri M., Perletti G., Magri V. Chronic prostatitis and related psychological problems. Which came first: The chicken or the egg? A systematic review. Arch Ital Urol Androl. 2023;95(1):11300. doi: 10.4081/aiua.2023.11300. Shevchenko S.Yu., Kulchavenya E.V., Baranchukova A.A. The possibility of correcting oxidative stress in patients with inflammatory type of chronic abacterial prostatitis (chronic pelvic pain syndrome category IIIa). Urologiia. 2023;6:22–29 Doi: https: //dx.doi.org/10.18565/urology.2023.6.22-29. Russian (Шевченко С.Ю., Кульчавеня Е.В., Баранчукова А.А. Возможность коррекции оксидативного стресса у больных хроническим абактериальным простатитом с признаками воспаления (синдром хронической тазовой боли категории III-a). Урология. 2023;6:22–29. doi: https: //dx.doi.org/10.18565/urology.2023.6.22-29).
  3. Doiron R.C., Shoskes D.A., Nickel J.C. Male CP/CPPS: where do we stand? World J Urol. 2019;37(6):1015–1022. doi: 10.1007/s00345-019-02718-6.
  4. Sebastianelli A., Spatafora P., Morselli S., Vignozzi L., Serni S., McVary K.T., Kaplan S., Gravas S., Chapple C., Gacci M. Tadalafil Alone or in Combination with Tamsulosin for the Management for LUTS/BPH and ED. Curr Urol Rep. 2020;21(12):56. doi: 10.1007/s11934-020-01009-7.
  5. Kulchavenya E.V., Treyvish L.S., Telina E.V., Tsukanov A.Yu., Neimark A.I., Neimark A.B., Kholtobin D.P., Razdorskaya M.V. Onto-phylogenetic prerequisites for development of chronic cystitis in women. Urologiia. 2023;6:30–37. doi: https: //dx.doi.org/10.18565/urology.2023.6.30-37. Russian ( Кульчавеня Е.В., Трейвиш Л.С., Телина Е.В., Цуканов А.Ю., Неймарк А.И., Неймарк А.Б., Холтобин Д.П., Раздорская М.В. Онто-филогенетические предпосылки хронизации цистита у женщин. Урология. 2023;6:30–37. doi: https: //dx.doi.org/10.18565/urology.2023.6.30-37).
  6. Kulchavenya E.V., Neymark A.I., Tcukanov A.Yu., Plugin P.S., Neymark A.B., Razdorskaya M.V. Combined therapy of patients with recurrent cystitis using a complex of natural antimicrobial peptides and cytokines: first results. Urologiia. 2022;6:47–55. Russian (Кульчавеня Е.В., Неймарк А.И., Цуканов А.Ю., Плугин П.С., Неймарк А.Б., Раздорская М.В. Комбинированная терапия больных рецидивирующим циститом с применением комплекса природных антимикробных пептидов и цитокинов: первые результаты. Урология. 2022;6:47–55. Doi: https: //dx.doi.org/10.18565/urology.2022.6.47-55)
  7. Al-Shukri S.H., Kuzmin I.V., Lukina E.E. The use of the Uroprost prostate peptide complex in patients with impaired urinary outflow from the bladder. Experimental and clinical urology. 2010;3:80–88. Russian (Аль-Шукри С.Х., Кузьмин И.В., Лукина Е.Е. Применение комплекса пептидов предстательной железы Уропрост у больных с нарушением оттока мочи из мочевого пузыря. Экспериментальная и клиническая урология. 2010;3:80–88).
  8. Kuzmin I.V. Vitaprost-forte in the treatment of patients with benign prostatic hyperplasia: pathogenetic foundations and clinical results. Urologia. 2019;4:141–147. doi: 10.18565/urology.2019.4.141-147. Russian (Кузьмин И.В. Витапрост-форте в лечении больных доброкачественной гиперплазией предстательной железы: патогенетические основы и клинические результаты. Урология. 2019;4:141–147. doi: 10.18565/urology.2019.4.141-147).
  9. Kuzmin I.V., Borovets S.Y., Gorbachev A.G., Al-Shukri S.K. Prostatic bioregulatory polypeptide prostatilen: pharmacological properties and 30-year experience of clinical application in urology. Urology reports (St.-Petersburg). 2020;10(3):243–258. doi: 10.17816/uroved42472. Russian (Кузьмин И.В., Боровец С.Ю., Горбачев А.Г., Аль-Шукри С.Х. Простатический биорегуляторный полипептид простатилен: фармакологические свойства и опыт 30-летнего клинического применения в урологии. Урологические ведомости. 2020;10(3):243–258. https://doi.org/10.17816/uroved42472).
  10. Kuzmin IV, Slesarevskaya MN, Al-Shukri SKh. Bioregulatory therapy for chronic abacterial prostatitis. Urology reports (St. Petersburg). 2022;12(3):191–201. doi: https://doi.org/10.17816/uroved111581. Russian (Кузьмин И.В., Слесаревская М.Н., Аль-Шукри С.Х. Биорегулирующая терапия больных хроническим абактериальным простатитом. Урологические ведомости. 2022;12(3):191–201. doi: https://doi.org/10.17816/uroved111581).
  11. Неймарк А.И., Давыдов А.В., Каблова И.В. Комплексное лечение больных хроническим бактериальным простатитом с применением биологическиактивных пептидов. Урологические ведомости. 2022;12(3):221–227. doi: https://doi.org/10.17816/uroved109913.
  12. Neymark A.I., Nozdrachev N.A., Kulchavenya E.V., Kholtobin D.P., Davydov A.V., Neymark A.B., Kovaleva Yu.S., Yakovlev A.V. se of the drug Prostatex plus in patients with chronic abacterial prostatitis and BPH. Urologiia. 2024;2:41-46 Doi: https://dx.doi.org/10.18565/urology.2024.2.41-46 Russian (Неймарк А.И., Ноздрачев Н.А., Кульчавеня Е.В., Холтобин Д.П., Давыдов А.В., Неймарк А.Б., Ковалева Ю.С., Яковлев А.В. Применение препарата Простатекс плюс у пациентов с хроническим абактериальным простатитом на фоне ДГПЖ. Урология. 2024;2:41–46. doi: https://dx.doi.org/10.18565/urology.2024.2.41-46).
  13. Krieger J.N., Nyberg L.Jr., Nickel J.C. NIH consensus definition and classification of prostatitis. JAMA. 1999;282(3):236–237. doi: 10.1001/jama.282.3.236.
  14. Kulchavenya E.V., Neymark A.I. Prostatitis. 2nd ed., reprint. and additional M.: GEOTAR-Media, 2022. 248 p. ISBN 978-5-9704-7060-2. Russian (Кульчавеня Е.В., Неймарк А.И. Простатит. 2-е изд., перераб. и доп. М.: ГЭОТАР-Медиа, 2022. 248 c. ISBN 978-5-9704-7060-2).
  15. Engeler D., Baranowski A.P., Berghmans B., Birch J., Borovicka J., Cottrell A.M., Dütschler J., Dinis-Oliveira P., Elneil S., Flink I., Messelink (Vice-chair) E.J., Parsons B., Pinto R.A., van Poelgeest (Patient Advocate) M.L., Tidman V., Vyawahare B., de C Williams Guidelines Associates A.C.: Abreu-Mendes P., S. Dabestani S., Tornic J., Zumstein Guidelines Office: C. Bezuidenhout. EAU guidelines on Chronic Pelvic Pain. Edn Present EAU Annu Congr in Paris, 2024. Доступ: https://d56bochluxqnz.cloudfront.net/documents/full-guideline/EAU-Guidelines-on-Chronic-Pelvic-Pain-2024.pdf (02.08.2024)
  16. Bonkat G., Bartoletti R., Bruyère F., Cai T., Geerlings S.E., Köves B., Kranz J., Schubert S., A. Pilatz, R. Veeratterapillay, F. Wagenlehner. EAU Guidelines on Urological Infections. Edn Present EAU Annu Congr in Paris, 2024. Доступ: https://d56bochluxqnz.cloudfront.net/documents/full-guideline/EAU-Guidelines-on-Urological-Infections-2024.pdf (02.08.2024)
  17. Franz J., Kieselbach K., Lahmann C., Gratzke C., Miernik A. Chronic Primary Pelvic Pain Syndrome in Men. Dtsch Arztebl Int. 2023;120(29–30):508–518. doi: 10.3238/arztebl.m2023.0036.
  18. True L.D., Berger R.E., Rothman I., Ross S.O., Krieger J.N. Prostate histopathology and the chronic prostatitis/chronic pelvic pain syndrome: a prospective biopsy study. J Urol. 1999;162:2014–2018.
  19. Nickel J.C., Alexander R.B., Schaeffer A.J., Landis J.R., Knauss J.S., Propert K.J. Chronic Prostatitis Collaborative Research Network Study Group. Leukocytes and bacteria in men with chronic prostatitis/chronic pelvic pain syndrome compared to asymptomatic controls. J Urol. 2003;170(3):818–22. doi: 10.1097/01.ju.0000082252.49374.e9.
  20. Desireddi N.V., Campbell P.L., Stern J.A., Sobkoviak R., Chuai S., Shahrara S., Thumbikat P., Pope R.M., Landis J.R., Koch A.E., Schaeffer A.J. Monocyte chemoattractant protein-1 and macrophage inflammatory protein-1alpha as possible biomarkers for the chronic pelvic pain syndrome. J Urol. 2008;179(5):1857–1861. doi: 10.1016/j.juro.2008.01.028.
  21. Penna G., Mondaini N., Amuchastegui S., Degli Innocenti S., Carini M., Giubilei G., Fibbi B., Colli E., Maggi M., Adorini L. Seminal plasma cytokines and chemokines in prostate inflammation: interleukin 8 as a predictive biomarker in chronic prostatitis/chronic pelvic pain syndrome and benign prostatic hyperplasia. Eur Urol. 2007;51(2):524–533. doi: 10.1016/j.eururo.2006.07.016.
  22. Hou D.S., Long W.M., Shen J., Zhao L.P., Pang X.Y., Xu C. Characterisation of the bacterial community in expressed prostatic secretions from patients with chronic prostatitis/chronic pelvic pain syndrome and infertile men: a preliminary investigation. Asian J Androl. 2012;14(4):566–573. doi: 10.1038/aja.2012.30.
  23. Woodworth D., Mayer E., Leu K., Ashe-McNalley C., Naliboff B.D., Labus J.S., Tillisch K, Kutch JJ, Farmer MA, Apkarian A.V., Johnson K.A., Mackey S.C., Ness T.J., Landis J.R., Deutsch G., Harris R.E., Clauw D.J., Mullins C., Ellingson B.M.; MAPP Research Network. Unique Microstructural Changes in the Brain Associated with Urological Chronic Pelvic Pain Syndrome (UCPPS) Revealed by Diffusion Tensor MRI, Super-Resolution Track Density Imaging, and Statistical Parameter Mapping: A MAPP Network Neuroimaging Study. PLoS One. 2015;10(10):e0140250. doi: 10.1371/journal.pone.0140250.
  24. Nickel J.C., Baranowski A.P., Pontari M., Berger R.E., Tripp D.A. Management of men diagnosed with chronic prostatitis/chronic pelvic pain syndrome who have failed traditional management. Rev Urol. 2007;9(2):63–72.
  25. Gacci M., Andersson K.E., Chapple C., Maggi M., Mirone V., Oelke M., Porst H., Roehrborn C., Stief C., Giuliano F. Latest Evidence on the Use of Phosphodiesterase Type 5 Inhibitors for the Treatment of Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia. Eur Urol. 2016;70(1):124–133. doi: 10.1016/j.eururo.2015.12.048.

Arquivos suplementares

Arquivos suplementares
Ação
1. JATS XML

Declaração de direitos autorais © Bionika Media, 2024