uti Urogenital Tract Infection Urogenit Tract Infect 2465-8243 2465-8510 Korean Association of Urogenital Tract Infection and Inflammation 10.14777/uti.2017.12.01.35 uti-12-35 Original Article The Effects of Microwave Thermotherapy for Chronic Prostatitis/Chronic Pelvic Pain Syndrome: A Prospective, Randomized Study ChungHong ChoiHoon 1 YooTag Keun 2 ChoJeong Man 2 KimHong Sup Department of Urology, Konkuk University School of Medicine, Chungju Department of Urology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan Department of Urology, Nowon Eulji Hospital, Eulji University School of Medicine, Seoul, Korea Correspondence to: Hong Sup Kim http://orcid.org/0000-0001-7820-5303 Department of Urology, Konkuk University Chungju Hospital, 82 Gugwon-daero, Chungju 27376, Korea Tel: +82-43-840-8270, Fax: +82-43-848-4722 E-mail: hskim@kku.ac.kr 042017 19042017 12135 41 09112016 04122016 12122016 Copyright © 2017 Korean Association of Urogenital Tract Infection and Inflammation 2017 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Purpose:

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) causes pain and urinary symptoms that involve the prostate and/or other parts of the male. We analyzed the clinical outcomes of medication and microwave thermotherapy.

 Materials and Methods:

A total of 132 patients with CP/CPPS for at least 3 months were assigned to one of the three study groups (group A: medication; group B: thermotherapy; group C: combination therapy). The NIH-CPSI was recorded at baseline, and at weeks 2, 4, 8, and 12 post-therapy. EPS was evaluated, and semen analysis was performed to assess the changes in prostatic inflammation. Moreover, patient satisfaction questionnaire was completed.

 Results:

Comparisons between groups A and B, as well as between groups B and C showed no significant changes in pain, quality of life, and total scores. At week 12, group C, when compared with group A, had a significantly improved voiding score (4.19±3.02 vs. 2.71±2.30, p=0.019) and EPS (12.47±15.91 vs. 3.73±4.82, p=0.003). At week 4, the patient satisfaction score in group C was significantly different from that in other groups (p=0.043), but there was no difference at week 12 (p＞0.05). There was no statistically significant difference in laboratory test results, PSA, and prostate volume between the three groups at baseline and week 12. Complications of thermotherapy resolved with conservative management.

 Conclusions:

Our results showed that a combination of medication and thermotherapy improved NIH-CPSI and patient satisfaction in CP/CPPS more than medication alone. We suggested that thermotherapy could be another treatment option for CP/CPPS.

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URO-DRTM (Somang Medical, Gangneung, Korea).

Study flow diagram. Group A: medical therapy, group B: microwave thermotherapy, group C: medication and microwave thermotherapy.

Changes of pain, voiding, quality of life (QoL), and total score. Group A: medical therapy, group B: microwave thermotherapy, group C: medication and microwave thermotherapy, NIH-CPSI: The National Institutes of Health Chronic Prostatitis Symptom Index.

Patient characteristics

Characteristic Group A (n=37) Group B (n=41) Group C (n=35)
Age (y) 31.5±6.7 35.1±8.9 38.1±8.0
Height (cm) 168.8±6.56 169.5±4.5 170.4±4.55
Body weight (kg) 67.5±9.07 68.5±9.84 69.5±8.91
Category      
  IIIA (VAS 0 to 15) 13 21 13
  IIIB (VAS 0 to 30) 24 20 22
Duration of symptoms (mo) 24.95±27.15 (3-120) 24.59±7.10 (2-168) 23.94±5.92 (3-240)
Previous treatment history of CP/CPPS 21 (56.8) 20 (48.8) 19 (54.3)
Prostate specific antigen (ng/ml)      
  Baseline 0.9±0.8 1.1±0.8 1.0±0.8
  Week 12 0.8±0.6 1.5±1.6 1.0±0.4
Prostate volume (TRUS, ml)      
  Baseline 19.2±5.9 22.7±5.6 21.5±5.1
  Week 12 19.6±5.1 24.6±6.6 20.6±5.7
White blood cells (/l)      
  Baseline 6,236±1,597 6,632±1,480 7,043±1,554
  Week 12 6,306±2,012 6,657±1,635 6,320±1,376

Values are presented as mean±standard deviation, number only, or number (%).

Group A: medical therapy, group B: microwave thermotherapy, group C: medication and microwave thermotherapy, VAS: visual analogue scale, CP/CPPS: chronic prostatitis/chronic pelvic pain syndrome, TRUS: transrectal ultrasound.

All parameters were no statistically significant difference compared with each groups.

NIH-CPSI score at the baseline and at week 12

NIH-CPSI Group A (n=37) Group B (n=41) Group C (n=35)
Baseline Week 12 Baseline Week 12 Baseline Week 12
Pain 11.24±3.92 6.51±4.23 11.02±3.06 6.76±3.55 11.49±3.30 5.91±4.05
Voiding 6.11±2.58 4.19±3.02 5.29±3.03 3.17±2.52 4.66±3.10 2.71±2.30
QoL 8.97±2.92 6.49±2.67 8.27±2.66 5.46±2.25 7.80±2.17 5.83±2.62
Total 26.27±5.45 17.19±8.23 24.59±7.10 15.39±6.51 23.94±5.92 14.46±7.34

Values are presented as mean±standard deviation.

Group A: medical therapy, group B: microwave thermotherapy, group C: medication and microwave thermotherapy, NIH-CPSI: The National Institutes of Health Chronic Prostatitis Symptom Index, QoL: quality of life.

Changes of patient satisfaction questionnaire

Patient satisfaction Group A (n=37) Group B (n=41) Group C (n=35)
IIIA (n=13) IIIB (n=24) IIIA (n=21) IIIB (n=20) IIIA (n=13) IIIB (n=22)
Week 4 Week 12 Week 4 Week 12 Week 4 Week 12 Week 4 Week 12 Week 4 Week 12 Week 4 Week 12
Very satisfied - 3 - 1 - 3 2 - 1 2 3 4
Satisfied 5 3 7 8 8 5 8 10 6 8 8 8
Neutral 7 5 15 12 10 12 9 9 5 3 10 10
Dissatisfied 2 2 1 2 3 - 1 1 - - 1 -
Very dissatisfied - - 1 1 - 1 - - - - - -

Group A: medical therapy, group B: microwave thermotherapy, group C: medication and microwave thermotherapy. Visual analogue scale: category IIIA, 0 to 15; category IIIB, 0 to 30.