The Effects of Microwave Thermotherapy for Chronic Prostatitis/Chronic Pelvic Pain Syndrome: A Prospective, Randomized Study

Hong Chung; Hoon Choi; Tag Keun Yoo; Jeong Man Cho; Hong Sup Kim

doi:10.14777/uti.2017.12.01.35

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Chung, Choi, Yoo, Cho, and Kim: The Effects of Microwave Thermotherapy for Chronic Prostatitis/Chronic Pelvic Pain Syndrome: A Prospective, Randomized Study

Original Article

Urogenit Tract Infect 2017;12(1):35-41.

Published online: 19 April 2017

DOI: https://doi.org/10.14777/uti.2017.12.01.35

The Effects of Microwave Thermotherapy for Chronic Prostatitis/Chronic Pelvic Pain Syndrome: A Prospective, Randomized Study

Hong Chung, Hoon Choi¹, Tag Keun Yoo², Jeong Man Cho², Hong Sup Kim

Department of Urology, Konkuk University School of Medicine, Chungju

¹Department of Urology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan

²Department 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

Received 9 November 2016 Revised 4 December 2016 Accepted 12 December 2016

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.

Abstract

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.

Keywords: Drug therapy, Microwaves, Prostate, Prostatitis

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Fig. 1.

URO-DR^TM (Somang Medical, Gangneung, Korea).

Fig. 2.

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

Fig. 3.

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.

Table 1.

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.

Table 2.

NIH-CPSI score at the baseline and at week 12

NIH-CPSI	Group A (n=37)		Group B (n=41)		Group C (n=35)
NIH-CPSI	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.

Table 3.

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.

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