Gabapentin for the Treatment of Chronic Pelvic Pain Syndrome in Patients with High Pain Score

Seok Cho; In-Rae Cho

doi:10.14777/uti.2019.14.2.55

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Cho and Cho: Gabapentin for the Treatment of Chronic Pelvic Pain Syndrome in Patients with High Pain Score

Original Article

Urogenit Tract Infect 2019;14(2):55-59.

Published online: 20 August 2019

DOI: https://doi.org/10.14777/uti.2019.14.2.55

Gabapentin for the Treatment of Chronic Pelvic Pain Syndrome in Patients with High Pain Score

Seok Cho, In-Rae Cho

Department of Urology, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea

Correspondence to: In-Rae Cho https://orcid.org/0000-0002-6331-5806 Department of Urology, Inje University Ilsan Paik Hospital, 170 Juhwa-ro, Ilsanseo-gu, Goyang 10380, Korea Tel: +82-31-910-7230, Fax: +82-31-910-7239 E-mail: ircho@paik.ac.kr

Received 26 July 2019 Revised 14 August 2019 Accepted 21 August 2019

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

The underlying pathogenic mechanisms of chronic pelvic pain syndrome (CPPS) are unclear. A growing body of evidence suggests that the urogenital pain of CPPS may be neuropathic in origin. The objective of this study was to determine if gabapentin can be an effective treatment for the symptoms of CPPS with severe pain.

Materials and Methods

Thirty five males with CPPS (category IIIa 25, IIIb 10) and the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) total pain score ≥9 in the previous six months were enrolled in this study between October 2010 and December 2011. The dosage of gabapentin was increased from 300 mg/d to 600 mg/d during the first four weeks. The primary outcome was evaluated as an improvement in the NIH-CPSI from the baseline to week eight.

Results

This study examined 35 males with CPPS and a mean age of 54.2±9.8 years, mean disease duration of 34.2±27.7 months, and a mean prostate volume of 24.9±5.3 ml. The decrease in the total NIH-CPSI pain domain at four weeks was significant with no change observed after eight weeks. Between the category IIIa and IIIb CPPS patients, the change in the total pain domain was not significant.

Conclusions

Gabapentin may be effective in some males with CPPS who have a high pain score. More gabapentin may be useless and possibly harmful if gabapentin does not decrease the pain at four weeks.

Keywords: Chronic prostatitis with chronic pelvic pain syndrome, Gabapentin, Pain, Prostatitis

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Fig. 1.

Pain domain changes from baseline to week 8 in IIIA group, IIIB group and total.

Table 1.

Baseline characteristics of the patients

Characteristic	Category of CPPS
Characteristic	IIIa (n=25)	IIIb (n=10)	Total (n=35)
Age (y)	51.3±10.9	58.6±6.8	54.2±9.8
Duration of symptoms (mo)	36.7±31.5	30.4±21.8	34.2±27.7
Prostate volume (ml)	23.8±5.2	26.6±5.7	24.9±5.3
Sum of pain domain	12.80±2.43	13.00±2.20	12.88±2.36

Values are presented as mean±standard deviation.

CPPS: chronic pelvic pain syndrome.

Table 2.

Outcome measurements based on the NIH-CPSI pain domain at baseline, four weeks and four weeks

Category of CPPS	Sum of pain domain (differences from baseline)
Category of CPPS	Baseline	At 4 weeks	p-value^a)	At 8 weeks	p-value^b)	p-value^c)
IIIa (n=25)	12.80±2.43	10.47±3.77 (2.33±3.38)	0.0124	10.07±3.65 (2.73±3.22)	0.0031	0.7048
IIIb (n=10)	13.00±2.20	10.10±3.50 (2.90±2.32)	0.0369	10.50±4.30 (2.50±3.40)	0.1190	0.8221
Total (n=35)	12.88±2.36	10.32±3.67 (2.56±2.97)	0.0009	10.24±3.93 (2.64±3.31)	0.0011	0.9301

Values are presented as mean±standard deviation. NIH-CPSI: National Institutes of Health Chronic Prostatitis Symptom Index, CPPS: chronic pelvic pain syndrome.

^a) Difference between baseline and 4 weeks;

^b) difference between baseline and 8 weeks;

^c) difference between four weeks and four weeks;

^a-c) Results from the Mann–Whitney U test.

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