Assessment Of The Therapeutic Efficacy Of Trans-rectal Triple Physiotherapy Combined With Pharmacotherapy In Patients With Chronic Prostatitis/chronic Pelvic Pain Syndrome(CP/CPPS)

[Objective]CP/CPPS is one of the most commonly diagnosed diseases in clinical urology,and it has a sizable damaging effect on the patients’ physical and mental health and quality of life.The aim of this research is to evaluate the therapeutic effect of the combination of trans-rectal triple physiotherapy plus pharmacotherapy in chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS)and to compare this combinatorial effect with the effect of pharmacotherapy alone retrospectively.[Methods]A total of 73 patients with CP/CPPS who were treated for 8 weeks at outpatient department of urology in Qilu hospital between June 2015 and June 2016 with a follow-up of at least 8 weeks were analysed.According to their treatment strategy,the patients were divided into two groups:the first group consisted of 38 patients who were treated with a pharmacotherapy of antibiotics,a-blocker,and anti-inflammatory phytotherapy,and the second group consisted of 35 patients who received a combination of the same pharmacotherapy as the first group and trans-rectal triple physiotherapy,which consisted of hyperthermia,prostate massage and magnetic stimulation.Demographic data and laboratory test results of two groups were collected by charts reviewing for comprison.And all of the patients were evaluated by the National institutes of Health-Chronic Prostatitis Symptom Index(NIH-CPSI),Hospital Anxiety and Depression Scale(HADS),post-void residual urine volume(PVR)and maximum flow rate(Qmax)before and after therapy and underwent an 8-week follow-up after the cessation of therapy.Statistical analysis was performed using the Statistical Package for Social Science(SPSS for Windows,version 21.0,SPSS Inc.,Chicago,IL,USA)program.Correlations between categorical variables were evaluated by the Pearson’s chi square test or Fisher’s exact test and continuous variables by independent t-test in this study.The two-sided p-value was used in our analyses,and a p-value of less than 0.05 was considered statistically significant.[Results]There were 27 patients diagnosed with type IIIA prostatitis and 46 patients diagnosed with Ⅲβ prostatitis,with an average age of 40.05±9.59 years(ranging from 24 to 61).The demographic data and basic laboratory test results before treatment,including age,weight,height,BMI,educational level,prostate volume and so on,were not significantly different between these two groups(P>0.05),which meant these two groups of cases were comparable.At the termination of therapy and 8-week follow-up,significant improvements in NIH-CPSI total and subscale scores and PRV were observed in both groups,with significantly better outcomes in the second group.The Qmax of Patients in the first group was 14.13±1.79 mL/s at the end of the therapy and 14.45±2.41 mL/s at the 8-week follow-up,without exhibiting a significant improvement compared with the baseline(P>0.05).While patients who received the combined therapy showed a significant increase in Qmax at the termination of therapy as well as 8-week follow-up(16.37±1.55mL/s,16.51±2.03mL/s vs 13.14±2.09mL/s;P<0.05).For HADS,both groups exhibited a significant improvement(P<0.05),and there was no significant difference between the groups(P>0.05).[Conclusion]The combination of trans-rectal triple physiotherapy and pharmacotherapy may be a safe and effective therapeutic strategy for patients with CP/CPPS.Thus,there is a need for more prospective,randomized,controlled studies to confirm our results.