Kronik Prostatit Kategori Tip IIIA / Kronik Pelvik Ağrı Sendromlu Hastalarda Antioksidan Tedavinin Semptomlar Üzerine Etkisi

Abstract

Amaç: Çalışmanın amacı kronik prostatit kategori tip IIIA / kronik pelvik ağrı sendromlu KP/KPAS hastalarda antioksidan tedavinin semptomlar üzerine etkisinin değerlendirilmesidir.Gereç ve Yöntemler: Ekim 2016 ile Aralık 2017 arasında antioksidan ajan olan Progeny-M® ile tedavi edilen KP/KPAS kategori IIIA hastaların verileri retrospektif olarak değerlendirildi. Tedavi öncesi ve tedavi sonrası semptomların değerlendirilmesinde National Institute of Health- Kronik Prostatit Semptom İndeksi NIH-KPSİ kullanıldı. Tedaviden sonra NIH-KPSİ toplam skorunda %25’ten fazla azalma tedaviye yanıt olarak kabul edildi. P

Keywords

• Kronik prostatit, Kronik pelvik ağrı sendromu, Antioksidan tedavi, Kronik prostatit semptom indeksi

Efficacy of Antioxidant Treatment on the Symptoms of Patients with Chronic Prostatitis/Chronic Pelvic Pain Syndrome Category IIIA

Abstract

Objective: The aim of this study was to evaluate the effect of antioxidant treatment on the symptoms in patients with chronic prostatitis/chronic pelvic pain syndrome CP/CPPS category IIIA.Material and Methods: We retrospectively evaluated the data of patients with chronic prostatitis/chronic pelvic pain syndrome category IIIA who were treated by Progeny- M®, an antioxidant agent, between October 2016 and December 2017. The pretreatment and posttreatment symptoms were assessed using the National Institutes of Health-Chronic Prostatitis Symptom Index NIH-CPSI . A reduction of the NIH-CPSI total score by ≥25% after the treatment was accepted as an improvement. A value of P < 0.05 was considered statistically significant.Results: Thirty-five out of 53 patients diagnosed with chronic prostatitis were CP/CPPS category IIIA. Seventeen of them were treated with antioxidant agent Progeny- M® for a month. Mean NIH-CPSI total score was significantly decreased after the treatment with Progeny-M® compared to the pretreatment mean score p < 0.001 . Pretreatment mean pain, urinary and quality of life scores of NIH- CPSI 12.1±3.8, 4.7±2.8, 7.6±2.7, respectively were significantly decreased compared to posttreatment scores 8.2±4.2, 3.1±2.0, 5.2±2.6 p < 0.001, p=0.002, p=0.004, respectively .Conclusion: The mean total, pain, urinary and quality of life NIH-CPSI scores significantly decreased after 4 weeks of Progeny-M® treatment in patients with CP/CPPS category IIIA. 58.8% the patients had improved NIH-CSPI scores after the treatment

Keywords

• Chronic prostatitis, Chronic pelvic pain syndrome, Antioxidant therapy, Chronic prostatitis symptom index

References

1. Krieger JN, Lee SW, Jeon J, Cheah PY, Liong ML, Riley DE. Epidemiology of prostatitis. Int J Antimicrob Agents 2008; 31 Suppl. 1: 85-90.
2. Krieger JN, Nyberg L Jr, Nickel JC. NIH consensus definition and classification of prostatitis. JAMA 1999; 282:236-7.
3. Nickel JC: Prostatitis syndromes: An update for urologic practice. Can J Urol 2000;7: 1091-8.
4. Schaeffer AJ, Datta NS, Fowler JE Jr, Krieger JN, Litwin MS, Nadler RB. Chronic Prostatitis Collaborative Research N. 2002 Overview summary statement. Diagnosis and management of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). Urology 2002; 60:1-4.
5. Schaeffer AJ, Knauss JS, Landis JR, Propert KJ, Alexander RB, Litwin MS, Nyberg LM. Leukocyte and bacterial counts do not correlate with severity of symptoms in men with chronic prostatitis: The National Institutes of Health Chronic Prostatitis Cohort Study. Journal of Urology 2002; 168:1048-53.
6. Litwin MS, McNaughton-Collins M, Fowler FJ Jr, Nickel JC, Calhoun EA, Pontari MA, Alexander RB, Farrar JT, O'Leary MP. The National Institutes of Health chronic prostatitis symptom index: Development and validation of a new outcome measure. J Urology 1999; 162:369-75.
7. Breser ML, Salazar FC, Rivero VE, Motrich RD. Immunological mechanisms underlying chronic pelvic pain and prostate in chronic pelvic pain syndrome. Front Immunol 2017; 8:898.
8. Nickel JC, Downey J, Clark J, Casey RW, Pommerville PJ, Barkin J, Steinhoff G, Brock G, Patrick AB, Flax S, Goldfarb B, Palmer BW, Zadra J. Levofloxacin for chronic prostatitis/chronic pelvic pain syndrome in men: A randomized placebo-controlled multicenter trial. Urology 2003;62(4):614-7.

9. Nickel JC, Narayan P, McKay J, Doyle C. Treatment of chronic prostatitis/ chronic pelvic pain syndrome with tamsulosin: A randomized double blind trial. J Urol 2004;171(4):1594-7.
10. Zhao WP, Zhang ZG, Li XD, Yu D, Rui XF, Li GH, Ding GQ. Celecoxib reduces symptoms in men with difficult chronic pelvic pain syndrome (Category IIIA). Braz J Med Biol Res 2009;42(10):963-7.
11. Rugendorff EW, Weidner W, Ebeling L, Buck AC. Results of treatment with pollen extract (cernilton N) in chronic prostatitis and prostatodynia. Br J Urol 1993;71: 433-8.
12. Shahed AR, Shoskes DA. Oxidative stress in prostatic fluid of patients with chronic pelvic pain syndrome: correlation with gram positive bacterial growth and treatment response. J Androl 2000;21:669-75.
13. Pasqualotto FF, Sharma RK, Potts JM, Nelson DR, Thomas AJ, Agarwal A. Seminal oxidative stress in patients with chronic prostatitis. Urology 2000;55(6):881- 5.
14. Cai T, Verze P, La Rocca R, Palmieri A, Tiscione D, Luciani LG, Mazzoli S, Mirone V, Malossini G. The Clinical Efficacy of Pollen Extract and Vitamins on chronic prostatitis/chronic pelvic pain syndrome is linked to a decrease in the pro-inflammatory cytokine interleukin-8. World J Mens Health 2017; 35(2):120-8.
15. Potts JM, Pasqualotto FF. Seminal oxidative stress in patients with chronic prostatitis. Andrologia 2003; 35:304- 8.
16. Potts JM, Sharma RK, Pasqualotto FF, Nelson DR, Agarwal A. Association of Ureaplasma urealyticum infection with abnormal seminal reactive oxygen species and absence of leukocytospermia. J Urol 2000;163:1775-8.
17. Morgia G, Mucciardi G, Galì A, Madonia M, Marchese F, Di Benedetto A, Romano G, Bonvissuto G, Castelli T, Macchione L, Magno C. Treatment of chronic prostatitis/ chronic pelvic pain syndrome category IIIA with Serenoa repens plus selenium and lycopene (Profluss) versus S. repens alone: An Italian randomized multicenter- controlled study. Urol Int 2010; 84:400-6.
18. Shoskes DA, Zeitlin SI, Shahed A, Rajfer J. Quercetin in men with category III chronic prostatitis: A preliminary prospective, double-blind, placebo-controlled trial. Urology 1999;54(6): 960-3.
19. Oka M, Ueda M, Oyama T, Kyotani J, Tanaka, M. Effect of the phytotherapeutic agent Eviprostat on 17beta- estradiol-induced nonbacterial inflammation in the rat prostate. Prostate 2009;69:1404-10.
20. Hajighorbani M, Ahmadi-Hamedani M, Shahab E, Hayati F, Kafshdoozan K, Keramati K, Amini AH. Evaluation of the protective effect of pentoxifylline on carrageenan-induced chronic non-bacterial prostatitis in rats. Inflammopharmacology 2017;25(3):343-50.