Modern Methods of Non-Inflammatory Chronic Pelvic Pain Syndrome Treatment

Abstract

Relevance. Today there is an additional progressive option to apply into the non-inflammatory CPPS, which is presented by regenerative medicine and specifically platelet-rich plasma(PRP) treatment.
 Aim – to evaluate efficacy of PRP treatment in combination with pharmacotherapy and ESWT for non-inflammatory CPPS.
 Materials and methods. Prospective study was conducted in a group of 40 outpatients with diagnosis of non-inflammatory chronic pelvic pain syndrome in Men’s Health Clinic (Kyiv, Ukraine). Mean age was equal to 46.4±10.2. The set of specific examinations included: trans-rectal prostate scanning, prostate secret sample analysis, visual analogue pain scale (VAS), International Prostate Symptom Score (IPSS) and International Index of Erectile Function (IIEF-5).
 Results. Study results showed that there are significant differences in mean VAS scores in time point at 28-th day of treatment where patients of MG demonstrated lower pain level (p<0.05) than patients of CG, meanwhile both groups had significant (p<0.05) decrease of pain levels in comparison with initial data. In 3 months after treatment, we could see elevation of pain in CG to the level that have no significant differences with initial data, while patients of MG still have significantly lower pain level, but difference between groups come insignificant.
 IPSS levels at 28-th day of treatment showed significant (p<0.05) efficacy (bringing symptoms from moderate to mild level) in both groups with lack of difference between them. Such situation was observer also in 3 months after treatment with slight increase of symptom intensity in both MG and CG. In 6 months after treatment, we have registered elevation of IPSS mean score in CG up to the level of insignificant difference with initial data.
 IIEF-5 data showed significant (p<0.05) improvement of symptoms at 28-th day of treatment in both CG and MG without significant difference between groups. In 3 months after treatment, we observed that in CG the level of symptoms raised to the level that have insignificant difference with initial data, but in MG the improvement was still significant. The same situation was observed in 6 months after treatment.
 Conclusions. The efficacy of PRP treatment in combination with pharmacotherapy and ESWT for non-inflammatory CPPS was evaluated. Significant clinical effects were found both for PRP combination with ESWT and NSAID and just ESWT and NSAID directly after course of treatment, meanwhile in 3 and 6 months after treatment the results start to show difference in favor of PRP inclusion.