Therapeutic Efficacy of Bipolar Radiofrequency Thermotherapy for Patients with Chronic Prostatitis: A Retrospective Analysis of 26 Cases

Abstract

PurposeChronic prostatitis (CP) does not yet have a universally successful therapy. Alternative treatments including thermotherapy have been adopted in the multimodal management of pain and voiding dysfunction. We retrospectively analyzed the therapeutic efficacy of bipolar radiofrequency thermotherapy for patients who were unsatisfied with conventional medication for CP.Materials and MethodsA retrospective study between October 2009 and September 2010 of 26 patients who were under 50 years old and diagnosed with CP (National Institutes of Health [NIH]-category III) was performed. Twenty patients were diagnosed with inflammatory CP (NIH-category IIIa) and the rest with noninflammatory CP (NIH-category IIIb). We used the Tempro system at an intraprostatic temperature of 55℃ for 50 minutes with a medium heating rate. All patients also completed the NIH-Chronic Prostatitis Symptom Index (CPSI) before and after treatment.ResultsIn the patients diagnosed with CP, the mean serum prostate-specific antigen (PSA) level was 0.9±0.3 ng/ml, the prostate volume was 27.1±5.5 g, and the average score for all 3 domains on the NIH-CPSI significantly decreased. The total scores decreased from 19.8±7.1 to 11.1±7.0, the pain domain decreased from 8.6±3.1 to 4.8±3.1, the voiding symptom domain decreased from 5.1±1.8 to 2.9±1.8, and the effect on the quality of life decreased from 6.1±2.2 to 3.4±2.2 (p<0.05).ConclusionsBipolar radiofrequency thermotherapy for patients with CP intractable to conventional medication can provide significant improvement in the NIH-CPSI. Large, randomized controlled trials will also be required to confirm the efficacy of this therapy.

Effect of bipolar radiofrequency thermotherapy on benign prostate hyperplasia

“…Although TURP remains the gold standard for the surgical treatment of BPH, urologists and patients are seeking less invasive outpatient procedures to reduce the size of the prostate and alleviate LUTS (Allen & Aghajanyan, 2017). One of these treatments is transurethral bipolar radiofrequency treatment (Tempro © -Direx; Lim et al, 2012). The aim of radiofrequency treatment in patients with BPH is the permanent thermoablation of occlusive prostate tissue without significant damage to the adjacent tissues, including the rectum and urethra.…”

Bipolar radiofrequency thermotherapy treatment of the prostate in urinary catheter‐dependent men

“…RF energy released from the electrodes activates ions and causes friction. The heat generated as a result of this friction allows reaching an appropriate temperature 9 . The term thermotherapy was coined to describe treatment temperatures above 45°C.…”

“…In patients for whom surgical treatment is indicated, the surgery‐associated high morbidity and mortality rates have led researchers to seek minimally invasive treatment options. Among the currently available minimally invasive heat treatments are transurethral microwave therapy (TUMT), transurethral needle ablation (TUNA), convective radiofrequency (RF) water vapor thermal therapy (Rezum), and bipolar RF thermotherapy, in which the aim is to apply thermotherapy to the prostate 8,9 …”

Bipolar prostate thermotherapy for the improvement of chronic prostatitis symptoms and ejaculation problems

“…Among the various strategies suggested for treating CP/CPPS, thermal treatment appears as a promising approach that is reported to clinically decrease pain and symptoms in patients with weak response to standard treatments. In the treatment approaches that have been used to date, overall improvements have been reported using thermal therapy in terms of both objective and subjective evaluations [25]. Thermal therapy can alter afferent nerve fibers which are effective in the transmission of pain caused by inflammation in the prostate gland.…”