Journals / Türk Üroloji Dergisi/Turkish Journal of Urology / 2006 / Cilt: 32 - Sayı: 3
Comparison of the efficiency of mono and triple therapy in chronic pelvic pain syndrome
- Pages
- 393–397
- DOI
- —
Abstract
Introduction: We compared the efficiency of monotherapy with α-blocker and combination therapy (α- blocker, muscle relaxant and antiinflammatory) using National Institute of Health- Chronic Prostatitis Symptom Index (NIH-CPSI) in chronic pelvic pain syndrome (CPPS). Materials and Methods: 45 patients (median age 34.1±8.3 year) who presented with lower urinary tract symptoms suggestive of prostatitis were evaluated for bacterial infection by Meares-Stamey criteria. The patients with diagnosis of category IIIB CPPS were randomized into 2 groups. Group 1; 23 patients were treated with combination therapy α-blocker (terazosin 5mg/day), muscle relaxant (thiocolchicoside 120mg/day) and antiinflammatory (ibuprofen 1200mg/day), group 2; 22 patients were treated with monotherapy (α-blocker, terazosin 5mg/day) for six months. Six patients were excluded from the study because of side effects of the drugs (gastric complaints in three patients, hypotension in three patients). Both of the groups were evaluated by NIH-CPSI before, after treatment and 6 months after completion of treatment. SPSS 11.0 was used for statistical analysis. Pre- and post-treatment scores were compared by Wilcoxon test. Results: Pre-treatment NIH-CPSI scores in group 1 were 8.80, 7.00 and 6.05 for pain, urinary symptoms and quality of life, respectively. Post treatment NIH-CPSI scores were 3.45, 3.40 and 2.45, respectively. In group 2, pre-treatment NIH-CPSI scores were 9.89, 5.21 and 8.21 and post treatment scores were 4.74, 2.32 and 4.00, respectively. The decrease in pain, urinary symptoms and quality of life scores were statistically significant for both groups. There was no statistically significant difference between two groups with respect to efficiency of treatment. NIH-CPSI pain, urinary symptoms and quality of life scores 6 months after completion of treatment were 4.64, 4.22 and 3.62 in group I and 5.92, 3.22 and 5.40 in group 2. Although the symptoms were increased after completion of treatment, it was insignificant. Conclusion: We found that α-blocker monotherapy was as effective and safe as combination therapy in the treatment of CPPS. Also, it was more economic than combination therapy.
Özet
Kategori IIIB kronik pelvik ağrı sendromunda (KPAS) α-bloker monoterapisi ile kombinasyon tedavisinin (α- bloker, kas gevşetici, antiinflamatuar) etkinliğini National Institute of Health- Kronik Prostatit Semptom İndeksi (NIH-KPSI) kullanarak karşılaştırdık. Prostatit düşündüren alt üriner sistem semptomlarıyla başvuran 45 hasta (ortalama yaş 34.1±8.3) Meares- Stamey kriterlerine göre bakteriyel enfeksiyon açısından değerlendirildi. Kategori IIIB KPAS tanısı konulan hastalar iki gruba ayrıldı. Grup 1; 23 hastaya kombinasyon terapisi α-bloker (terazosin, 5 mg/gün), kas gevşetici (thiocolchicoside 120 mg/gün) ve antiinflamatuar (ibuprofen 1200 mg/gün), Grup 2; 22 hastaya monoterapi (α- bloker, terazosin 5 mg/gün) 6 ay süreyle verildi. Altı hasta ilacın yen etkileri nedeniyle çalışmadan çıkarıldı (hipotansiyon 3 hasta, gastrik şikayetler 3 hasta). İki gruptaki hastalar tedavi öncesi, tedavi bitiminde ve tedavi bitiminden 6 ay sonra NIH-KPSI ile değerlendirildi. İstatistik analiz olarak SPSS 11.0 kullanıldı. Tedavi öncesi ve sonrası skorlar Wilcoxon testi ile karşılaştırıldı. Tedavi öncesi grup 1'de NIH-KPSİ ağrı, üriner belirti ve yaşam kalitesi skorları sırasıyla 8.80, 7.00 ve 6.05 ve tedavi sonrası sırasıyla 3.45, 3.40 ve 2.45 idi. Grup 2'de, NIH-KPSİ skorları sırasıyla tedavi öncesi 9.89, 5.21 ve 8.21 ve tedavi sonrası 4.74, 2.32 ve 4.00 idi. İki grupta da ağrı, üriner semptom ve yaşam kalitesi skorları istatistiksel olarak anlamlı azaldı. İki grup arasında tedavi etkinliği bakımından istatistiksel farklılık yoktu. Tedavi bitiminden 6 ay sonraki NIH-KPSİ ağrı, üriner belirti ve yaşam kalitesi skorları sırasıyla grup 1'de 4.64, 4.22 ve 3.62, grup 2'de 5.92, 3.22 ve 5.40 idi. Tedavi kesildikten sonra belirtiler artmakla beraber, bu artış anlamlı değildi. Alfa bloker monoterapisi kategori IIIB KPAS tedavisinde güvenli ve etkilidir. Kombinasyon tedavisinden daha ekonomiktir.