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01.06.2011 | Original Article

Effects of a 6-month course of tamsulosin for chronic prostatitis/chronic pelvic pain syndrome: a multicenter, randomized trial

Erschienen in: World Journal of Urology | Ausgabe 3/2011

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Abstract

Objective

To evaluate the efficacy and long-term benefits of tamsulosin in the treatment of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).

Methods

A total of 100 men diagnosed with CP/CPPS were randomly allocated to receive either 0.2 mg of tamsulosin daily or placebo for 6 months. Patients were followed up at 3, 6, 12, 18 and 30 months after initiation of treatment. The primary outcome variable was the change from baseline in the total and domain scores of the NIH-CPSI. Secondary variables used to evaluate efficacy of treatment included the following: peak urinary flow rate, post-voiding residual (PVR) volume and the International Index of Erectile Function (IIEF).

Results

The tamsulosin patients had modest satisfactory improvements compared to the placebo group during treatment. Six months after initiation of treatment, the mean decrement of total NIH-CPSI score in tamsulosin and placebo group were 7.5 ± 1.9 and 4.0 ± 2.3, respectively, P < 0.01. After cessation of therapy, the significant difference waned gradually. Two years after cessation of therapy, the mean decrement of total NIH-CPSI score in two groups were 3.0 ± 1.3 and 1.9 ± 0.9, respectively, P > 0.05. No differences were observed for data of patients classified as class III A or III B and data of peak urinary flow rate, PVR and the IIEF during the study period.

Conclusion

Our study shows that a 6-month course of tamsulosin ameliorated symptoms of CP/CPPS during treatment. However, these effects decreased gradually 6 months after cessation of treatment. This suggests that long-term tamsulosin may be indicated, particularly in the responders.
Literatur
1.
Zurück zum Zitat Nickel JC, Downey J, Hunter D, Clark J (2001) Prevalence of prostatitis-like symptoms in a population based study using the National Institutes of Health chronic prostatitis symptom index. J Urol 165:842–845PubMedCrossRef Nickel JC, Downey J, Hunter D, Clark J (2001) Prevalence of prostatitis-like symptoms in a population based study using the National Institutes of Health chronic prostatitis symptom index. J Urol 165:842–845PubMedCrossRef
2.
Zurück zum Zitat Cornel EB, van Haarst EP, Schaarsbergc RW, Geels J (2005) The effect of biofeedback physical therapy in men with chronic pelvic pain syndrome type III. Eur Urol 47:607–611PubMedCrossRef Cornel EB, van Haarst EP, Schaarsbergc RW, Geels J (2005) The effect of biofeedback physical therapy in men with chronic pelvic pain syndrome type III. Eur Urol 47:607–611PubMedCrossRef
3.
Zurück zum Zitat Ishigooka M, Zermann DH, Doggweiler R, Schmidt RA (2000) Similarity of distributions of spinal c-Fos and plasma extravasation after acute chemical irritation of the bladder and the prostate. J Urol 164:1751–1756PubMedCrossRef Ishigooka M, Zermann DH, Doggweiler R, Schmidt RA (2000) Similarity of distributions of spinal c-Fos and plasma extravasation after acute chemical irritation of the bladder and the prostate. J Urol 164:1751–1756PubMedCrossRef
4.
Zurück zum Zitat Nickel JC (2006) Alpha-blockers for the treatment of prostatitis-like syndromes. Rev Urol 8(suppl 4):S26–S34PubMed Nickel JC (2006) Alpha-blockers for the treatment of prostatitis-like syndromes. Rev Urol 8(suppl 4):S26–S34PubMed
5.
Zurück zum Zitat Tugcu V, Tasci AI, Fazlioglu A, Gurbuz G, Ozbek E, Sahin S, Kurtulus F, Cek M (2006) A placebo-controlled comparison of the efficiency of triple- and monotherapy in category III B chronic pelvic pain syndrome (CPPS). Eur Urol 51(4):1113–1118PubMedCrossRef Tugcu V, Tasci AI, Fazlioglu A, Gurbuz G, Ozbek E, Sahin S, Kurtulus F, Cek M (2006) A placebo-controlled comparison of the efficiency of triple- and monotherapy in category III B chronic pelvic pain syndrome (CPPS). Eur Urol 51(4):1113–1118PubMedCrossRef
6.
Zurück zum Zitat Nickel JC, Krieger JN, McNaughton-Collins M, Anderson RU, Pontari M et al (2008) Alfuzosin and symptoms of chronic prostatitis-chronic pelvic pain syndrome. N Engl J Med 359(25):2663–2673PubMedCrossRef Nickel JC, Krieger JN, McNaughton-Collins M, Anderson RU, Pontari M et al (2008) Alfuzosin and symptoms of chronic prostatitis-chronic pelvic pain syndrome. N Engl J Med 359(25):2663–2673PubMedCrossRef
7.
Zurück zum Zitat Nickel JC, Narayan P, McKay J, Doyle C (2004) Treatment of chronic prostatitis/chronic pelvic pain syndrome with tamsulosin: a randomized double blind trial. J Urol 171(4):1594–1597PubMedCrossRef Nickel JC, Narayan P, McKay J, Doyle C (2004) Treatment of chronic prostatitis/chronic pelvic pain syndrome with tamsulosin: a randomized double blind trial. J Urol 171(4):1594–1597PubMedCrossRef
8.
Zurück zum Zitat Cheah PY, Liong ML, Yuen KH et al (2004) Initial, long term, and durable responses to terazosin, placebo, or other therapies for chronic prostatitis/chronic pelvic pain syndrome. Urology 64:881–886PubMedCrossRef Cheah PY, Liong ML, Yuen KH et al (2004) Initial, long term, and durable responses to terazosin, placebo, or other therapies for chronic prostatitis/chronic pelvic pain syndrome. Urology 64:881–886PubMedCrossRef
9.
Zurück zum Zitat Litwin MS, McNaughton-Collins M, Fowler FJ Jr et al (1999) The National Institutes of health chronic prostatitis symptom index (NIH-CPSI): development and validation of a new outcomes measure. J Urol 162:369–375PubMedCrossRef Litwin MS, McNaughton-Collins M, Fowler FJ Jr et al (1999) The National Institutes of health chronic prostatitis symptom index (NIH-CPSI): development and validation of a new outcomes measure. J Urol 162:369–375PubMedCrossRef
10.
Zurück zum Zitat Propert KJ, Litwin MS, Wang Y et al (2006) Responsiveness of the national institutes of health chronic prostatitis symptom index (NIH-CPSI). Qual Life Res 15:299–305PubMedCrossRef Propert KJ, Litwin MS, Wang Y et al (2006) Responsiveness of the national institutes of health chronic prostatitis symptom index (NIH-CPSI). Qual Life Res 15:299–305PubMedCrossRef
11.
Zurück zum Zitat Rosen RC, Riley A, Wagner G, Osterloh IH, Kirkpatrick J, Mishra A (1997) The international index of erectile function (IIEF): a multidimensional scale for assessment of erectile dysfunction. Urology 49:822–830PubMedCrossRef Rosen RC, Riley A, Wagner G, Osterloh IH, Kirkpatrick J, Mishra A (1997) The international index of erectile function (IIEF): a multidimensional scale for assessment of erectile dysfunction. Urology 49:822–830PubMedCrossRef
12.
Zurück zum Zitat Duclos AJ, Lee CT, Shoskes DA (2007) Current treatment options in the management of chronic prostatitis. Ther Clin Risk Manag 3:507–512PubMed Duclos AJ, Lee CT, Shoskes DA (2007) Current treatment options in the management of chronic prostatitis. Ther Clin Risk Manag 3:507–512PubMed
13.
Zurück zum Zitat Liao LM, Shi BY, Liang CQ (1999) Ambulatory urodynamic monitoring of external urethral sphincter behavior in chronic prostatitis patients. Asian Journal of Andrology 1(4):215–217PubMed Liao LM, Shi BY, Liang CQ (1999) Ambulatory urodynamic monitoring of external urethral sphincter behavior in chronic prostatitis patients. Asian Journal of Andrology 1(4):215–217PubMed
14.
Zurück zum Zitat Andersson KE, Gratzke C (2007) Pharmacology of alpha1-adrenoceptor antagonists in the lower urinary tract and central nervous system. Nat Clin Pract Urol 4:368–378PubMedCrossRef Andersson KE, Gratzke C (2007) Pharmacology of alpha1-adrenoceptor antagonists in the lower urinary tract and central nervous system. Nat Clin Pract Urol 4:368–378PubMedCrossRef
15.
Zurück zum Zitat Ishigooka M, Nakada T, Hashimoto T et al (2002) Spinal substance P immunoreactivity is enhanced by acute chemical stimulation of the rat prostate. Urology 59(1):139–144PubMedCrossRef Ishigooka M, Nakada T, Hashimoto T et al (2002) Spinal substance P immunoreactivity is enhanced by acute chemical stimulation of the rat prostate. Urology 59(1):139–144PubMedCrossRef
16.
Zurück zum Zitat Geppetti P, Nassini R, Materazzi S, Benemei S (2008) The concept of neurogenic inflammation. BJU Int 101(Suppl):2–6PubMedCrossRef Geppetti P, Nassini R, Materazzi S, Benemei S (2008) The concept of neurogenic inflammation. BJU Int 101(Suppl):2–6PubMedCrossRef
17.
Zurück zum Zitat Nickel JC, Narayan P, McKay J, Doyle C (2004) Treatment of chronic prostatitis/chronic pelvic pain syndrome with tamsulosin: a randomized double blind trial. J Urol 171:1594–1597PubMedCrossRef Nickel JC, Narayan P, McKay J, Doyle C (2004) Treatment of chronic prostatitis/chronic pelvic pain syndrome with tamsulosin: a randomized double blind trial. J Urol 171:1594–1597PubMedCrossRef
18.
Zurück zum Zitat Mehik A, Alas P, Nickel JC, Sarpola A, Helstrom PJ (2003) Alfuzosin treatment for chronicprostatitis/chronic pelvic pain syndrome:a prospective, randomized, double-blind, placebo-controlled, pilot study. Urology 62:425–429PubMedCrossRef Mehik A, Alas P, Nickel JC, Sarpola A, Helstrom PJ (2003) Alfuzosin treatment for chronicprostatitis/chronic pelvic pain syndrome:a prospective, randomized, double-blind, placebo-controlled, pilot study. Urology 62:425–429PubMedCrossRef
19.
Zurück zum Zitat Chen Y, Song B, Jin XY, Xiong EQ, Zhang JH (2005) Possible mechanism of referred pain in the perineum and pelvis associated with the prostate in rats. J Urol 174:2405–2408PubMedCrossRef Chen Y, Song B, Jin XY, Xiong EQ, Zhang JH (2005) Possible mechanism of referred pain in the perineum and pelvis associated with the prostate in rats. J Urol 174:2405–2408PubMedCrossRef
20.
Zurück zum Zitat Li NC, Chen S, Yang XH, Du LD, Yang JY, Na YQ (2003) Efficacy of low-dose tamsulosin in chinese patients with symptomatic benign prostatic hyperplasia. Clin Drug Invest 23(12):781–787CrossRef Li NC, Chen S, Yang XH, Du LD, Yang JY, Na YQ (2003) Efficacy of low-dose tamsulosin in chinese patients with symptomatic benign prostatic hyperplasia. Clin Drug Invest 23(12):781–787CrossRef
Metadaten
Titel
Effects of a 6-month course of tamsulosin for chronic prostatitis/chronic pelvic pain syndrome: a multicenter, randomized trial
Publikationsdatum
01.06.2011
Erschienen in
World Journal of Urology / Ausgabe 3/2011
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-010-0537-3

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