Comparison of the Efficacy of Antibiotic Monotherapy and Antibiotic Plus Alpha-blocker Combination Therapy for Patients with Inflammatory Chronic Prostatitis/Chronic Pelvic Pain Syndrome / 대한비뇨기과학회지

PURPOSE: The objectives of this study was to compare the efficacy of antibiotic monotherapy with antibiotic plus alpha-blocker combination therapy for the treatment of inflammatory chronic pelvic pain syndrome (CPPS) patients. MATERIALS AND METHODS: Between October 2005 and May 2006, 69 patients who were diagnosed as CPPS(National Institutes of Health; NIH-catagory IIIa), were included in this study. The patients were randomly placed into two groups: group I was treated with gatifloxacin alone(35 patients), and group II was treated with gatifloxacin and doxazosin(34 patients) for 6 weeks. For all the patients, the urinalysis, expressed prostatic massage, the National Institute of Health-Chronic Prostatitis Symptom Index(NIH-CPSI) and a distal rectal examination(DRE) were performed at the initial visit. The NIH-CPSI was compared both before and after the treatment. RESULTS: On the initial diagnosis, the mean CPSI of the group I patients was 24.0+/-6.3, and that for the group II patients was 24.7+/-6.9. After the treatment, that of the group I was 16.6+/-5.4, and that of group II was 13.4+/-5.3. After 6 weeks of treatment, the changes in the total CPSI scores had significantly improved in group II compared with group I(p<0.05). A statistically significant improvement occurred in the pain score, the voiding symptom score and the quality of life in the group II compared with group I(p<0.05) CONCLUSIONS: This study suggests that combination therapy of antibiotic plus alpha-blocker would be more effective than antibiotic monotheraphy for treating patients with inflammatory chronic prostatitis/chronic pelvic pain syndrome.

The Characteristics of Voiding Difficulty in Women and the Effect of Tamsulosin / 대한비뇨기과학회지

PURPOSE: The aim of this study was to define the characteristics of female voiding difficulty, and evaluate the effects of the alpha-blocker, tamsulosin, on the symptoms in those patients. MATERIAL AND METHODS: 148 patients, who complained of voiding difficulty between March 2002 and September 2004, were retrospectively evaluated. 32 patients with anatomical and neuropathic causes were excluded, with the remaining 116 assigned to 4 groups from their urodynamic evaluations: group I, bladder outlet obstruction (BOO) only; group II, BOO plus an overactive bladder (OAB); group III, detrusor underactivity (DU) only; and group IV, DU plus an OAB. After 2 weeks of observation, tamsulosin, 0.2mg/d, was prescribed in all groups, with the patients re-evaluated after 3 months. RESULTS: 58 (50%), 23 (19.8%), 20 (17.3%) and 15 (12.9%) of the 116 study subjects were placed into groups I, II, III and IV, respectively. In group I, 45 (77.5%) had symptomatic improvement after taking tamsulosin for 3 months, and in group II improvement was observed in 73.9% (17/23) of patients. In groups III and IV; however, improvements were seen in only 25 (5/20) and 13.3% (2/15) of cases, respectively. Dizziness, postural hypotension and urinary incontinence occurred in some patients, but these disappeared after the medication was discontinued. CONCLUSIONS: 81 patients (69.8%) had a bladder outlet obstruction, without detrusor underactivity, and 62 (76.5%) of these exhibited a voiding improvement after taking tamsulosin for three months. However, in patients with detrusor underactivity, the response rate was very low (20%).

Efficacy of Combination Therapy for Patients with Chronic Prostatitis/Chronic Pelvic Pain Syndrome: A Prospective Study / 대한비뇨기과학회지

PURPOSE: The National Institute of Health (NIH) category III chronic nonbacterial prostatitis/chronic pelvic pain syndromes (CPPS) are commonly seen disorders; however, there has been no consensus on how to manage these patients. The purpose of this trial was to compare the efficacy of antibiotic monotherapy and antibiotic plus alpha-blocker combination therapy for the treatment of CPPS patients. MATERIALS AND METHODS: The study was comprised of 54 patients who were randomly placed into two groups: group I was treated with levofloxacin alone (28 patients), and group II was treated with levofloxacin and alfuzosin (26 patients). The levofloxacin, or the levofloxacin and alfuzosin were given to the respective groups for 8 weeks. The NIH Chronic Prostatitis Symptom Index (NIH-CPSI) was evaluated both before and after the treatment. RESULTS: Before the treatment, the mean CPSI of the group I patients was 23.1+/-8.1, and after the treatment, it was 15.6+/-5.6. For the group II, the mean CPSI before the treatment was 23.9+/-8.3, and after the treatment, it was 11.0+/-4.5. The difference between the pre-and post-treatment CPSI scores of group II was significantly larger than that of group I (p=0.001). The mean differences of the CPSI from the initial scores to the final scores in both groups were followed: 2.2 in group I and 4.3 in group II for the pain domain, 1.5 in group I and 2.8 in group II for the urinary domain, and 3.8 in group I and 5.7 in group II for the quality of life domain. CONCLUSIONS: Combination therapy of levofloxacin with alfuzosin appeared more effective for treating patients with chronic prostatitis/chronic pelvic pain syndrome than just administering antibiotic alone.