Efficacy of prostatic massage in treatment of chronic prostatitis patients

ABSTRACT

To evaluate the efficacy of prostatic massage in treatment of chronic bacterial prostatitis [CBP = Category II] and chronic non-bacterial prostatitis [CNBP = Category IIIa] Category II patients were divided into two groups; group A [n=17] was treated with antibiotics and prostatic massage, and group B [n=20] with antibiotics alone. The same was done in Category IlIa [group C, n=25 and group D, n=19] The eighty-one patients were evaluated before and after treatment. Evaluation at baseline and after treatment consisted of complete history and previously validated questionnaires including the National Institutes of Health Chronic Prostatitis Symptom Index [NIH-CPSI] and the O'Leary Sexual Function Inventory [SFI]. TRUS was also done for all patients before and after treatment. Treatment consisted of triweekly prostatic massage combined with specific culture directed and /or empirical antimicrobial therapy for at least one month. According to this study, we found that patients with chronic prostatitis [category II and IlIa] treated with antibiotics and prostatic massage showed a significant improvement, compared to baseline, in all types of pain related to the prostate, frequency, dysuria, and dribbling. There was also a significant improvement regarding painful ejaculation and erectile dysfunction. Although the incidence of improvement in symptoms was more towards prostatic massage; however, this improvement was not significant when compared with patients treated with antibiotics alone. Premature ejaculation was significantly improved in cases of chronic pelvic pain syndrome, inflammatory type [category IlIa] treated with prostatic massage more than category IlIa treated with antibiotics alone. Frequency was significantly improved incases of chronic pelvic pain syndrome, inflammatory type [category IlIa], treated with prostatic massage more than chronic bacterial prostatitis [category II] treated also by prostatic massage. On the other h and, the ejaculation quality [ejaculation volume and difficulty] worsened significantly in cases treated with prostatic massage