Syndrome of chronic task pain in patients with calculus prostatitis: search for optimal therapy


  • В. В. Спиридоненко ГУ «Институт урологии НАМН Украины», г. Киев



calculous prostatitis, chronic pelvic pain syndrome, extracorporeal shock wave therapy, diclofenac, nimesulide


The objective: to determine the efficacy of the combination of the method of extracorporeal shock wave therapy (ESWT) and non-steroidal anti-inflammatory drugs (NSAIDs) in the correction of pain in chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) in patients with CP of the IIIb category.
Patients and methods. Extracorporeal shock wave therapy in 57 men (mean age 38.2 ± 2.1 years) with symptoms of CPPS on the basis of chronic calculous prostatitis (CP category IIIb) was performed in the Department of Sexopathology and Andrology of the Institute of Urology of the NASU of Ukraine.
All patients were divided into three groups, in I (n=27) – patients received suppositories Dicloberl 100 mg once a day for 20 days, in II (n=19) – suppositories Dicloberl 100 mg once a day 20 days and Nimesil 100 mg inside the morning after a meal – 5 days; In ІІІ (n=11) tocopherol acetate 400 mg once a day for 30 days inside after eating.
The duration of the disease was from 8 months to 5,2 years. All patients underwent a standard urologic examination and pain assessment on the NIH-CPSI scale. The parameters given above were monitored 3 times during the study: before treatment, 1 and 3 months after treatment. At the last visit, the subjective assessment of the efficacy and tolerability of the drug was recorded by patients and treating physicians.
It was found that the use of diclofenac sodium in suppositories, in persons with CP / CTPS receiving ESWT, contributed to a significant reduction in pain on the scale of NIH-CPSI for a 30-day period of treatment at 48,4±1,8% (p<0,05) and demonstrated high compliance (according to the patient –77,7%, according to the doctor – 81,4%).
Results. It was also found that the use of a combination of diclofenac sodium suppositories with the oral form of nimesulide, in these cases, reduced the NIH-CPSI values by 55,7±2,1% of the initial, and the compliance was 84,1% according to the patient, – 89,3% (р<0,05).
Conclusion. Carrying out extracorporeal shock wave therapy in persons with calculous prostatitis and chronic pelvic pain syndrome is an effective measure of pain relief, and NSAIDs (diclofenac sodium and nimesulide) significantly improve the results of treatment.

Author Biography

В. В. Спиридоненко, ГУ «Институт урологии НАМН Украины», г. Киев

V. Spyrydonenko


Горпинченко И.И., Гурженко Ю.Н., Нагорный А.Е. Опыт применения многокомпонентных фитопрепаратов у больных при хроническом абактериальном простатите/синдроме хронической тазовой боли // Здоровье мужчины. – 2014. – No 1 (48). – С. 36–42.

Горпинченко И.И., Гурженко Ю.Н. Изучение эффективности комбинированной терапии у пациентов с синдромом хронической тазовой боли при использовании препарата Дексалгин и фитопрепарата Простамол Уно //Здоровье мужчины. – 2013. – No 4 (47). – С. 62–65.

Горпинченко И.И., Гурженко Ю.Н., Федорук А.С., Спиридоненко В.В., Мигов В.Г., Квач Н.Д. Нестандартный фитотерапевтический подход к лечению синдрома хронической тазовой боли у мужчин// Здоровье мужчины. – 2011. – No 4 (39). – С. 40–46.

Горпинченко И.И., Гурженко Ю.Н. Опыт использования неспецифических противовоспалительных препаратов (Диклоберл) при лечении больных хроническим неспецифическим простатитом с наличием и отсутствием алгического синдрома //Здоровье мужчины. – 2009. – No 4 (31). – С. 103–110.

Гурженко Ю.Н., Мигов В.Г. Исследование эффективности комбинированного лечения СХТБ с использованием нестероидных противовоспалительных препаратов и альфа-адреноблокаторов // Здоровье мужчины. – 2011, No 3 (38). – С. 51–59.

Романюк М.Г. Синдром хронічного тазового болю: етіологія, патогенез, діагностика та методи лікування // Здоровье мужчины. – 2016. – No 3 (58). – С. 6–9.

Романюк М.Г., Корниенко А.М., Аксенов П.В. Эффективность Нимесила при хроническом простатите/синдроме хронической тазовой боли у мужчин // Здоровье мужчины. – 2016. – No 2 (57). – С. 56–59.

Спиридоненко В.В. Хронічний калькульозний простатит: етіологія, патогенез, діагностика та сучасні методи лікування // Здоровье мужчины. – 2016. – No 4 (59). – С. 6–9.

Al Edwan G.M., Muheilan M.M., Atta O.N. Long term efficacy of extracorporeal shock wave therapy [ESWT] for treatment of refractory chronic abacterial prostatitis. Ann Med Surg (Lond). 2017 Jan 6;14:12–17.

Guo Q., Hong M., Wang ZP. Extracorporeal shock wave therapy for chronic pelvic pain syndrome: an update. Zhonghua Nan Ke Xue. 2014 Aug;20(8): 747–50.

Fojecki GL, Tiessen S, Osther PJ. Extracorporeal shock wave therapy (ESWT) in urology: a systematic review of outcome in Peyronie’s disease, erectile dysfunction and chronic pelvic pain. World J Urol. 2017 Jan;35(1):1–9.

Kernesiuk M.N., Prouza O. Experience of the use of extracorporeal shock wave therapy in the treatment of category III B chronic prostatitis. Urologiia. 2013 Nov-Dec;(6):36, 38–9.

Kul’chavenya E.V., Shevchenko S.Y., Brizhatyuk E.V. Extracorporeal shock wave therapy in chronic prostatitis. Urologia. 2016 Apr;(2):77–8.

Leskinen M.J. Prostatic pain. Duodecim. 2011;127(6):607–14.

Moayednia A, Haghdani S, Khosrawi S, Yousefi E, Vahdatpour B. Long-term effect of extracorporeal shock wave therapy on the treatment of chronic pelvic pain syndrome due to non bacterial prostatitis. J Res Med Sci. 2014 Apr;19(4):293–6.

Pajovic B., Radojevic N., Dimitrovski A., Vukovic M. Comparison of the efficiency of combined extracorporeal shock-wave therapy and triple therapy versus triple therapy itself in Category III B chronic pelvic pain syndrome (CPPS). Aging Male. 2016 Sep;19(3):202–207.

Pierce M.W., Kuriyama A., Whelan J.S. et al. Therapeutic intervention for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS): a systematic review and meta-analysis. PLoS One. 2012;7(8).

Vahdatpour B., Alizadeh F., Moayednia A. et al. Efficacy of extracorporeal shock wave therapy for the treatment of chronic pelvic pain syndrome: a randomized, controlled trial. ISRN Urol. 2013 Aug 28; 2013:972601.

Zeng X.Y., Liang C., Ye Z.Q. Extracorporeal shock wave treatment for non-inflammatory chronic pelvic pain syndrome: a prospective, randomized and sham-controlled study. Chin Med J (Engl). 2012 Jan;125(1):114–8.

Zhang L., Tong H., Li Y.J., Shan Y.X. Extracorporeal shock wave: An effective and safe therapy for the pain symptom of type IIIB prostatitis. Zhonghua Nan Ke Xue. 2015 Apr;21(4):325–9.

Zimmermann R., Cumpanas A., Miclea F., Janetschek G. Extracorporeal shock wave therapy for the treatment of chronic pelvic pain syndrome in males: a randomised, double-blind, placebo-controlled study. Eur. Urol. 2009. Sep;56(3):418–24.

Litwin M.S., McNaughton-Collins M., Fowler F.J et al. The National Institutes of Health chronic prostatitis symptom index: development and validation of a new outcome measure. Chronic Prostatitis Collaborative Research Network. J Urol 1999; 162:369-375.

Nickel J.C., Downey J. et al. (2001). «Predictors of patient response to antibiotic therapy for the chronic prostatitis/chronic pelvic pain syndrome: a prospective multicenter clinical trial. J Urol. – 2001. – 165(5): 1539. – 44.