Combined treatment of patients with chronic abacterial prostatitis and depressive syndrome
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Abstract
Chronic abacterіal prostatitis (CAP) - the most common variant of chronic inflammation of the prostate. The disorders of the nervous system, in particular depression, play an important role in the pathogenesis of the CAP.
The objective. Evaluate the effectiveness of an inhibitor of serotonin reuptake (sertraline) in treatment of patients with chronic abacterial prostatitis and depressive syndrome in conjunction with the contents of proinflammatory and anti-inflammatory cytokines in the ejaculate. Patients and methods. Sixty-four patients with CAP aged 19 to 38 years were included in the study. Patients of the main groups (n=32) received rectal electrostimulation (10 sessions a day later) in combination with oral sertraline (50–200 mg/day) for 1 month. Patients of the control group (n=32) received only physiotherapy.
To assess the symptoms of chronic prostatitis using questionnaire NIH-CPSI. Symptoms of depression were studied using the PHQ-9 questionnaire. Concentration of cytokines in the ejaculate was determined by ELISA.
Results. Under the influence of the treatment showed a significant reduction in the symptoms of chronic prostatitis and depression, a statistically significant (p <0.05) reduction in the concentration of antiinflammatory cytokines ejaculate (IL-1в, IL-8, TNF-б) in the study and control groups. A significant increase in the concentration of anti-inflammatory cytokines ejaculate (IL-10, TGF-в) was only observed in patients of the main group. Clinical efficacy in the symptoms of chronic prostatitis in the study group was significantly greater (p<0,05) than the control group and was 84% versus 63%, and in respect of the symptoms of depression – that 63 34%, respectively.
Conclusion. The results demonstrate the effectiveness (84%) of the combination of physiotherapy and antidepressant (sertraline) in the treatment of CAP, and also show the role of neuro-immune regulation and its disorders (including depressive disorders) in the pathogenesis of СAP.
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