COMPARISON OF THE EFFICIENCY OF MONO AND TRIPLE THERAPHY IN CHRONIC PELVIC PAIN SYNDROME

Introduction: We compared the efficiency of monotherapy with α-blocker and combination therapy (α-

blocker, muscle relaxant and antiinflammatory) using National Institute of Health- Chronic Prostatitis

Symptom Index (NIH-CPSI) in chronic pelvic pain syndrome (CPPS).

Materials and Methods: 45 patients (median age 34.1±8.3 year) who presented with lower urinary tract

symptoms suggestive of prostatitis were evaluated for bacterial infection by Meares-Stamey criteria. The

patients with diagnosis of category IIIB CPPS were randomized into 2 groups. Group 1; 23 patients were

treated with combination therapy α-blocker (terazosin 5mg/day), muscle relaxant (thiocolchicoside

120mg/day) and antiinflammatory (ibuprofen 1200mg/day), group 2; 22 patients were treated with

monotherapy (α-blocker, terazosin 5mg/day) for six months. Six patients were excluded from the study

because of side effects of the drugs (gastric complaints in three patients, hypotension in three patients). Both of

the groups were evaluated by NIH-CPSI before, after treatment and 6 months after completion of treatment.

SPSS 11.0 was used for statistical analysis. Pre- and post-treatment scores were compared by Wilcoxon test.

Results: Pre-treatment NIH-CPSI scores in group 1 were 8.80, 7.00 and 6.05 for pain, urinary symptoms

and quality of life, respectively. Post treatment NIH-CPSI scores were 3.45, 3.40 and 2.45, respectively. In

group 2, pre-treatment NIH-CPSI scores were 9.89, 5.21 and 8.21 and post treatment scores were 4.74, 2.32

and 4.00, respectively. The decrease in pain, urinary symptoms and quality of life scores were statistically

significant for both groups. There was no statistically significant difference between two groups with respect to

efficiency of treatment. NIH-CPSI pain, urinary symptoms and quality of life scores 6 months after completion

of treatment were 4.64, 4.22 and 3.62 in group I and 5.92, 3.22 and 5.40 in group 2. Although the symptoms

were increased after completion of treatment, it was insignificant.

Conclusion: We found that α-blocker monotherapy was as effective and safe as combination therapy in

the treatment of CPPS. Also, it was more economic than combination therapy.