Therapeutic effect of transurethral needle ablation in non-bacterial prostatitis: chronic pelvic pain syndrome type IIIa.
OBJECTIVE
Non-bacterial prostatitis is difficult to manage with conventional treatment. This study was undertaken to evaluate the therapeutic effect of transurethral needle ablation (TUNA) on men with chronic inflammatory non-bacterial prostatitis.


METHODS
Thirty-two patients with non-bacterial prostatitis (type IIIa) were treated with TUNA. The TUNA procedure, which uses radiofrequency energy, heats the prostate tissue to approximately 90-110 degrees C over a 5-min period. Evaluation consisted of a prostatitis symptom severity score chart, the monitoring of the leukocyte count in the expressed prostatic secretion (EPS) and a subjective global assessment.


RESULTS
The decrease in the prostate symptom severity score chart at 3 and 6 months compared with the baseline assessment was statistically significant. Analysis of the leukocyte levels in the EPS in 14 patients was available. All 14 patients had a decrease in the EPS leukocyte count 3 months after treatment. However, six of these men (43%) still had EPS leukocyte levels above the normal indices (>10 white blood cells per high-power field). A second session of TUNA on these partial responders resulted in three of the six men obtaining a normal EPS leukocyte count. At 6 months following treatment, complete, partial and poor improvement in terms of subjective global assessment were noted in 60, 35 and 5% of patients, respectively. No major complications, including those of sexual dysfunction or retrograde ejaculation, were noted in this cohort.


CONCLUSIONS
Transurethral needle ablation appears to be an easy, safe and effective treatment for men with chronic inflammatory non-bacterial prostatitis.
Chiang
Po Hui
PH
Department of Urology, Chang Gung Memorial Hospital, Kaohsiung, Taiwan. cphtem@yahoo.com.tw
Chiang
Chin Pei
CP
D000328:Adult; D017115:Catheter Ablation / Q000379:methods*; D002908:Chronic Disease; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D010147:Pain Measurement; D017699:Pelvic Pain / Q000175:diagnosis / Q000601:surgery; D011336:Probability; D011446:Prospective Studies; D011472:Prostatitis / Q000175:diagnosis* / Q000601:surgery*; D011788:Quality of Life; D018570:Risk Assessment; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D020728:Transurethral Resection of Prostate / Q000379:methods*; D016896:Treatment Outcome