title: Anti-nanobacterial therapy for men with chronic prostatitis/chronic pelvic pain syndrome and prostatic stones: preliminary experience.
abstract: OBJECTIVE
  Category III chronic prostatitis/chronic pelvic pain syndrome (CPPS) is a common debilitating condition of unclear etiology. Patients often have prostatic calcifications but a link to symptoms is controversial. Nanobacteria are implicated in stone formation in the urinary tract and, therefore, therapy to eliminate nanobacteria and the stones that they produce might have an impact on CPPS symptoms.
  
  
  METHODS
  A total of 16 men with recalcitrant CPPS refractory to multiple prior therapies were treated with comET (Nanobac Life Sciences, Tampa, Florida), which consists of 500 mg tetracycline, a proprietary nutraceutical and an ethylenediaminetetraacetic acid suppository daily. The National Institute of Health Chronic Prostatitis Symptom Index (NIH-CPSI), transrectal ultrasound, and blood and urine tests for nanobacterial antigen were performed at the start and conclusion of 3 months of therapy. One patient was lost to followup.
  
  
  RESULTS
  Mean NIH-CPSI total score +/- SD decreased from 25.7 +/- 1.6 to 13.7 +/- 2.0 (p <0.0001). Significant improvement was seen in each subscore domain. A total of 12 patients (80%) had at least 25% improvement on NIH-CPSI and 8 (53%) had at least 50% improvement. Nanobacterial antigen or antibody was found in 60% of serum and 40% of urine samples. In 10 patients who underwent transrectal ultrasound after therapy prostatic stones were decreased in size or resolved in 50%.
  
  
  CONCLUSIONS
  Therapy designed to eliminate nanobacteria resulted in significant improvement in the symptoms of recalcitrant CPPS in the majority of men, whether due to the treatment of stone producing nanobacteria or through some other mechanism. Prospective placebo controlled trials are warranted.
authors.affiliation: Department of Kidney Transplantation, Cleveland Clinic Florida, Weston, Florida 33331, USA. dshoskes@mac.com
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Shoskes
authors.forename: Kim D
authors.initials: KD
authors.lastname: Thomas
authors.forename: Eyda
authors.initials: E
authors.lastname: Gomez
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000150:complications* / Q000188:drug therapy*; D002137:Calculi / Q000150:complications* / Q000188:drug therapy*; D002908:Chronic Disease; D006801:Humans; D008297:Male; D008875:Middle Aged; D036103:Nanotechnology; D017699:Pelvic Pain / Q000150:complications* / Q000188:drug therapy*; D011469:Prostatic Diseases / Q000150:complications / Q000188:drug therapy; D011472:Prostatitis / Q000150:complications* / Q000188:drug therapy* / Q000382:microbiology; D013577:Syndrome
chemical_list: D000900:Anti-Bacterial Agents