Heat/burning sensation induced by topical application of capsaicin on perineal cutaneous area: new approach in diagnosis and treatment of chronic prostatitis/chronic pelvic pain syndrome?
OBJECTIVE
To investigate the feasibility, safety, and efficacy of perineal cutaneous application of capsaicin as a test for the diagnosis, as well as a potential therapeutic tool, in patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).


METHODS
We recruited 22 patients (mean age 34.5 years, range 19 to 56), who had been diagnosed with CP/CPPS according to the National Institutes of Health criteria, and 6 healthy control subjects. Both groups received a topical application of 5 mL capsaicin at a concentration of 10(-5) M to the perineal body skin. The patients were asked to mark on a visual analogue scale the intensity of any heat or burning sensation. All the patients had completed a National Institutes of Health Chronic Prostatitis Symptom Index before and 1 week after the test. The scores of the two groups were compared using the Mann-Whitney U test.


RESULTS
The patients with CP/CPPS reported a heat/burning sensation intensity that was statistically greater than that of the healthy controls (7.5 versus 4.3, P <0.001) and a shorter time to heat sensation onset and maximal intensity (1.5 versus 3.4 minutes, P <0.001, and 2.5 versus 7 minutes, P <0.001, respectively). Of the 22 patients, 16 reported an improvement of symptoms after 7 days and the mean National Institutes of Health Chronic Prostatitis Symptom Index score decreased from 27 to 16 (P <0.01).


CONCLUSIONS
We found a statistically significant difference in the pain visual analogue scale and interval between topical application and the onset of the heat/burning sensation between patients with CP/CPPS and healthy controls. The small sample size strongly suggests the need for additional larger and more controlled studies.
Turini
Damiano
D
Department of Urology, University of Ferrara, Ferrara, Italy.
Beneforti
Patrizia
P
Spinelli
Michele
M
Malagutti
Silvia
S
Lazzeri
Massimo
M
D000287:Administration, Topical; D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage*; D002211:Capsaicin / Q000008:administration & dosage*; D002908:Chronic Disease; D005240:Feasibility Studies; D006801:Humans; D006930:Hyperalgesia / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D036421:Nerve Fibers, Unmyelinated / Q000187:drug effects; D009619:Nociceptors; D010147:Pain Measurement; D017699:Pelvic Pain / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D010502:Perineum / Q000294:innervation; D011472:Prostatitis / Q000175:diagnosis* / Q000188:drug therapy; D016896:Treatment Outcome
D018712:Analgesics, Non-Narcotic; D002211:Capsaicin