title: Local anesthetic and steroidal prostatic injection for chronic pelvic pain syndrome: an effective last resort?
abstract: OBJECTIVE
  the chronic pelvic pain syndrome is a severely debilitating and protracted condition for patients and a challenging condition for clinicians to treat. We report our experience with an adjunctive treatment in four patients using peri- and intra-prostatic injection of Levobupivicaine and Methylprednisolone combination via a transperineal approach under general anaesthesia.
  
  
  METHODS
  a retrospective observational report.
  
  
  RESULTS
  all patients had found little or no relief of their perineal/pelvic pain with the use of antimicrobials, alpha blockers, anti-inflammatories, anticholinergics, Elmiron or with TURP. In all cases, the use of prostatic injection treatment has resulted in a complete eradication of perineal pain and significant improvement to quality of life for at least a period of time.
  
  
  CONCLUSIONS
  we suggest prostatic injection treatment as a last resort therapy in relieving pain. Our report provides a basis for a larger randomised controlled study with longer term follow-up to evaluate its efficacy and durability.
authors.affiliation: Department of Urology, Craigavon Area Hospital, Portadown, Northern Ireland, UK. vkoo76@gmail.com
authors.forename: Vincent S W
authors.initials: VS
authors.lastname: Koo
authors.forename: Aidan
authors.initials: A
authors.lastname: O'brien
mesh_terms: D000779:Anesthetics, Local / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D006801:Humans; D007277:Injections, Jet; D008297:Male; D008875:Middle Aged; D017699:Pelvic Pain / Q000188:drug therapy*; D011472:Prostatitis / Q000188:drug therapy*; D013256:Steroids / Q000008:administration & dosage*; D013577:Syndrome; D016896:Treatment Outcome
chemical_list: D000779:Anesthetics, Local; D013256:Steroids