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RU Anderson; D Wise; and M Meadows; Stanford, CA (Presented by Dr. Anderson)
Introduction and Objectives: Male patients diagnosed with chronic abacterial prostatitis/chronic pelvic pain syndrome with no demonstrable infection are categorized by NIH classification into category IIIA (inflammatory with WBCs in prostatic fluid (EPS) or IIIB (non-inflammatory with no WBCs in EPS). We have evaluated a physiotherapy approach to management using frequent internal pelvic massage.
Methods: Subjects underwent routine history, pain questionnaire/visual analog scale (VAS), and physical examination with massage of the prostate to obtain EPS for microbiologic culture and stained for WBCs with safranin red and crystal violet to quantify leukocytes. Assessment of internal myofascial painful trigger points was done and surface anorectal electromyography (EMG) performed. Patients were then treated with weekly myofascial release massage and ischemic compression of trigger points. Reassessment of patients was performed after a minimum of 3 months of therapy.
Results: 23 subjects (23 - 71 years old) were enrolled. They had an initial median VAS score of 6.7 (range 0 - 10), an initial median pain score of 15.5 (range 0 - 40), and an initial median urinary symptom score of 10.4 (range 0 - 28). Median resting anorectal surface EMG was 13.00 &#micro;V. Each patient underwent a median of 18 myofascial release treatments. Patients followed a minimum of 3 months revealed median resting EMG of 6.40 &#micro;V, VAS score of 4.3, pain score of 9.7, and urinary score of 7.0.
Conclusions: Internal myofascial release therapy represents an alternative medical therapy for chronic prostatitis that may be effective over a durable time course. Source of funding: none.
Source: 1999 AUA Meeting
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