Rowe E, Smith C, Laverick L, Elkabir J, Witherow R O'N, Patel A
Department of Urology, St. Mary's Hospital, London, United Kingdom.
J Urol. 2005 Jun;173(6):2044-7. doi: 10.1097/01.ju.0000158445.68149.38.
Male chronic pelvic pain syndrome is a condition of uncertain etiology and treatment is often unsatisfactory. There is evidence that the symptom complex may result from pelvic floor muscular dysfunction and/or neural hypersensitivity/inflammation. We hypothesized that the application of electromagnetic therapy may have a neuromodulating effect on pelvic floor spasm and neural hypersensitivity.
Following full Stamey localization men with National Institute of Diabetes and Digestive and Kidney Diseases category III prostatitis were prospectively randomized to receive active electromagnetic or placebo therapy. Active therapy consisted of 15 minutes of pelvic floor stimulation at a frequency of 10 Hz, followed by a further 15 minutes at 50 Hz, twice weekly for 4 weeks. Patients were evaluated at baseline, 3 months and 1 year after treatment using validated visual analog scores.
A total of 21 men with a mean age of 47.8 years (range 25 to 67) were analyzed. Mean symptom scores decreased significantly in the actively treated group at 3 months and 1 year (p <0.05), unlike the placebo group, which showed no significant change (p >0.05). Subanalysis of those receiving active treatment showed that the greatest improvement was in pain related symptoms.
The novel use of pelvic floor electromagnetic therapy may be a promising new noninvasive option for chronic pelvic pain syndrome in men.
男性慢性盆腔疼痛综合征病因不明，治疗效果往往不尽人意。有证据表明，该症状复合体可能由盆底肌肉功能障碍和/或神经超敏反应/炎症引起。我们推测，电磁疗法的应用可能对盆底痉挛和神经超敏反应具有神经调节作用。
在进行全面的斯塔米定位后，将患有美国国立糖尿病、消化和肾脏疾病研究所III类前列腺炎的男性患者前瞻性随机分为接受主动电磁疗法或安慰剂治疗两组。主动治疗包括以10赫兹的频率对盆底进行15分钟的刺激，随后以50赫兹的频率再进行15分钟的刺激，每周两次，共4周。在治疗后的基线、3个月和1年，使用经过验证的视觉模拟评分对患者进行评估。
共分析了21名平均年龄为47.8岁（范围25至67岁）的男性。与安慰剂组无显著变化（p>0.05）不同，主动治疗组在3个月和1年时的平均症状评分显著降低（p<0.05）。对接受主动治疗的患者进行亚分析表明，疼痛相关症状改善最为明显。
盆底电磁疗法的新应用可能是男性慢性盆腔疼痛综合征一种有前景的新型非侵入性治疗选择。
