Bozzini Giorgio, Provenzano Marco, Buffi Nicolò, Seveso Mauro, Lughezzani Giovanni, Guazzoni Giorgio, Mandressi Alberto, Taverna Gianluigi
Departmentt of Urology, Humanitas Mater Domini, Via Gerenzano 2, I - 21053, Castellanza, Varese, Italy.
Humanitas University, Milan, Italy.
BMC Urol. 2016 Jun 8;16(1):25. doi: 10.1186/s12894-016-0144-8.
Nonbacterial prostatitis, together with chronic pelvic pain syndrome, accounts for 90-95 % of prostatitis cases. Anti-inflammatory medications are commonly used to reduce storage/inflammatory symptoms that can deteriorate quality of life. The purpose of this study was to observe the efficacy and safety of beclomethasone dipropionate rectal suppositories (Topster®) in inflammations of the lower urinary tract in men.
Patients underwent diagnostic and therapeutic protocols according to current evidence-based practice. Efficacy assessments: voiding parameters, perineal pain, International Prostate Symptom Score (IPSS), digital rectal examination (DRE). Adverse events and patient compliance were recorded throughout the study.
One hundred eighty patients were enrolled, mean age 52 ± 14.97. Most frequent diagnosis: nonbacterial prostatitis (85 %). All patients completed visits 1 and 2. All patients were treated with beclomethasone dipropionate (BDP) suppositories, 136/180 also with Serenoa repens (SR) extract. Antibiotics were rarely required. 162/180 patients presented clinically significant improvements and terminated treatment. Mean change vs. baseline in voiding frequency: -3.55 ± 2.70 n/day in patients taking only BDP and -3.68 ± 2.81 n/day in those taking both BDP and SR (P<.0001 in both groups). Uroflowmetry improved significantly; change from baseline 3.26 ± 5.35 ml/s in BDP only group and 5.61 ± 7.32 ml/s in BDP + SR group (P = 0.0002 for BDP, P<.0001 for BDP + SR). Urine stream normal in 35 % of patients at visit 1 and 57.22 % of patients at visit 2. Mean change in perineal pain, on 0-10 VAS, -0.66 ± 2.24 for BDP only group (P = 0.0699) and -1.37 ± 2.40 for BDP + SR group (P<.0001). IPSS increased at visit 2. No adverse events were reported. For all parameters, none of the comparisons between groups was found to be statistically significant.
This study confirmed the drug's good safety profile. We also observed an improvement in the main storage symptoms and clinical findings associated with lower urinary tract inflammation in patients treated with beclomethasone dipropionate suppositories.
非细菌性前列腺炎与慢性盆腔疼痛综合征一起,占前列腺炎病例的90 - 95%。抗炎药物常用于减轻可降低生活质量的储尿/炎症症状。本研究的目的是观察丙酸倍氯米松直肠栓剂(Topster®)治疗男性下尿路感染的疗效和安全性。
患者根据当前循证医学实践接受诊断和治疗方案。疗效评估:排尿参数、会阴部疼痛、国际前列腺症状评分(IPSS)、直肠指检(DRE)。在整个研究过程中记录不良事件和患者依从性。
共纳入180例患者,平均年龄52 ± 14.97岁。最常见诊断为:非细菌性前列腺炎(85%)。所有患者完成了第1次和第2次就诊。所有患者均接受丙酸倍氯米松(BDP)栓剂治疗,136/180例患者还联合使用了锯叶棕(SR)提取物。很少需要使用抗生素。162/180例患者临床症状显著改善并终止治疗。仅服用BDP的患者排尿频率较基线的平均变化为 - 3.55 ± 2.70次/天,同时服用BDP和SR的患者为 - 3.68 ± 2.81次/天(两组P均<0.0001)。尿流率显著改善;仅使用BDP组较基线的变化为3.26 ± 5.35 ml/s,BDP + SR组为5.61 ± 7.32 ml/s(BDP组P = 0.0002,BDP + SR组P<0.0001)。第1次就诊时35%的患者尿流正常,第2次就诊时为57.22%。会阴部疼痛的平均变化,在0 - 10视觉模拟评分(VAS)上,仅使用BDP组为 - 0.66 ± 2.24(P = 0.0699),BDP + SR组为 - 1.37 ± 2.40(P<0.0001)。第2次就诊时IPSS升高。未报告不良事件。对于所有参数,未发现组间比较有统计学意义。
本研究证实了该药物良好的安全性。我们还观察到,使用丙酸倍氯米松栓剂治疗的患者,其与下尿路感染相关的主要储尿症状和临床体征有所改善。