Department of Urology, Faculty of Medicine, Kutahya Health Sciences University, Kütahya, Turkey.
Department of Urology, Faculty of Medicine, Altinbas University, Istanbul, Turkey.
Prostate. 2023 Jun;83(8):751-758. doi: 10.1002/pros.24513. Epub 2023 Mar 5.
Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a heterogenous condition that impacts the Quality of life severely, and it has multimodal complex treatment options. We aimed to compare the efficacy of two well-described neuromodulation therapies, transcutaneous tibial nerve stimulation (TTNS) versus percutaneous tibial nerve stimulation (PTNS) in the treatment of category IIIB CP/CPPS.
This study was designed as a randomized prospective clinical trial. We randomized category IIIB CP/CPPS patients into two treatment groups as TTNS and PTNS groups. Category IIIB CP/CPPS was diagnosed by two or four-glass Meares-Stamey test. All patients included in our study were antibiotic/anti-inflammatory resistant. Transcutaneous and percutaneous treatments were applied 30 min sessions for 12 weeks. Patients were evaluated by Turkish-validated National Health Institute Chronic Prostatitis Symptom Index (NIH-CPSI) and visual analogue scale (VAS) initially and after treatment. Treatment success was evaluated within each group and also compared with each other.
A total of 38 patients in the TTNS group and 42 patients in the PTNS group were included in the final analysis. The mean VAS scores of the TTNS group were lower than the PTNS group initially (7.11 and 7.43, respectively), (p = 0.03). The pretreatment NIH-CPSI scores were similar between groups (p = 0.07). VAS scores, total NIH-CPSI, NIH-CPSI micturation, NIH-CPSI pain, and NIH-CPSI QoL scores decreased significantly at the end of the treatment in both groups. We found a significantly higher VAS and NIH-CPSI scores decrease in the PTNS group compared to the TTNS group (p < 0.01).
Both PTNS and TTNS are effective treatment methods in category IIIB CP/CPPS. Comparing the two methods, PTNS provided a higher level of improvement in terms of pain and quality of life.
慢性前列腺炎/慢性骨盆疼痛综合征（CP/CPPS）是一种异质性疾病，严重影响生活质量，且有多种复杂的治疗选择。我们旨在比较两种描述完善的神经调节治疗方法——经皮胫神经刺激（PTNS）与经皮腓肠神经刺激（TTNS）在治疗 IIIB 型 CP/CPPS 中的疗效。
本研究设计为一项随机前瞻性临床试验。我们将 IIIB 型 CP/CPPS 患者随机分为 TTNS 和 PTNS 两组。通过二或四杯梅尔斯-斯泰梅试验诊断为 IIIB 型 CP/CPPS。我们研究中的所有患者均对抗生素/抗炎治疗耐药。经皮和经皮治疗均为 30 分钟/次，共 12 周。患者在初始和治疗后均采用经土耳其验证的国立卫生研究院慢性前列腺炎症状指数（NIH-CPSI）和视觉模拟评分（VAS）进行评估。在每组内评估治疗效果，并进行组间比较。
TTNS 组共有 38 例患者，PTNS 组共有 42 例患者纳入最终分析。TTNS 组的平均 VAS 评分初始时低于 PTNS 组（分别为 7.11 和 7.43，p=0.03）。两组间治疗前 NIH-CPSI 评分相似（p=0.07）。VAS 评分、总 NIH-CPSI、NIH-CPSI 排尿、NIH-CPSI 疼痛和 NIH-CPSI 生活质量评分在两组治疗结束时均显著下降。我们发现 PTNS 组 VAS 和 NIH-CPSI 评分下降幅度明显高于 TTNS 组（p<0.01）。
PTNS 和 TTNS 均为 IIIB 型 CP/CPPS 的有效治疗方法。与两种方法相比，PTNS 在疼痛和生活质量方面提供了更高水平的改善。
