Shaker Hassan, Said Nouran Omar El, ElSaeed Karim Omar
Urology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Pharmacy Practice & Clinical Pharmacy, Faculty of Pharmacy, Future University in Egypt, Cairo, Egypt.
Basic Clin Androl. 2024 Apr 2;34(1):7. doi: 10.1186/s12610-024-00223-4.
Chronic post-penile prosthesis pain is de novo pain persisting > 2 months post-operatively. This pain is inadequately reported, poorly understood and undermanaged. The purpose of this current pilot study was to improvise a medical approach to alleviate the condition and assess the combination of Pregabalin and Amitriptyline in its management.
The study enrolled 9 patients complaining of idiopathic penile, pelvic, or scrotal pain persisting > 2 months after penile prosthesis implantation. Patients were prescribed pregabalin 75mg/12h (escalated after 1 week to 150mg/12h upon demand) and Amitriptyline 25mg once daily for 3 months. The pain was reassessed after 10, 30 and 100 days. The dose of pregabalin required and the side effects of the medication were noted. Findings revealed a significant decrease in pain duration (p = 0.007), frequency (p < 0.001), and intensity (p < 0.001); in glanular (p = 0.008), shaft pain (p = 0.046) but not scrotal (p = 0.112). Moreover, a significant decrease was found in sharp pain (p = 0.003) and pain aggravated by touch (p = 0.008) but not aching pain (p = 0.277). Additionally, significant improvement was reported in QoL (p < 0.001) and dose escalation of pregabalin to 150mg/12h was required in only 1 case (11%).
The combination of pregabalin and amitriptyline is very effective in the management of chronic idiopathic pain following penile prosthesis implantation. However, due to the ambiguity and lack of reporting of the condition, we recommend a multicentric contribution to acknowledge the condition, and weigh its prevalence accurately, whilst evaluating the efficacy of our approach. This study received ethical approval from Ain Shams University Research Ethics Committee (REC) FWA 000017585, on 04/13/2023 (REC-FMASU@med.asu.edu.eg).
no FMASU R98/2023.
阴茎假体植入术后慢性疼痛是指术后持续超过2个月的新发疼痛。这种疼痛报告不足、了解甚少且管理不善。本项初步研究的目的是改进一种医疗方法以缓解该病症，并评估普瑞巴林和阿米替林联合治疗在其管理中的作用。
该研究纳入了9名患者，他们主诉在阴茎假体植入术后2个月以上持续存在特发性阴茎、盆腔或阴囊疼痛。患者被处方普瑞巴林75mg/12小时（1周后根据需要增至150mg/12小时）和阿米替林25mg每日一次，持续3个月。在10天、30天和100天后对疼痛进行重新评估。记录所需普瑞巴林剂量和药物副作用。结果显示疼痛持续时间（p = 0.007）、频率（p < 0.001）和强度（p < 0.001）显著降低；龟头疼痛（p = 0.008）、阴茎体疼痛（p = 0.046）降低，但阴囊疼痛（p = 0.112）未降低。此外，锐痛（p = 0.003）和触痛加剧的疼痛（p = 0.008）显著降低，但酸痛（p = 0.277）未降低。另外，生活质量显著改善（p < 0.001），仅1例（11%）患者需要将普瑞巴林剂量增至150mg/12小时。
普瑞巴林和阿米替林联合治疗对阴茎假体植入术后慢性特发性疼痛的管理非常有效。然而，由于该病症的模糊性和报告不足，我们建议多中心合作以认识该病症，并准确衡量其患病率，同时评估我们方法的疗效。本研究于2023年4月13日获得艾因夏姆斯大学研究伦理委员会（REC）FWA 000017585的伦理批准（REC-FMASU@med.asu.edu.eg）。
无FMASU R98/2023。
