Department of Radiology, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan.
Department of Interventional Radiology, Okuno Clinic Tokyo, 4th Fl Ginrei Bldg., 7-8-4, Roppongi, Minato-Ku, Tokyo, 106-0032, Japan.
Cardiovasc Intervent Radiol. 2024 Oct;47(10):1348-1355. doi: 10.1007/s00270-024-03842-6. Epub 2024 Aug 27.
To investigate the preliminary treatment outcomes of transcatheter arterial embolization (TAE) for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).
This retrospective study included patients with refractory CP/CPPS who underwent TAE between April 2022 and February 2023. All patients had persistent pelvic pain for at least 3 months, a total score of at least 15 on the NIH-Chronic Prostatitis Symptom Index (NIH-CPSI), and lacked evidence of infection. All procedures were performed by injecting imipenem/cilastatin sodium (IPM/CS) from bilateral prostatic arteries ± internal pudendal arteries. NIH-CPSI, pain numeric rating scale (NRS), and complications were evaluated at 1, 3, and 6 months after the initial TAE and at the final follow-up.
Out of 48 patients, 44 were included in this study, with four excluded because of loss of follow-up. No severe procedure-related complications were observed. Pretreatment and post-treatment evaluations at 1, 3, and 6 months after the initial TAE and at the final follow-up (mean 16.6 months) revealed a decrease in the mean NIH-CPSI scores from 27 ± 6 to 21 ± 8, 20 ± 9, 17 ± 9, and 18 ± 9, respectively (all P < 0.001). Pain NRS scores were also decreased from 7.0 ± 1.6 to 4.8 ± 2.5, 4.1 ± 2.6, 3.7 ± 2.4, and 3.4 ± 2.3, respectively (all P < 0.001). The proportions of clinical success, defined as a reduction of at least 6 points from baseline in the NIH-CPSI, at 6 months after TAE and at the final follow-up were 70 and 64%, respectively.
This study provides evidence of the feasibility of TAE using IPM/CS for CP/CPPS, suggesting both symptomatic improvement and safety.
探讨经导管动脉栓塞术（TAE）治疗慢性前列腺炎/慢性骨盆疼痛综合征（CP/CPPS）的初步治疗效果。
本回顾性研究纳入了 2022 年 4 月至 2023 年 2 月期间因难治性 CP/CPPS 接受 TAE 治疗的患者。所有患者均有持续至少 3 个月的骨盆疼痛，NIH 慢性前列腺炎症状指数（NIH-CPSI）总分至少为 15 分，且缺乏感染证据。所有操作均通过从双侧前列腺动脉和/或阴部内动脉注入亚胺培南/西司他丁钠（IPM/CS）进行。在初始 TAE 后 1、3 和 6 个月以及最终随访时，采用 NIH-CPSI、疼痛数字评分量表（NRS）和并发症评估疗效。
48 例患者中，44 例纳入本研究，4 例因失访而排除。未观察到严重与操作相关的并发症。初始 TAE 后 1、3、6 个月及最终随访（平均 16.6 个月）时，NIH-CPSI 评分从 27±6 分别降至 21±8、20±9、17±9 和 18±9（均 P<0.001），NRS 评分也从 7.0±1.6 分别降至 4.8±2.5、4.1±2.6、3.7±2.4 和 3.4±2.3（均 P<0.001）。TAE 后 6 个月和最终随访时，临床成功率（NIH-CPSI 评分较基线至少降低 6 分）的比例分别为 70%和 64%。
本研究为 IPM/CS 用于 CP/CPPS 的 TAE 提供了可行性证据，提示可改善症状且安全。
