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A transurethral TEMPRO bipolar radio frequency (RF) for the treatment of chronic abacterial prostatitis/chronic pelvic pain syndrome (CP/CPPS)

Abstract by Hong Woo Rhee, MD., Jun Sik Shin, MD.,

   Hong Woo Rhee, MD., Jun Sik Shin, MD.

Introduction and Objectives:
Chronic abacterial prostatitis/chronic pelvic pain syndrome (NIH category IIIa,b) has been a challenging issue in outpatient urological practice. Although there are several kinds of medical and 2nd line therapies including thermal therapy, patients with CP/CPPS do not satisfy to eradicate or minimize the symptoms, especially pain domain.We evaluate a new bipolar RF thermal therapy to treat CP/CPPS and report our results of 431 patients after at least 3 months follow-up.  

Materials and Methods:
We used the Tempro bipolar RF system with a treatment protocol of 55o C for 50 min. to 71 CP/CPPS patients (high temperature group), and then 360 patients were treated under the condition of 45oC for 60 min. without cooling (low temperature group). All the patients undergoing bipolar RF therapy were initially treated with 1st line classic regimen-ciprofloxacin, alpha blocker, NSAID- for more than 2 weeks and did not respond to improve CPSI score, especially pain domain. We evaluated the symptom improvement according to RF treatment protocol by NIH-CPSI score. 

Results:
Table 1. Baseline characteristics of CP/CPPS patients 

  High temp. group Low temp. group
 No. of pts. (n)      71                 360
  Age (yrs) 42.5 ± 11.4 39.1 ± 9.6
Prostate vol.(gm)  28.4 ± 8.3.   29.6 ± 7.3
NIH category (n)    
     IIIa   41(57.7%)   221(61.4%)
     IIIb   30(42.3%) 139(38.6%)
Most bothersome Sx.(n)    
   pelvic pain(perineal, testicular, penis tip, pubic or bladder)    49(69.0%)    259(71.9%)
 urination assoc. pain   16(22.5%)    78(21.6%)
ejaculation assoc. pain    6(8.5%)    23(6.4%)
 

Table 2. Side effects of bipolar RF therapy on CP/CPPS according to RF protocol
  High temp. group Low temp. group p-value
 Urine retention (%)     21 (29.6%)                9 (2.5%) 0.019*
Gross hematuria (%)     16 (22.5%)     31 (8.6%)      0.067
Frequency/Urgency (%)     18 (25.4%)     68 (18.9%)      0.325
 UTI/Epididymitis (%)      2 (2.8%)      9 (2.5%)        -

*: significant difference (P<0.05)  Table 3. Results of bipolar RF efficacy on the CPSI score
 

  Pre-RF CPSI score Post-RF CPSI score p-value
  High temp. group Low temp. group High temp. group Low temp. group  
Total CPSI   24.1 ± 7.6                26.4 ± 6.9                16.2 ± 5.1 16.7 ± 4.8 0.074

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