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Abstract 11

Surgical (Endourological) Management in Selected Chronic Prostatitis Patients

B Gushchin, A Martov

Institute of Urology, Moscow, Russia

Introduction Chronic prostatitis (CP) is a common urological condition. The majority of these patients undergo treatment according to multiple protocols. In most cases this disease entity is managed with pharmaceuticals, such as antibacterial formulations, alpha-blockers, phytotherapeutic agents, and others. In a selected group of the CP patients with an evidence of bladder outlet obstruction we performed surgical treatment.

Patients and Methods In the last 7 years in our institution, a total number of 117 CP patients were treated with transurethral surgery of the prostate/bladder neck. The diagnosis was made clinically and/or morphologically. The disease duration in 43% of the patients exceeded 5 years. Most of these patients had a combination of CP and BPH (21.5%), prostate calculi (13,7%), and bladder neck fibrosis (32,4%). In addition to clinical evaluation in all CP patients who were subject to surgical treatment, ultrasonography and urodynamic studies were performed before and after surgery. Endoscopic surgery included bladder neck incision, partial or complete transurethral resection.

Results Postoperative uroflow and residual urine measurements documented complete resolution of the bladder outlet obstruction in 85 (72,%) of the patients. We achieved only modest results with symptom relief. When obstructive and irritative symptoms were separately looked at, it appeared that the CP patients subgroup with predominant obstructive symptoms benefited from the surgical management of CP, while patients with irritative symptoms have shown only slight and temporary improvement, if any.

Conclusion Surgical (endourological) management is a successful treatment modality in a selected CP with a prolonged disease duration and concomitant prostate calculi, BPH, or bladder neck fibrosis who demonstrate the predominance of obstructive symptoms over pain and irritative symptoms.