PARIS, FRANCE (UroToday.com) - Some studies have shown a significant reduction of inflammatory parameters in prostatic tissues of patients with BPH treated with Serenoa repens (Permixon).
In this study, Kravchick, et al. assessed its possible role in the treatment of patients with chronic prostatitis and comparde its effectiveness with Tamsulosin.
157 patients with chronic prostatitis were included in this study. The pre-massage and post-massage test (PPMT) was performed in all patients. Patients with culture positive for Gram-negative uropathogens (Category II) were treated with Ciprofloxacin 500 mg twice daily for 28 days. In all patients serologic analysis for HSV-2 IgM and urinary PCR test for Chlamydia trachomatis were performed. Patients with positive results were treated appropriately. Afterwards all patients were randomized into the study and control groups. Patients in the study group received Permixon 160 mg x 2 for 6 weeks, while patients in the control group were treated with Tamsulosin 0.4 mg daily for 6 weeks. NIH CPSI questioners were used to evaluate clinical efficacy of the treatments. They considered medications given for HTN, IHD and ED to exclude their influence on score reports. Statistical analyses were used to compare the results of different treatments.
The mean age of patients in the group was 47 (ranged 24-61). Bacterial prostatitis was reported in 11.2% of our patients, while C. trachomatis and HSV-2 were diagnosed in 7.5 % and 6.5%, respectively. There was no significant difference between control and study groups in respect of the mean age, incidence of HTN, CHF and ED, as well as category II/ III prostatitis. Total NIH CPSI scores were significantly improved in 72.3% and 75.7% of the patients in control and study groups, respectively. However, the decline of pain scores was greater in the study group (-4.13 v/s -1.79, p<0.04). Additionally, they compared the capability of anti- bacterial/chlamydial/HSV treatment to decrease NIH CPSI scores. After these treatments total NIH CPSI and pain scores decreased significantly in 78% of the patients (-8.19 and – 5.3, p<0.05 and p<0.03). The addition of Tamsulosin failed to show any significant improvement in total NIH CPSI, however it improved scores for urination (-3.28; p<0.015) and quality of life (-4.2; p< 0.035) in 62% of the patients. Patients who used Permixon reported significant decline in total NIH CPSI (-9.3; p<0.03) and pain scores (-4.0; p<0.023) in 71.
The results of this study showed the Permixon may decrease total NIH CPSI scores. It is comparable with Tamsulosin, but has better results in pain control. In addition, its combination with alpha blockers in patients with type II/IIIA may improve urination and pain control.
Presented by Kravchick SG,1 Peled R,2 and Cytron S1 at the 27th Annual European Association of Urology (EAU) Congress - February 24 - 28, 2012 - Le Palais des Congrès de Paris, Paris, France
1Barzilai Med. Center, Dept. of Urology, Ashkelon, Israel, 2Ben Gurion University, Dept. of Health Management, Beer Sheva, Israel
View EAU 2012 Annual Meeting Coverage
