目的:探讨经导管动脉栓塞术(TAE)治疗慢性前列腺炎/慢性盆腔疼痛综合征(CP/CPPS)的初步疗效。
方法:这项回顾性研究包括2022年4月至2023年2月期间接受TAE的难治性CP/CPPS患者。所有患者持续盆腔疼痛至少3个月,NIH-慢性前列腺炎症状指数(NIH-CPSI)总分至少15分,缺乏感染的证据.所有程序均通过从双侧前列腺动脉±阴部内动脉注射亚胺培南/西司他丁钠(IPM/CS)进行。NIH-CPSI,疼痛数字评定量表(NRS),在初次TAE后1个月,3个月和6个月以及最后一次随访时对并发症进行评估.
结果:在48例患者中,44人被包括在这项研究中,其中4人因失去随访而被排除。未观察到严重的手术相关并发症。在初始TAE后1、3和6个月和最终随访(平均16.6个月)的治疗前和治疗后评估显示,平均NIH-CPSI评分分别从27±6降至21±8、20±9、17±9和18±9(均P<0.001)。疼痛NRS评分也分别从7.0±1.6降至4.8±2.5、4.1±2.6、3.7±2.4和3.4±2.3(均P<0.001)。临床成功的比例,定义为从NIH-CPSI基线减少至少6点,在TAE后6个月和最后一次随访时,分别为70%和64%,分别。
结论:本研究为TAE使用IPM/CS进行CP/CPPS的可行性提供了证据,提示症状改善和安全性。
OBJECTIVE: To investigate the preliminary treatment outcomes of transcatheter arterial embolization (TAE) for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).
METHODS: 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.
RESULTS: 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.
CONCLUSIONS: This study provides evidence of the feasibility of TAE using IPM/CS for CP/CPPS, suggesting both symptomatic improvement and safety.