Chronic Prostatitis/Chronic Pelvic Pain Syndrome: Is There a Role for Local Drug Infiltration Therapy?

Abstract

The clinical syndrome of chronic prostatitis ranges from well-defined chronic bacterial infections to poorly defined chronic pelvic pain syndrome (CPPS), previously referred to as "prostatodynia" or "abacterial prostatitis." Faced with the obscure nature of the disease, its protracted course, and the poor response to oral medication, urologists have considered alternative routes of drug administration. We review the indications and outcomes of local drug infiltration (intraprostatic antibiotic and zinc, intrasphincteric botulinum toxin A, pudendal nerve blocks) and discuss their potential use and benefit in the treatment of chronic prostatitis syndromes.

195 Intraprostatic Injection of Botulinum Toxin-A in Patients with Refractory Chronic Pelvic Pain Syndrome: The Transurethral vs. Transrectal Approach

“…Many treatment protocols have been assessed previously, e.g., a-blocker therapy and antimicrobial therapy, but have failed to provide an acceptable outcome [15][16][17][18][19][20][21], and the search for other drug regimens for such patients has gained favour among physicians [22,23].…”

Transurethral intraprostatic injection of botulinum neurotoxin type A for the treatment of chronic prostatitis/chronic pelvic pain syndrome: results of a prospective pilot double‐blind and randomized placebo‐controlled study

“…A suppressive effect of BoNT-A on smooth muscle tone and sensory neurons, along with atrophy of the prostate gland induced by intraprostatic injection of BoNT-A, may be important mechanisms in relieving LUTS [10][11][12][13][14][15][16][17].…”

Intraprostatic injection of botulinum toxin-A in patients with refractory chronic pelvic pain syndrome: The transurethral vs. transrectal approach

“…The management of refractory CP/CPPS is frustrating and disappointing both for patients and physicians. Many treatment protocols have been assessed previously, e.g., α-blocker therapy and antimicrobial therapy, but have failed to provide an acceptable outcome [15–21] , and the search for other drug regimens for such patients has gained favour among physicians [22,23] .…”