Comprehensive assessment and pharmacological correction of pain syndrome in the non-inflammatory form of chronic abacterial prostatitis

The aim of the study was to improve the results of pharmacotherapy of pain syndrome associated with chronic prostatitis (CP) of category IIIB. Material and methods: The object of the study were patients suffering from chronic prostatitis of category IIIB (n = 90) (main group) and healthy men (n = 30) (control group). The average age of patients with CP IIIB was (41,5 ± 4,7) years, men of the control group (36,4 ± 2,8) years. The NIH-CPSI-QL scale was used to characterize the pain syndrome. To identify the neuropathic component of pain, the DN4 neuropathic pain questionnaire was used. The results of the examination of healthy men were taken as normal. The patients were randomly divided into two subgroups of 45 people. Patients of the 1st subgroup (n = 45) received standard therapy (NSAIDs, alpha-1-adrenoblocker, venotonic). The duration of treatment was 28 days. In subgroup 2 (n = 45), alpha-lipoic acid was prescribed 600 mg intravenously 1 time per day per 200 ml of phys. r-ra (No. 5). Subsequently, patients were transferred to standard therapy, lasting 28 days, which was supplemented with alpha-lipoic acid at 600 mg / day, e/d, per os. Results and their discussion: All (100 %) patients with HAP IIIB had pain syndrome with localization, mainly (61.1 %), in the pelvic and/or prostate area, which had an extremely negative impact on their quality of life. The neuropathic component of pain was detected in 34.5 % of patients and only in 12.3 % of patients in the control (p 0.05). Thus, the frequency of identification of neuropathic pain in CP IIIB was 2.8 times higher than in healthy men (p 0.05). The standard therapy did not have a positive effect on the neuropathic component of the pain syndrome, on the contrary, the frequency of its detection increased to 37.6 % (p 0.05). The introduction of alpha-lipoic acid into the complex therapy of patients with CP IIIB reduced the frequency of neuropathic pain by 12.8 %, and the pain index (IB) by 19.9 % (p 0.05). Conclusions: Using the DN4 questionnaire, it is possible to identify signs of neuropathic pain in every third patient suffering from category IIIB CP. Correction of the pain syndrome within the framework of using standard algorithms for the treatment of patients with CP IIIB is impossible. The inclusion of alpha-lipoic acid preparations in the composition of complex therapy can be recommended as an effective remedy in patients suffering from category IIIB CP.