AUA 2004 - Biofeedback

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Program#/Poster#: 116

Presentation Title: CHRONIC PELVIC PAIN SYNDROME TYPE 3 SUCCESFULLY TREATED WITH BIOFEEDBACK PHYSICAL THERAPY

Presentation Time: 5/8/2004 1:00:00 PM

Author Block: Erik B. Cornel, Ernst P. Van Haarst. Hospital Group Twente, Hengelo, Netherlands, st. Lucas Andreas Ziekenhuis, Amsterdam, Netherlands

Introduction and Objective: Men with chronic pelvic pain syndrome (CPPS) type III experience chronic pelvic pain of uncertain aetiology with varying degrees of urinary symptoms. Recent studies suggests that the symptoms of chronic prostatitis / chronic pelvic pain syndrome type III may be due to or associated with pelvic floor muscle dysfunction. Therapies such as biofeedback physical therapy and pelvic floor re-education, aimed to improve relaxation and proper use of the pelvic floor muscles, are expected to give symptom improvement. The objective of this prospective study was to evaluate the effect of biofeedback physical therapy on the symptoms of men with CCPS type III.

Methods: Between March 2000 to March 2002, 23 consecutive men (mean age 46 years, range from 29 years to 56 years) who were diagnosed with chronic prostatitis / chronic pelvic pain syndrome type III participated in a pelvic floor biofeedback re-educating program. Diagnosis was based on history including the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) questionnaire, physical examination including pelvic floor muscle tonus, urine analysis, uroflowmetry with residual urine measurement and transrectal ultrasonography of the prostate. The NIH-CPSI total score is a valid, reliable and responsive measure of prostatitis symptoms and was therefore used for diagnosis and to monitor the effect of therapy. Moreover, pelvic floor muscle tonus measurements were used not only to complete diagnosis but also to monitor the effect of the biofeedback physical therapy. For statistical analysis the Wilcoxon signed ranks test for paired samples was performed.

Results: Two of the 23 men who were diagnosed with chronic prostatitis / chronic pelvic pain syndrome type 3 could not be properly trained and did not show any improvement. The mean total NIH-CPPI score changed for the 21 treated men from 26 (range 11-33) of baseline to 8 (range 1-19) after treatment (p < 0.001). The mean value of the pelvic muscle tonus, normally 1 mev, was at diagnosis 5 (range 2.5-100) and decreased to 1.4 (range 0.5-2.8) after treatment (p = 0.003).

Conclusions: Our data demonstrate that there is a role for biofeedback physical therapy and pelvic floor re-education in the treatment of chronic prostatitis / chronic pelvic pain syndrome type 3 patients