Chronic prostatitis symptoms stabilize over time: UT
Anonymous User
By: Charles Bankhead
Urology Times
Boston-Perhaps offering a measure of reassurance to prostatitis patients and
their urologists, data from a prospective study suggest that the symptoms of
chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) typically improve or
remain stable over time.
During a 1-year follow-up of a cohort receiving "usual care" for their
symptoms, half the patients had symptom improvement, and more than one-third
reported their symptoms unchanged. Symptoms deteriorated in about 14% of
patients.
"The primary message in these results is that symptoms of chronic prostatitis
and chronic pelvic pain syndrome don't deteriorate," said Michael P. O'Leary,
MD. "Even among patients with significant symptoms, only 14% got worse. Half
the patients actually improved slightly."
The results helped address questions about changes over time in the severity of
symptoms associated with CP/CPPS. The study involved 179 men enrolled in the
Chronic Prostatitis Collaborative Network, a prospective observational cohort
study. Each patient was followed for at least 1 year to assess changes in
symptoms, said Dr. O'Leary, associate professor of urologic surgery at Harvard
Medical School and Brigham and Women's Hospital in Boston.
Symptoms improve, stabilize
Patient symptoms were assessed by means of the National Institutes of Health
Chronic Prostatitis Symptom Index (CPSI). The index has been validated for
accuracy in assessing subscales related to pain, urinary symptoms, and quality
of life in patients with the condition. Evaluation of the patients also
included a global response assessment scale that rated changes in symptoms
across a range that encompassed "markedly improved" at one end of the spectrum
and "markedly worsened" at the other.
Patients had CPSI and global evaluations at baseline and then every 3 months
during follow-up. Throughout the study, patients received standard or usual
care and did not participate in evaluations of new therapies.
"In particular, none of the patients received antibiotics," said Dr. O'Leary.
"The enrollment criteria stipulated that a patient had to be off antibiotics
for at least 3 months prior to beginning the study."
After 1 year, the vast majority of patients reported that their symptoms had
improved or remained stable. Half said their symptoms were better, and an
additional 37% reported no change in their symptoms. The remaining 13% to 14%
reported symptom deterioration over the course of the year.
At baseline, the total symptom score on the CPSI averaged 21.9 and ranged
between 0 and 43. A year later, the total score had declined to a mean of 18.3,
Dr. O'Leary reported. Scores for pain, urinary symptoms, and quality of life
all had improved at 12 months.
'Not likely to get worse'
Most of the improvement occurred during the first 3 months of follow-up. For
example, the mean total score on the CPSI declined to 19.6 from baseline to 3
months and then to 18.3 between 3 months and 1 year. Similarly, urinary
symptoms decreased from a mean of 4.4 at baseline to 3.8 at 3 months then to
3.6 at 12 months. However, all CPSI subscales, as well as the total score on
the index, showed improvement throughout the follow-up period.
An even higher proportion of patients (59%) demonstrated improvement on the
global response assessment. An additional 27% said their symptoms remained
unchanged, and 14% said their symptoms had deteriorated over 12 months.
Analysis of the data did show an association between higher symptom scores at
baseline and both the likelihood of improvement and the magnitude of symptom
improvement.
In general, patients with higher baseline symptom scores reported more
improvement at 12 months. Caucasian patients were more likely than
African-Americans to report improvement.
"Symptoms do fluctuate, and patients do detect changes in symptoms, as
indicated by scores on the global response assessment," said Dr. O'Leary. "Our
results show that symptom improvement is more likely to occur than is worsening
of symptoms.
"The finding that patients with higher symptom scores at baseline had greater
improvement offers some hope that patients with really bad symptoms are at
least not likely to get worse and might actually improve slightly."
John Garst
Anonymous User <anon...@remailer.havenco.com> wrote:
...
> During a 1-year follow-up of a cohort receiving "usual care" for their
> symptoms, half the patients had symptom improvement, and more than one-third
> reported their symptoms unchanged. Symptoms deteriorated in about 14% of
*1* year!
It ain't much, but I guess it's something.
AndrewsFunk
>> symptoms, half the patients had symptom improvement, and more than
>one-third
>> reported their symptoms unchanged. Symptoms deteriorated in about 14% of
>> patients....
>
>*1* year!
>
>It ain't much, but I guess it's something.
>
>
>
>
>
>
It's good to hear something encouraging on this board for a change!
bdith
Yes it is good to hear something encouraging. And while the results
only track CP sufferers for one year, if I recall correctly the
patients being studied comprised a wide variety sufferers (shorter
term and longer term). Which means that we'd generally expect the
same results year after year. I'll bet when we get the year 2 results
we'll see another approx. 50% improve, 37% stabilize and 13%
deteriorate -- the same people might not fall in to each group, but
nonetheless this study seems to *prove* what many men on this board
say -- symptoms (in general) improve with time.
bd.
Derek
"Jack Nastyface" wrote.....
> To my mind the most important research which can be conducted on CP/CPPS
is
> that targeted to discovering it's etiology. Studies like the one cited
above
> do little to add to the real knowledge base while using up scarce
resources.
> And so I ask: "What do we do with this information?"
Exactly...good point. The study tells us nothing other than things we
already know, and doesn't make aware the seriousness of this conditon.
Chosen words in the study like, 'not likely to get worse', 'typically
improve,' 'remain stable over time', and 'chronic pelvic pain syndrome
doesn't deteriorate', keep this disease viewed by the medical community as
just an annoyance suffered by men, that will eventually get better.
bdith
>
> Exactly...good point. The study tells us nothing other than things we
> already know, and doesn't make aware the seriousness of this conditon.
> Chosen words in the study like, 'not likely to get worse', 'typically
> improve,' 'remain stable over time', and 'chronic pelvic pain syndrome
> doesn't deteriorate', keep this disease viewed by the medical community as
> just an annoyance suffered by men, that will eventually get better.
True...but I think these studies also will have a positive
psychological impact on sufferers. If someone told me last summer
that there was an 87% chance that I would not get worse, I think I
would have found that quite up lifting. I don't believe that this
illness is 'all in the mind' but like any illness, if you're not
worried and anxious about it, I'm sure you can handle the symptoms
better.
bd.
ar
Derek
"bdith" wrote....
> True...but I think these studies also will have a positive
> psychological impact on sufferers. If someone told me last summer
> that there was an 87% chance that I would not get worse, I think I
> would have found that quite up lifting.
I have to agree with that.