Repetitive prostatic massage therapy for chronic refractory prostatitis: the Philippine experience

Area of Science:

• Urology
• Infectious Diseases
• Integrative Medicine

Background:

• Prostatitis is a challenging condition often refractory to conventional therapies.
• Patients seek alternative treatments, including prostatic massage and antibiotics, internationally.
• The efficacy of this combined approach for refractory prostatitis requires prospective evaluation.

Purpose of the Study:

• To prospectively evaluate the treatment response of patients undergoing prostatic massage and antibiotic therapy in Manila.
• To assess changes in symptom severity, frequency, quality of life, voiding symptoms, and sexual function.

Main Methods:

• Twenty-six patients with refractory prostatitis were treated with triweekly prostatic massage and antibiotics for 6-12 weeks.
• Standardized questionnaires including Symptom Frequency Questionnaire (SFQ), Symptom Severity Index (SSI), International Prostate Symptom Score (I-PSS), and Quality of Life (QoL) were used.
• Follow-up assessments were conducted at baseline, 4 months, and up to 2 years.

Main Results:

• Significant decrease in average symptom severity (SSI) observed by 4 months, sustained for 2 years.
• Forty-six percent of patients showed >60% improvement in symptom severity (SSI).
• Thirty-three percent reported marked subjective improvement (SGA); 5 of 26 patients had sustained improvement at 2 years.

Conclusions:

• Prostatic massage combined with antibiotics may be a promising treatment for difficult, refractory prostatitis.
• While symptom severity improves, symptom frequency, quality of life, voiding, and sexual function showed less significant improvement.
• Further studies are warranted to confirm the value of this approach and predict patient response.