Surgical therapy of prostatitis: a systematic review

Area of Science:

• Urology
• Surgical Oncology
• Evidence-Based Medicine

Background:

• Prostatitis encompasses four distinct clinical entities, with chronic forms (categories 2 and 3) having unclear etiologies and debated treatment strategies.
• Chronic bacterial prostatitis and chronic prostatitis/chronic pelvic pain syndrome represent significant challenges in urological practice.
• Current evidence on surgical interventions for chronic prostatitis is limited, necessitating a comprehensive review.

Purpose of the Study:

• To systematically review existing evidence on the surgical treatment of chronic prostatitis (categories 2 and 3).
• To evaluate the clinical implications and outcomes of surgical interventions for chronic prostatitis.
• To assess the efficacy and safety of surgical options for chronic prostatitis.

Main Methods:

• A systematic literature search was conducted to identify relevant studies on surgical prostatitis treatment.
• 16 publications were included in the final systematic review out of 6683 identified articles.
• Data on patient outcomes and complications following surgical procedures were extracted and analyzed.

Main Results:

• Transurethral prostate resection (TURP) in 110 patients resulted in 70% being cured, 15% improved, and 15% unchanged.
• Radical prostatectomy in 21 patients led to symptom resolution in 95% of cases.
• No significant increase in the rate or type of complications was observed following surgical interventions.

Conclusions:

• Surgical therapy may represent a viable treatment option for chronic bacterial prostatitis and chronic prostatitis/chronic pelvic pain syndrome.
• The current evidence base is limited, with a lack of randomized controlled trials.
• Further high-quality research, including randomized controlled trials, is required to establish definitive clinical guidelines for surgical prostatitis treatment.