EFFECTS OF THERAPY FOR CHRONIC ABACTERIAL PROSTATITIS ON THE PSYCHOSOMATIC STATUS OF THE PATIENT

Chronic abacterial prostatitis (CAP) or chronic pelvic pain syndrome (CPPS) is one of the most common diseases in the practice of any urologist. The psychosomatic status of a patient with CAP/CPPS significantly affects the effectiveness of the therapy and the risk of relapse of the disease.

Objective. To assess the psychological status of patients with CAP/CPPS during and after therapy.

Material and methods. The study included 62 patients with an established diagnosis of CAP. The patients were randomized according to the method of shock wave therapy (ESWT) into the main (n=32) and control (n=30) groups. The psychological status of patients was assessed at 2, 4, 8, 12, 16, 20 and 24 weeks based on the Hospital Anxiety and Depression Scale (HADS). The results were processed statistically, the differences were considered significant at a probability of occurrence of more than 95% (p<0.05).

Results. There were no differences in age, prostate volume, uroflowmetry and symptoms assessed by the IPSS, IIEF5, LANNS, NIH-CPSI questionnaires, and voiding diary in the study groups (p> 0.05). Moderate and high severity of LUTS, pain syndrome, erectile function and anxiety-depressive syndrome in both observation groups is noteworthy. Before the start of therapy, patients in both groups had severe symptoms in the anxiety and depression domains of HADS: 15±6 and 17±3 for the main and 17±3 and 18±3 for the control observation groups, respectively (p> 0.05). Further dynamics was characterized by a decrease in symptoms. In the main observation group more pronounced positive dynamics was recorded with regression and subsequent stabilization at the level of mild in the domains of anxiety and depression of the HADS scale already in the 2nd week of the experiment (p<0.05).

Conclusion. Thus, patients with exacerbation of CAP have clinically significant anxiety-depressive syndromes, which tend to be relieved against the background of CAP therapy. The rate and degree of reduction of anxiety-depressive symptoms depend, among other things, on the options of the therapy. Reducing the intensity of the ESWT session in our study had a positive effect. A comprehensive approach to normalizing the psychosomatic status of patients with CAP is required.

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