Surgical therapy of prostatitis: a systematic review

The clinical term "prostatitis" refers to a clinical syndrome defined by the following 4 distinct entities: acute bacterial prostatitis (category 1), chronic bacterial prostatitis (category 2), chronic prostatitis/chronic pelvic pain syndrome (category 3), and asymptomatic prostatitis (category 4) The etiology of the chronic forms is still not fully understood and choice of therapy is often debated. The objective of this systematic review is to collect evidence on the surgical treatment of the chronic form of prostatitis and to evaluate its clinical implication.

We performed a systematic literature search and identified 6683 relevant publications, of which 16 were included in the review.

Transurethral prostate resection was performed in 110 patients; 78 patients (70%) were reported as "cured", 16 patients (15%) as improved, and 16 patients (15%) as unchanged. Radical prostatectomy was performed in 21 patients; a full resolution of prostatitis related symptoms was reported for 20 patients (95%). No increased rates of complications or unusual complications were noted.

Surgical therapy of chronic bacterial prostatitis or chronic pelvic pain syndrome might be a viable option; however, since little evidence is currently available and no randomized controlled trials have been conducted, the presently available data does not provide a base for clinical decisions.

World journal of urology. 2017 Jun 13 [Epub ahead of print]

Dominik S Schoeb, Daniel Schlager, Martin Boeker, Ulrich Wetterauer, Martin Schoenthaler, Thomas R W Herrmann, Arkadiusz Miernik

Department of Urology, Faculty of Medicine and Medical Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany. ., Department of Urology, Faculty of Medicine and Medical Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany., Institute for Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany., Department of Urology and Urologic Oncology, Hannover University Medical School, Hannover, Germany.

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