The efficacy of terazosin in the management of chronic pelvic pain syndrome (CPPS): Comparison between category IIIa and IIIb

Abstract

Purpose: To evaluate the efficacy of terazosin in chronic pelvic pain syndrome (CPPS) and compare the effect of terazosin between CPPS IIIa and IIIb. Materials end Methods: Between January 2004 and February 2005, CPPS patients, aged 45 or below, with a small size prostate (≤25ml), were enrolled in this study. The study comprised of 127 patients (CPPS category IIIa; 71, CPPS category IIIb; 56), who were randomly placed into one of two groups; the terazosin (T) and non-terazosin (non T) groups. The terazosin group was given 3-4mg/day of terazosin for 12 weeks. In all patients, the urinalysis, expressed prostatic massage (EPS), uroflowmetry, National Institute of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) and transrectal ultrasonography (TRUS) were checked at the initial visit. After 12 weeks, the NIH-CPSI and uroflowmetry were evaluated, and the change in the NIH-CPSI domain scores and maximal flow rate (Qmax) between the two groups evaluated; a sub-analysis was also performed between categories IIIa and IIIb. Results: The changes in the NIH-CPSI domains (pain, voiding symptom, quality of life, total) and Qmax of the T group were more significantly improved than those in the non T group (p<0.05). For category IIIa (n=71), the T group (n=42) showed significant improvements in all NIH-CPSI domains and the Qmax (p<0.05); whereas, the non-T group (n=29) only showed significant improvement in the pain and total scores in the NIH-CPSI domains (p<0.05). However, in a comparison between both category IIIa groups, there were no significant difference in the changes in the NIH-CPSI domains, with the exception of the Qmax (p>0.05). In category IIIb (n=56), the T group (n=29) showed significant improvements in all NIH-CPSI domains and the Qmax (p<0.05), but the non-T group (n=27) showed no significant improvement in the NIH-CPSI domains or the Qmax (p>0.05). Comparing both category IIIb groups, the T group showed a greater improvement in the pain score in the NIH-CPSI domains and the Qmax than the non-T group. Conclusions: Terazosin was effective in all domains of the symptom score and in the Qmax for CPPS.