New treatment relieves men's chronic pelvic pain

Chronic inflammation of the prostate can lead to constant pain that is hard to treat, but a new approach seems to hold out promise.

Researchers have found that therapy designed to eliminate newly identified microorganisms called nanobacteria may alleviate these symptoms in men who haven't been helped by other treatments.

While the cause of so-called chronic prostatitis/chronic pelvic pain syndrome (CPPS) is unclear, it seems that the formation of small calcium stones in the prostate might be the culprit, Dr. Daniel A. Shoskes and colleagues at the Cleveland Clinic Florida in Weston explain in the February issue of the Journal of Urology.

They also note that nanobacteria produce a calcium mineral, apatite, and the organisms have been implicated in the formation of kidney stones and the mineralization in blood vessels.

Shoskes' team theorized that elimination of prostatic stones may relieve CPPS symptoms, and evaluated the use of a treatment developed to eradicate calcification formed by nanobacteria in a trial involving 15 men. All of them had experienced symptoms for more than 9 months despite conventional treatments, and showed signs of prostatic stones on ultrasound.

The daily treatment, dubbed comET (Nanobac Life Sciences), consists of tetracycline intended to knock out the nanobacteria, a proprietary supplement that has been shown to help with prostate problems, and a rectal suppository of EDTA, a compound that binds to calcium and can dissolve stones.

After treatment for 3 to 4 months, the average score on a standard prostatitis symptom index had declined from 25.6 to 13.7, with significant reductions in pain and improved quality of life, the team found.

Altogether, 80 percent of the participants had significant improvement in symptoms. Among 10 patients who had a repeated ultrasound exam after treatment, prostatic stones had decreased or resolved in six.

"This therapy warrants further study in larger, placebo controlled trials designed to control for the placebo effect," the researchers conclude - as well as to explore the role of nanobacterial infection as a cause of prostatic stones, and whether these stones are actually the cause of CPPS.

SOURCE: Journal of Urology, February 2005.