A Randomized Controlled Trial Of Levofloxacin, Terazosin, And Combination Therapy In Patients With Category â…¢ Chronic Prostatitis/Chronic Pelvic Pain Syndrome

Objective:1. To explore the efficacy of levoloxacin, terazosin, and their combination in patients with category Ⅲ chronic prostatitis/chronic pelvic pain syndrome (CP/ CPPS).2. To compare the therapeutic effect of category Ⅲ A and category Ⅲ B CP/ CPPS.3. Evaluation of the clinical value of category Ⅲ CP in two subcategories:III A and Ⅲ B.4.To investigate the pathogenesis of category Ⅲ CP/CPPS.Materials and methods:1. A total of 115 patients with category Ⅲ CP/CPPS receiving six-week therapy were randomly divided into the levofloxacin group (n= 38), terazosin group (n=38), and combination group (n=39). The endpoints were the response rate of the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI), International Index of Erectile Function 5 (IIEF-5), expressed prostatic secretion-white blood cell (EPS-WBC), expressed prostatic secretion-small particle of lecithin (EPS-SPL), Maximum Flow Rate (MFR) and Average Flow Rate(AFR). After six weeks treatment, the data of related were compared before and after treatment.Results:1. After six weeks, the response rate of NIH-CPSI scores was 45.1%,22.4%, and 50.0% in the levofloxacin group, terazosin group, and combination group, respectively. There was significant difference between the levofloxacin group and terazosin group(P<0.01); There was significant difference between the terazosin group and combination group(P<0.01); There was no significant difference in NIH-CPSI scores was observed between the levofloxacin group and combination group (p>0.05).2. EPS-WBC counts in the levofloxacin group decreased from (13.4 ±4.6) to (6.8±2.9), terazosin group decreased from (12.7±4.3) to (10.1±3.8), while that of the combination group decreased from (12.6±4.4) to (6.0±2.3) Levofloxacin alone or levofloxacin plus terazosin could significantly reduce EPS-WBC counts compared with terazosin alone(P<0.05).3. IIEF-5 scores in the levofloxacin group before and after treatment were (10.8±2.9)、(16.1±4.4), terazosin group were (11.1±3.0)、(16.8±4.6), the combination group were (11.2 ±3.2)、(17.2±4.3) respectively, no significant difference was found between the three arms in terms of IIEF-5 scores (p>0.05).4. After six weeks, the MFR in the levofloxacin group increased from (16.1±5.8)ml/s to(19.3±6.1)ml/s, terazosin group increased from (16.5±6.3)ml/s to (20.1±6.7)ml/s, the combination group increased from (16.2±6.0)ml/s to (19.7±6.4)ml/s. There was no significant difference in the three arms (p>0.05).5. The AFR in the levofloxacin group before and after treatment were(8.3±3.4)ml/s and (9.9±3.3)ml/s, terazosin group were(8.0 ±3.1)ml/s and (10.1±3.2)ml/s, the combination group were(8.2±2.9)ml/s and (10.3 ±3.1)ml/s. There was no significant difference in the three arms(p>0.05).6. After six weeks, no significant difference in NIH-CPSI scores was observed between IIIA and IIIB patients in each arm(p>0.05).7. Furthermore, the changes in EPS-SPL counts was no significant difference according to subcategory in the three arms before and after treatment(p>0.05).Conclusion:1. A 6-week short-term treatment of levoloxacin or levoloxacin plus terazosin was more effective than terazosin alone in patients with category III CP/CPPS.2. levoloxacin treatment was not different from levoloxacin plus terazosin treatment in terms of treatment effect.3. There was no significant difference in the therapeutic effect of category ⅢA and category ⅢB prostatitis.4. According to EPS-WBC counts divided into category ⅢA and ⅢB is limited to diagnosis and treatment for category Ⅲ prostatitis, the significance of the classification to be further explore.