Serum prostate-specific antigen level changes may also play an important role in chronic prostatitis patients receiving THREM therapy
We read with interest the article by Wu et al. (1) who evaluated the efficacy and feasibility of traditional Chinese herbal medicine retention enema combined with perineal massage (THREM) in treating refractory chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). Though this is a study of small case number as 20 patients, the result is promising and provides new applicable strategy for these patients who are quietly suffer. This study analyzed the remarkable parameters of CP/CPPS including International Prostate Symptom Score (IPSS), National Institutes of Health-Chronic Prostatitis Symptoms Index (NIH-CPSI), and visual analogue scale (VAS) and demonstrated the positive effect of THREM therapy with a duration at least 6 months. Though the study is of retrospective nature, the findings provided meaningful information regarding the novel procedure especially the technique of perineal massage in taking care of refractory CP/CPPS. However, the authors did not include the serum prostatic-specific antigen (PSA) before and after the management. As we know, the speculated pathomechanisms of CP/CPPS might be multifactorial and the diagnosis principles have been established before the era of PSA many decades ago. Based on our unpublished data, we found the PSA level differences between before and after conventional prostate massage implies the therapeutic effect and diagnostic potential. We identified that the more the difference of the PSA, the more efficacy of prostate massage for the CP/CPPS symptoms. In addition, the association and co-existence of hemorrhoids and CP/CPPS is common, we are looking forward that the authors will give us more information in terms of these characteristics.
We believe that addressing the points we have highlighted would provide greater application for our readers.
Acknowledgments
Funding: None.
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References
- Wu Z, Liu C, Peng Y, et al. Traditional Chinese herbal medicine retention enema combined with perineal massage (THREM): a promising therapeutic strategy for refractory chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). Transl Androl Urol 2024;13:759-68. [Crossref] [PubMed]
