IN PRACTICE

The response to sertraline in men with chronic pelvic pain syndrome

R A Lee¹, R M West² and J D Wilson¹

¹ Department of Genitourinary Medicine, The General Infirmary at Leeds, UK
² Nuffield Institute for Health, University of Leeds, UK

Correspondence to:
Correspondence to:
R A Lee
Department of Genitourinary Medicine, The General Infirmary at Leeds, Great George Street, Leeds LS1 3EX, UK; rachel.lee{at}leedsth.nhs.uk

Objectives: Male chronic pelvic pain syndrome (CPPS) is difficult to manage. Although antidepressants are frequently used in clinical practice, to date no interventional study has been published. We investigated men with CPPS to assess their response to the serotonin specific reuptake inhibitor (SSRI) antidepressant, sertraline.

Methods: Men with CPPS underwent a four glass test to exclude an infective cause for their symptoms. They were randomised to sertraline or matched placebo for 13 weeks after which they were unblinded. They were then allowed to either continue sertraline or cross over to active treatment for a further 13 weeks. Prostatic symptom severity (PSS) and frequency (PSF) scores, the Hospital Anxiety and Depression (HAD) scale and a psychosexual (PSex) questionnaire were completed at 0, 6, 13, and 26 weeks. Statistical analysis was by the Mann-Whitney U and Wilcoxon signed rank tests.

Results: 14 men enrolled. At week 13 there was a mean reduction in PSS scores of 6.1 in the active and 2.0 in placebo group, and in PSF scores of 3.6 and 1.0, respectively. There was no statistically significant difference in the PSS and PSF scores between the active versus placebo group because of the small subject numbers. If analysed as a case series, there was a significant reduction in PSS (11.7; p = 0.01) and PSF (5.9; p = 0.03) from baseline following 13 weeks of sertraline. There was also a decrease in mean HAD depression score from 4.6 at baseline to 2.4.

Conclusion: Sertraline led to a significant improvement in prostatic symptom severity and frequency from baseline following 13 weeks of treatment. Although this analysis does not exclude a placebo effect, the randomised placebo controlled findings show a trend to improvement with sertraline when compared to placebo.

Abbreviations: CPPS, chronic pelvic pain syndrome; HAD scale, Hospital Anxiety and Depression scale; PCR, polymerase chain reaction; PSex questionnaire, psychosexual questionnaire; PSF, prostatic symptom frequency; PSS, prostatic symptom severity; SSRI, serotonin specific reuptake inhibitor

Keywords: chronic pelvic pain syndrome; sertraline

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Relevant Article

Whither "chronic prostatitis"?

G A Luzzi
Sex Transm Inf 2005 81: 96-97. [Extract] [Full Text] [PDF]