Effect of prostate-derived complex peptide preparations on erectile function in patients with chronic prostatitis

Borovets S.Yu., Rybalov M.A., Slesarevskaya M.N., Al-Shukri S.Kh.

1) Department of Urology with the Course of Urology and Clinic, Pavlov First Saint Petersburg State Medical University, Ministry of Health of Russia, St. Petersburg, Russia; 2) Urology Research Center, Research Institute of Surgery and Emergency Medicine, Pavlov First Saint Petersburg State Medical University, Ministry of Health of Russia, St. Petersburg, Russia; 3) Men’s Health Center, D.O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, St. Petersburg, Russia

Disturbances of microcirculation and congestive processes in prostatic tissue play a key role in the development of chronic prostatitis. High-frequency Doppler ultrasonography of the penile vessels is used for objective assessment of erectile function (EF) in patients with chronic prostatitis (CP). A pathogenetically oriented treatment option for chronic abacterial prostatitis is the use of peptide bioregulators, including Prostatilen, which has been used for more than 30 years. Aim. To evaluate the effect of a complex prostate-derived peptide preparation on erectile function and penile arteriolar blood flow in patients with chronic abacterial prostatitis. Materials and methods. A total of 50 patients aged 25 to 64 years with CP and concomitant erectile dysfunction (ED), who received Prostatilen-AC rectal suppositories (30+180 mg) once daily at bedtime for 10 days, are included in the study. Before and after treatment, the following parameters were assessed: EF using the IIEF-5 questionnaire, as well as peak systolic velocity (Vas) and mean linear velocity (Vam) of arterial blood flow in the vessels of the non-erect penis using high-frequency Doppler ultrasonography. Results. Before treatment, mild ED was identified in 8/50 (16%) patients, moderate ED in 24 (48%), and severe ED in 18 (36%) patients. The mean IIEF-5 score was 12.8±5.1. According to Doppler assessment, marked microcirculatory disturbances were detected in 26/50 (52%) patients. After treatment with Prostatilen-AC, the mean IIEF-5 score increased significantly compared with baseline, from 12.8±5.1 to 17.8±4.3 (p<0.05), respectively. After therapy, all patients demonstrated a reduction in the severity of clinical manifestations of ED: in 6 (12%) patients symptoms were absent, 20 (40%) patients had mild ED, 14 (28%) had moderate ED, and only 7 (14%) patients retained severe ED. Therapy was also associated with a statistically significant improvement in penile arteriolar blood flow parameters in the observed patients: mean Vas increased from 2.78±0.26 cm/s before treatment to 3.41±0.31 cm/s after treatment (p<0.05); mean Vam increased from 0.56±0.11 cm/s to 0.88±0.12 cm/s, respectively (p<0.05). Conclusion. Treatment of patients with CP and concomitant ED with a complex prostate-derived peptide preparation contributed to a reduction in the severity of clinical manifestations of ED. An objective criterion of treatment efficacy, reflecting improvement of microcirculation in the penile vessels, is provided by the results of high-frequency Doppler ultrasonography of the penile vessels. Improvement in penile arteriolar blood flow following treatment in patients with manifestations of ED was indicated by increases in its main Doppler parameters, Vas and Vam.

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About the Authors

Corresponding author: S.Yu. Borovets – Ph.D., MD, Professor, Department of Urology with the Course of Urology and Clinic, Pavlov First Saint Petersburg State Medical University; Men’s Health Center, D.O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, St. Petersburg, Russia; e-mail: sborovets@mail.ru

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