Local anesthetic and steroidal prostatic injection for chronic pelvic pain syndrome: an effective last resort?

Objective: the chronic pelvic pain syndrome is a severely debilitating and protracted condition for patients and a challenging condition for clinicians to treat. We report our experience with an adjunctive treatment in four patients using peri- and intra-prostatic injection of Levobupivicaine and Methylprednisolone combination via a transperineal approach under general anaesthesia.

Methods: a retrospective observational report.

Results: all patients had found little or no relief of their perineal/pelvic pain with the use of antimicrobials, alpha blockers, anti-inflammatories, anticholinergics, Elmiron or with TURP. In all cases, the use of prostatic injection treatment has resulted in a complete eradication of perineal pain and significant improvement to quality of life for at least a period of time.

Discussion: we suggest prostatic injection treatment as a last resort therapy in relieving pain. Our report provides a basis for a larger randomised controlled study with longer term follow-up to evaluate its efficacy and durability.