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DOI: 10.4172/2168-9857.1000207

ISSN: 2168-9857
Medical & Surgical Urology
Research Article Open Access

The Cause, Aetiology and Physiopathology of Chronic Prostatitis/Chronic

Pelvic Pain Syndrome (CP/CPPS) and its Effective Treatment with
Thermobalancing Therapy
Simon Allen*
Fine Treatment, 29 Rewley Road, Oxford, OX1 2RA, United Kingdom
*Corresponding author: Simon Allen, Director, Fine Treatment, 29 Rewley Road, Oxford, OX1 2RA, United Kingdom, Tel: +447958878300; Fax: +441865728255; E-
mail: info@finetreatment.com
Recieved date: October 05, 2018; Accepted date: October 12, 2018; Published date: October 19, 2018
Copyright: ©2018 Allen S. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use,
distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Introduction: Type-III chronic prostatitis (CP) is characterized by pelvic pain, sexual dysfunction and urinary
symptoms in the absence of infection. It is also known as chronic pelvic pain syndrome (CPPS) This study discusses
the cause of CP/CPPS, the understanding of which can help to find effective therapy.

Materials: An observational clinical trial, before and 6 months after treatment with Thermobalancing therapy (TT)
and Dr Allen’s therapeutic device (DATD), which uses natural body energy, has been used. The treatment group-45
patients with CP/CPPS, who received DATD, and the control group-45 men with CP/CPPS, who not.

Methods: The National Institute of Health Chronic Prostatitis Symptom Index (NIH-CPSI) include examination of
pain score and quality of life (QoL), ultrasound-prostate volume (PVmL), uroflowmetry-maximum urine flow rate
(Qmax).

Results: Compared to control, significant improvements from baseline to endpoint were seen: pain score, 10.38
to 3.58 against 10.49 to 9.71, (P<0.001); QoL index 8.11 to 2.98; against 8.47 to 8.33 (P<0.001); PVmL 31.75 ± 7.01
to 27.07 ± 4.52 against 30.77 ± 6.44 to 31.58 ± 7.14 (P<0.001); QmaxmL/sec, 11.93 ± 4.34 to 16.45 ± 3.50 against
12.59 ± 3.57 to 12.20 ± 2.54 (P<0.001).

Conclusions: Vascular changes, namely pathological activity of capillaries, in the prostate tissue cause CP/
CPPS. The focus of hypothermia combined with spontaneous expansion of capillaries create the pressure in the
prostate tissue and, consequently, the CP/CPPS symptoms. DATD, by accumulation of emitted body heat and
spreading this safe energy to the prostate in men with CP/CPPS, relieves pain and other symptoms effectively.

Keywords: Aetiology of CP/CPPS; Thermobalancing therapy; The cause of all chronic non-malignant internal diseases, including
Chronic prostatitis; Pathophysiology of CP/CPPS; Cause of chronic CP/CPPS, originates at the vascular level and termed as pathological
prostatitis symptoms activity of capillaries [11]. 2 physiological properties of capillaries are
activated by an initial trigger, which can be infection cold, stress, etc.
Introduction They named by physiologists’ constriction of capillaries [12], the first
property, which emerges a focus of micro-hypothermia in the prostate
Many scientists propose that chronic prostatitis/chronic pelvic pain tissue, and the second property spontaneous expansion of capillaries to
syndrome (CP/CPPS) may not exist as a disease, as its improve blood circulation in the affected area [13]. Expansion of
pathophysiological mechanisms are unknown and there are no suitable capillaries forms extra tissue gradually, and the focus of micro-
and effective treatments [1,2]. Other scholars see the immunological hypothermia in the prostate tissue becomes a continuous trigger itself
mechanisms underlying chronic pelvic pain and prostate inflammation leading to chronic disease.
in CP/CPPS [3,4]. Some of researchers are still looking for infection in
CP/CPPS and, consequently, recommend antibiotics, alpha-blockers To liquidate this focus of hypothermia and, consequently,
and antiphlogistics to treat this common disease [5,6]. spontaneous expansion of capillaries Thermobalancing therapy (TT)
with therapeutic device (DATD) were created and received a US
CP/CPPS is disease troubling men below their 50th with severe patent. The therapy with DADT, which accumulates the emitted body
pelvic pain, sexual dysfunction and urinary symptoms, having negative heat, provides continuous application of a natural source of energy to
impact on quality-of-life, with prevalence in average 8.2% of men’s affected prostate tissue, terminating the focus of hypothermia and
population [7,8]. Mental health remains a major challenge in men with chronic process [14]. It was shown that the use of TT with DATD for
CP/CPPS and is a source of frustration to both the patient and the treatment of men with benign prostatic hyperplasia (BPH) reduced
urologists or general practitioners, since standard treatments often fail the size of enlarged prostate and dramatically improved urinary
[9]. Therefore, new treatment procedures for CP/CPPS are required symptoms [15,16].
[10].

Med Sur Urol, an open access journal Volume 7 • Issue 4 • 1000207

ISSN: 2168-9857
Citation: Allen S (2018) The Cause, Aetiology and Physiopathology of Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) and its
Effective Treatment with Thermobalancing Therapy. Med Sur Urol 7: 207. doi:10.4172/2168-9857.1000207

Page 2 of 5

In men with CP/CPPS inflammation is not associated with an Santron Meditronic, Maharashtra, India), and ultrasound was used to
increased risk of this problem but chronic inflammation predicts the determine the volume of the prostate gland (US-9000E2 ultrasound
risk of symptomatic progression [17]. So, the prostate in men with CP/ scanner, Rising Medical Equipment Co. Ltd, China). The standard
CPPS is inflamed and this inflammation can be caused by the violation ellipsoid formula, length × width × height × 0.52, was used to
of the microcirculation in the prostate tissue due to pathological determine PV.
activity of capillaries. In this study, are presented changes in clinical
parameters and characteristics in men with CP/CPPS on TT with Outcome measures
DATD. Thorough examination of these factors can help to understand
the aetiology and pathogenesis of this chronic disease, i.e. the cause of Primary end-points were the changes in pain and QoL score after
CP/CPPS. the 6-month treatment period and secondary end-points were the
changes in PV and Qmax after the 6-month treatment.
Materials After screening, men in the treatment group were given DATD.
Which should be applied topically. It contains a thermoelement, which
Patient enrollment began in July 2013. The ethics committee of the is made of a special mixture of waxes. This thermoelement
State Medical University approved the clinical study, and the study accumulates the naturally emitted body heat and turns into a source of
complied with the tenets of the Declaration of Helsinki. energy itself. A second part of the device is an elastic belt that keeps a
The treatment group-45 men diagnosed with CP/CPPS, and the thermoelement in the projection of the prostate for a prolonged
control group-45 men with CP/CPPS. The two study groups were duration.
statistically similar. The data gathered in men with CP/CPPS who The thermoelement allows accumulation of body heat and acts as
received treatment with TT and DATD for 6 months was compared the heat source for the prostate. The neoprene belt keeps the
with the control group, men who did not receive DATD. thermoelement tightly applied to the skin, so the energy overcomes
skin barrier and spreads toward the affected prostate. Neoprene
Participants material prevents heat transfer by closing the thermoelement from the
The age of participants was <55 years. The clinical trial was outside (Figure 1).
conducted at The Department of Urology of the Yerevan State Medical
University. Men were included with confirmed diagnosis of chronic
prostatitis; with serum prostatic specific antigen (PSA) >4 ng/ mL, and
no histological evidence of cancer. Men with acute prostatitis; urethral
stricture, neurogenic bladder, and other co-morbidities such as
impaired renal function and diabetes mellitus were excluded from the
trial. Medical treatments at the time of enrollment were not taken into
consideration. The patient selection was carried out in a
multidisciplinary manner in conjunction with urologists. The written
informed consent for participation in the study was obtained from all
patients.

Methods
An observational clinically controlled study was used. The trial was
not placebo for ethical reasons, since men with CP/CPPS experience
serious mental problems [18]. Providing patients with CP/CPPS for
wearing a device that does not help does not make sense, since they
will not use it. Of course, after people felt better, they used the device
around their body for 6 months, as prescribed. Therefore, we
conducted the observational study in which treatment group Figure 1: Device on body.
underwent TT, and the control group did not.

Assessment DATD was registered in 2010 at the Medicines and Healthcare

Products Regulatory Agency as a class-1 medical device, as per the
The dynamic of symptoms in men with CP/CPPS who received TT independent, authorized CE Marking representative in UK or EU. The
with DATD, without medications and supplements, was compared regulation of medical devices in Europe and outside the European
with the control group, who did not receive DATD. The baseline Union are same, class-I medical device without a measuring function
evaluations included medical history; physical examination, digital and supplied in non-sterile conditions may only require a supplier’s
rectal examination; serum biochemical measurements, PSA test, declaration of conformity, where the manufacturer is responsible for
electrolytes, urinalysis; and renal function tests. Assessments were ensuring that the product complies with the relevant requirement.
made twice, at baseline and after the 6-month period of treatment. All
patients were evaluated for NIH-CPSI, pain and QoL scores, Statistical analysis
ultrasound PV mL, and uroflowmetry Qmax mL/s. Changes of clinical
symptoms in each group by using NIH-CPSI. Uroflowmetry was used As independent samples t-test and paired samples t-test are only
for the measurement of the rate of urine flow parameters (Sanuro2UL, suitable for interval and ratio data, we used the Wilcoxon signed-ranks

Med Sur Urol, an open access journal Volume 7 • Issue 4 • 1000207

ISSN: 2168-9857
Citation: Allen S (2018) The Cause, Aetiology and Physiopathology of Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) and its
Effective Treatment with Thermobalancing Therapy. Med Sur Urol 7: 207. doi:10.4172/2168-9857.1000207

Page 3 of 5

test for analyses. P<0.05 was considered statistically significant. adverse events were found during the clinical trial in the treatment
Statistical analyses were carried out using SPSS v22 (IBM, Armonk, group.
NY, USA).
The study was not randomized. Someone may expect that having a
“placebo” or “sham” group for controls could provide more robust
Results outcomes. However, in patients with CP/CPPS, their chronic pelvic
pain is largely unresponsive to standard medical interventions, and
Dynamic of pain and quality of life in men with CP/CPPS higher pain is naturally associated with diminished QoL [21].
Furthermore, different placebo-controlled studies in men with CP/
In this Figure 2, pain score in men with CP/CPPS in the treatment
CPPS have not found any improvement in patient using placebo-
group decreased from 10.38 to 3.58, P<0.001, after DATD was used. In
tablets, and often patients in the placebo group refused to complete the
the control group, pain score decreased slightly, from 10.49 to 9.71.
study because of worsening symptoms [22]. Therefore, it is practically
QoL decreased from 8.11 to 2.98, P<0.001, in the treatment group, impossible to convince patients with CP/CPPS to wear a shame device
while in the control group, QoL decreased slightly from 8.47 to 8.33. on their bodies for six months. Usually, patients experienced some
pain relief within a couple of weeks; therefore, they used DATD as was
Thus, the obtained data demonstrates that men in treatment group
required. Thus, an observational clinically controlled design was used
after use of DATD have better outcomes in the clinical symptoms than
in this study.
in the control group.

Figure 3: CP Cause PV Qmax.

Figure 2: CP Cause pain Qol.
Researches proposed immunological, neurological, endocrine, or
psychological mechanism of CP/CPPS development [23]. They looked
Dynamic of prostate volume and uroflowmetry Qmax in men into hypogonadism, a treatment of which is rises in the aging
with CP/CPPS population [24] and recommended the use of testosterone replacement
therapy for CP/CPPS, as target therapy [25,26]. In the last decade,
In this Figure 3, PV mL in men with CP/CPPS in the treatment
vascular dysfunction was suggested in aetiology of CP/CPPS [27], as
group decreased from 31.75 to 27.07 mL, P<0.001, after DATD was
chronic ischemic processes were found in the prostate tissue [28]. In
used. In the control group, PV mL increased slightly, from 30.77 to
CP/CPPS patients, color doppler examination of prostate has shown
31.58 mL.
that there is a significant increase in blood circulation in the prostatic
Qmax increased from 11.93 to 16.45 mL/s, P<0.001, in the capsule and diffusion flow throughout the parenchyma [29]. It was also
treatment group, while in the control group, Qmax decreased from established increased prostatic pressure in men with CP/CPPS [30].
12.59 to 12.20 mL/s.
Standard treatments fail to determine this disorder, so there is no
Thus, the obtained data demonstrates that men in treatment group understanding of the cause of CP/CPPS. Therefore, for CP/CPPS a
after use of DATD have better outcomes in the clinical parameters than multimodal approach is usually required that may include the six
in the control group. domains: urinary symptoms, psychological dysfunction, organ-specific
symptoms, infectious causes, neurologic dysfunction, and tenderness
Discussion of the pelvic floor muscles [31]. Another review suggests that
acupuncture and extracorporeal shockwave therapy may decrease
The outcomes of the clinical trial demonstrate that TT decreases prostatitis symptoms and may not be associated with a greater
pain significantly, and consequently improves QoL in men with CP/ incidence of adverse event [32]. It also was shown that some of the
CPPS. The reduction of PV and increases of Qmax prove that there is interventions can decrease prostatitis symptoms in an appreciable
improvement in the prostate tissue. The decrease in the size of the number without a greater incidence of adverse events, but the quality
prostate is associated with the cessation of inflammation caused by the of evidence was mostly low [33].
pathological activity of the capillaries. This leads to an improvement in
blood circulation in the prostate tissue and to a reduction in pain. Positive changes in clinical symptoms and parameters in patients
with CP/CPPS who used DATD should be explained by changes at the
These data confirm that TT with DATD are effective for men with vascular level in the prostate tissue [34]. The findings of this clinical
CP/CPPS, and DATD can be used for men with CP/CPPS, as an trial correlate with outcomes of another clinical controlled trial on
independent treatment option [19,20]. It should be noted that no Thermobalancing therapy in men with BPH, where was demonstrated

Med Sur Urol, an open access journal Volume 7 • Issue 4 • 1000207

ISSN: 2168-9857
Citation: Allen S (2018) The Cause, Aetiology and Physiopathology of Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) and its
Effective Treatment with Thermobalancing Therapy. Med Sur Urol 7: 207. doi:10.4172/2168-9857.1000207

Page 4 of 5

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Med Sur Urol, an open access journal Volume 7 • Issue 4 • 1000207

ISSN: 2168-9857
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Effective Treatment with Thermobalancing Therapy. Med Sur Urol 7: 207. doi:10.4172/2168-9857.1000207

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Med Sur Urol, an open access journal Volume 7 • Issue 4 • 1000207

ISSN: 2168-9857