Comparing electromagnetic stimulation with electrostimulation plus biofeedback in treating male refractory chronic pelvic pain syndrome

Objective The aim of this study was to compare the effectiveness of electromagnetic stimulation (EMS) versus electrostimulation plus biofeedback (ESB) for the treatment of refractory chronic pelvic pain syndrome (CPPS) in men. Materials and Methods A total of 23 male refractory CPPS patients were included in the study. EMS was applied for 30 minutes, three times weekly, for 6 weeks, for pelvic floor rehabilitation. We retrospectively compared the outcomes with 22 male refractory CPPS patients treated with ESB twice a week for 2 weeks, and later once a week for 4 weeks. Each ESB session lasted 45 minutes, including biofeedback (15 minutes) followed by electrostimulation (30 minutes). The outcome measures included the National Institutes of Health Chronic Prostatitis Symptoms Index (NIH-CPSI), International Prostate Symptom Score (IPSS), and a visual analogue score for pain from baseline to 12 weeks after completion of treatment. Results Significantly reduced pain, improved quality of life (QoL), and lowered total score of the NIH-CPSI were observed in both groups (all p < 0.05). The ESB group also demonstrated improvement in the urinary subscore of the NIH-CPSI. No significant differences were found between the groups in the urinary score measures of the NIH-CPSI. The mean pain score (p = 0.035), QoL (p = 0.012), and total score (p = 0.009) improved significantly in the ESB group compared with EMS group. Total IPSS and visual analogue score improved significantly after treatment in both groups. However, no significant differences were noted between the groups in the total and subdomain sums of the IPSS. Conclusion Both EMS and ESB physical therapy of the pelvic floor muscle effectively reduce pain, increase the QoL, and improve urinary tract symptoms in male CPPS patients who are refractory to medical treatments. The combination therapy of ES plus biofeedback demonstrates additional benefits in pain and QoL when compared with EMS alone.