Commentary on “Repetitive Transcranial Magnetic Stimulation for Chronic Prostatitis/Chronic Pelvic Pain Syndrome: A Prospective Pilot Study”

Article information

Int Neurourol J. 2020;24(3):296-296

Publication date (electronic) : 2020 September 30

doi : https://doi.org/10.5213/inj.2040268.134

Yu Seob Shin^1,*, Ki Soo Lee^2,*, Sung Chul Kam^,3,4

¹Department of Urology, Jeonbuk National University Medical School, and Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea

²Department of Urology, Donga University College of Medicine, Donga University Hospital, Busan, Korea

³Department of Urology, Gyeongsang National University College of Medicine, and lnstitute of Health Sciences of Gyeongsang National University, Jinju, Korea

⁴Department of Urology, Gyeongsang National University Changwon Hospital, Changwon, Korea

Corresponding author: Sung Chul Kam https://orcid.org/0000-0001-5403-3623 Department of Urology, Gyeongsang National University Changwon Hospital, 11 Samjeongja-ro, Seongsan-gu, Changwon 51472, Korea E-mail: kamsungchul@hanmail.net

*Yu Seob Shin and Ki Soo Lee contributed equally to this study as co-first authors.

Received 2020 July 14; Accepted 2020 August 4.

I have carefully read the article recently published in International Neurourology Journal by Nikkola et al. [1], and their findings are indeed interesting. Their article is one of the few reports to address the issue of treatment-resistant chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). The authors evaluated the feasibility, efficacy, and safety of repetitive transcranial magnetic stimulation (rTMS) in patients with treatment-resistant CP/CPPS [1]. rTMS was found to be well tolerated by CP/CPPS patients and at least moderately effective in pain alleviation in patients refractory to medical treatment [1]. rTMS treatment modulates intracortical inhibitory circuits and may help to repair intracortical inhibition in patients with neuropathic pain [1]. Currently, antibiotics, analgesics, α‐receptor blockers, and other medical therapies are used to treat CP/CPPS [2]. However, none of these approaches are potent and long‐lasting. Hence, attempts to develop new treatment modalities for CP/CPPS are meaningful. Nevertheless, in our opinion, their study would have been even more informative if the authors had provided a clear explanation about the negative results observed 12 weeks after rTMS. In their study, at 12 weeks after rTMS, the numerical rating scale (NRS) again ascended to near the baseline level, which fits the typical response profile of rTMS [1]. This raises the question of whether we will need rTMS for CP/CPPS if there is no significant improvement in NRS at 12 weeks. It would be very helpful for the readers if the authors could provide a clear explanation of this issue. Despite this limitation, the study of Nikkola et al. raises readers’ awareness of the issue of new treatment modalities for CP/CPPS.