Combination of pregabalin and Amitriptyline in management of chronic idiopathic pain following penile prosthesis implantation: a pilot study

IF 2.4 3区 医学 Q2 ANDROLOGY
Hassan Shaker, Nouran Omar El Said, Karim Omar ElSaeed
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Abstract

Chronic post-penile prosthesis pain is de novo pain persisting > 2 months post-operatively. This pain is inadequately reported, poorly understood and undermanaged. The purpose of this current pilot study was to improvise a medical approach to alleviate the condition and assess the combination of Pregabalin and Amitriptyline in its management. The study enrolled 9 patients complaining of idiopathic penile, pelvic, or scrotal pain persisting > 2 months after penile prosthesis implantation. Patients were prescribed pregabalin 75mg/12h (escalated after 1 week to 150mg/12h upon demand) and Amitriptyline 25mg once daily for 3 months. The pain was reassessed after 10, 30 and 100 days. The dose of pregabalin required and the side effects of the medication were noted. Findings revealed a significant decrease in pain duration (p = 0.007), frequency (p < 0.001), and intensity (p < 0.001); in glanular (p = 0.008), shaft pain (p = 0.046) but not scrotal (p = 0.112). Moreover, a significant decrease was found in sharp pain (p = 0.003) and pain aggravated by touch (p = 0.008) but not aching pain (p = 0.277). Additionally, significant improvement was reported in QoL (p < 0.001) and dose escalation of pregabalin to 150mg/12h was required in only 1 case (11%). The combination of pregabalin and amitriptyline is very effective in the management of chronic idiopathic pain following penile prosthesis implantation. However, due to the ambiguity and lack of reporting of the condition, we recommend a multicentric contribution to acknowledge the condition, and weigh its prevalence accurately, whilst evaluating the efficacy of our approach. This study received ethical approval from Ain Shams University Research Ethics Committee (REC) FWA 000017585, on 04/13/2023 (REC-FMASU@med.asu.edu.eg). no FMASU R98/2023.
普瑞巴林和阿米替林联合治疗阴茎假体植入术后慢性特发性疼痛:一项试点研究
阴茎假体术后慢性疼痛是指术后持续 2 个月以上的新发疼痛。对这种疼痛的报告不足、理解不深、管理不善。本试验研究的目的是改进医疗方法以缓解这种情况,并评估普瑞巴林和阿米替林的联合治疗效果。该研究共招募了 9 名主诉特发性阴茎、骨盆或阴囊疼痛的患者,这些疼痛在阴茎假体植入后持续 2 个月以上。研究人员为患者开具了普瑞巴林 75 毫克/12 小时(1 周后根据需要升级至 150 毫克/12 小时)和阿米替林 25 毫克,每天一次,持续 3 个月。10天、30天和100天后重新评估疼痛情况。记录了所需的普瑞巴林剂量和药物副作用。研究结果显示,疼痛持续时间(p = 0.007)、疼痛频率(p < 0.001)和疼痛强度(p < 0.001)均明显减少;龟头疼痛(p = 0.008)和轴痛(p = 0.046)明显减少,但阴囊疼痛(p = 0.112)没有明显减少。此外,锐痛(p = 0.003)和触痛(p = 0.008)明显减轻,但隐痛(p = 0.277)没有减轻。此外,患者的生活质量也有明显改善(p < 0.001),只有 1 例患者(11%)需要将普瑞巴林的剂量升级至 150 毫克/12 小时。普瑞巴林和阿米替林联合治疗阴茎假体植入术后的慢性特发性疼痛非常有效。然而,由于对该病症的报告含糊不清且缺乏报道,我们建议开展一项多中心研究,以确认该病症并准确衡量其患病率,同时评估我们所采用方法的疗效。本研究已于 2023 年 4 月 13 日获得艾因夏姆斯大学研究伦理委员会 (REC) FWA 000017585 的伦理批准 (REC-FMASU@med.asu.edu.eg)。编号为 FMASU R98/2023。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Basic and Clinical Andrology
Basic and Clinical Andrology Medicine-Urology
CiteScore
3.50
自引率
0.00%
发文量
21
审稿时长
22 weeks
期刊介绍: Basic and Clinical Andrology is an open access journal in the domain of andrology covering all aspects of male reproductive and sexual health in both human and animal models. The journal aims to bring to light the various clinical advancements and research developments in andrology from the international community.
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