Therapeutic use of pulsed electromagnetic field therapy reduces prostate volume and lower urinary tract symptoms in benign prostatic hyperplasia

Abstract

Background: Benign prostatic hyperplasia (BPH) etiology remains poorly understood, but chronic low-grade inflammation plays a role. Pulsed electromagnetic field therapy (PEMF) (1-50 Hz) is effective in reducing tissue inflammation.

Objectives: We designed a pilot study to evaluate the effects of PEMF on prostate volume (PV) in BPH.

Materials and methods: This is a prospective interventional trial on 27 naive patients with BPH and lower urinary tract symptoms (LUTS). At baseline (V₀ ), all patients had blood tests, transrectal ultrasound, and questionnaires (IPSS, IIEF-15) and received a perineal PEMF device (Magcell^® Microcirc, Physiomed Elektromedizin). PEMF was delivered on perineal area 5 minutes twice daily for 28 days, then (V₁ ) all baseline evaluations were repeated. Afterward, nine patients continued therapy for 3 more months (PT group) and 15 discontinued (FU group). A 4-month evaluation (V₂ ) was performed in both groups.

Results: A reduction was observed both at V₁ and at V₂ in PV: PV_V0 44.5 mL (38.0;61.6) vs PV_V1 42.1 mL (33.7;61.5, P = .039) vs PV_V2 41.7mL (32.7;62.8, P = .045). IPSS was reduced both at V₁ and at V₂ : IPSS_V0 11 (5.7;23.2) vs IPSS_V1 10 (6;16, P = .045) vs IPSS_V2 9 (6;14, P = .015). Baseline IPSS was related to IPSS reduction both at V₁ (r_s = 0.313;P = .003) and at V₂ (r_s = 0.664;P < .001). PV reduction in patients without metabolic syndrome (ΔPV_V1nMetS -4.7 mL, 95%CI -7.3;-2.0) was greater than in affected patients (ΔPV_V1MetS 1.7 mL, 95%CI -2.69;6.1)(P = .017, Relative Risk_MetS = 6). No changes were found in gonadal hormones or sexual function.

Discussion: PEMF was able to reduce PV after 28 days of therapy. Symptoms improved in a short time, with high compliance and no effects on hormonal and sexual function or any side effects. Patients with moderate-severe LUTS and without MetS seem to benefit more from this treatment.

Conclusion: PEMF reduces PV and improves LUTS in a relative short time, in BPH patients. These benefits seem greater in those patients with moderate-severe LUTS but without MetS.

Keywords: BPH; IPSS; LUTS; PEMF; inflammation; prostate volume.