Pulsed electromagnetic field with or without exercise therapy in the treatment of benign prostatic hyperplasia

To investigate the effect of pulsed electromagnetic field with or without exercise therapy in the treatment of benign prostatic hyperplasia. Sixty male patients aged 55–65 years with benign prostatic hyperplasia were invited to participate in this study. Patients were randomly assigned to Group A (n=20; patients who received pulsed electromagnetic field in addition to pelvic floor and aerobic exercises), Group B (n=20; patients who received pulsed electromagnetic field), and Group C (n=20; patients who received placebo electromagnetic field). The assessments included post-void residual urine, urine flow rate, prostate specific antigen, white blood cells count, and International Prostate Symptom Score were weighed, before and after a 4-week intervention. There were significant differences in Group A and B in all parameters. Group C showed non-significant differences in all measured variables except for International Prostate Symptom Score. Among groups, all parameters showed highly significant differences in favor of Group A. There were non-significant differences between Group A and B and significant difference between Groups A and C and between Groups B and C. The present study demonstrated that electromagnetic field had a significant impact on the treatment of benign prostatic hyperplasia. Accordingly, electromagnetic field can be utilized alone or in combination with other physiotherapy modalities. Moreover, clinicians should have the capacity to perceive the advantages accomplished using extra treatment alternatives. Electromagnetic field is a safe, noninvasive method and can be used for the treatment of benign prostatic hyperplasia.

INTRODUCTION

Benign prostatic hyperplasia (BPH) is defined as the origination of smooth muscle enlargement and proliferation of epithelial cells within the transitional area of the prostate gland. Enlargement of the gland might manifest in the lower urinary tract in two ways: (1) critical bladder outlet blocking due to enlarged tissue; and (2) increased tone of the diseased smooth muscle as well as the resistance inside the gland¹⁾. Voiding dysfunction might also be an obstructive characteristic of an enlarged prostate, while overactive bladder is thought to be a prominent reason for the storage symptoms observed in the lower urinary tract²⁾. The challenges created by lower urinary tract symptoms due to enlarged prostate in elderly men might be increasing and lead to this primitive diagnosis in public health³⁾.

The central plan of BPH treatment involves reducing the troublesome lower urinary tract symptoms that occur due to prostatic augmentation. Treatment should be adjusted as the disease progresses and getting away of complexities that can be joined with BPH⁴⁾. Different pharmacologic groups including alpha-adrenergic blockers, 5-alphareductase suppressors, cholinergic inhibitors, and phytotherapeutics were used⁵⁾. Determining the correct therapeutics for BPH is difficult. In the treatment of troublesome lower urinary tract symptoms, that is basic for healthcare professions as the manifestations may occur due to synergies between the pelvic organs and the central nervous system⁶⁾.

Treatment strategies also involve the surgical removal of all or part of the prostate gland, which can provoke uncontrolled urinary or sexual impediments⁷⁾. Exercises before and after surgery can have positive impacts on restoring function, especially managing incontinence. Pelvic floor exercises deliver distinctive unmistakable effects on the prostate, particularly in individuals who present with BPH⁸⁾.

Exercise can enhance blood circulation to the pelvic region, enabling the body to actively eliminate harmful agents and waste products; decrease pressure, therefore decompressing prostatic tissue⁹⁾; and lessen abdominal overweight, which enhances the lower body stress and consequently loosens the prostate/rectal zone, promoting blood stream toward and outside these sites¹⁰⁾.

The physiological impacts of low-frequency electromagnetic field (EMF) have been suggested to include the possibility of different considerations since they could enter through the body tissues. The EMF is thought to have the ability to affect the cells that induce different cellular changes including cell reproduction and differentiation¹¹⁾, programmed cell death, new DNA formation, RNA synthesis, protein formulation, protein phosphorylation, redox-mediated increases in inflammatory cells, increased microvesicular motility, ATP production, hormone secretion, increased antioxidant activity of enzymes, enhanced cellular metabolic action, and hindered adherence activity¹²⁾. The organization of restraining action and signal augmentation on organic activity has earlier been speculated to be induced only through biochemical carriers and receptors; however, present studies prove that molecular synergies may not remain the unique determinants implicated in the biological interface. Chemical agents are possibly the particle ingredients accentuated by directing energy fields carrying signal transduction¹³⁾. EMF possesses numerous well-reported biological effects including inflammation and pain suppression. This therapy is noninvasive, secure, and easy to use for treating the origin of discomfort, damage, and inflammation¹⁴⁾. Actually, there were limited number of studies conducted that investigated the effects of EMF in the treatment of BPH. Furthermore, the present study adds exercises therapy in the form of pelvic floor and aerobic exercises. Therefore, this study aimed to investigate the effect of pulsed EMF with or without exercise therapy in the treatment of BPH.