Objective       To determine the clinical effect of α-blocker combined with Cox-2 inhibitor in treatment of chronic prostatitis Ⅲb (CPⅢb)

and investigate the pathogenesis of CPⅢb based on the underlying mechanism.       Methods       Forty patients suffered from defecography-identified CPⅢb accompanied with pubicorectalis muscle spasm who admitted in our hospital from September 2012 to September 2013 were enrolled in this study. They were divided into α-blocker treatment group (0.2 mg/d tamsulosin

Group A) and α-blocker combined with Cox-2 inhibitor treatment group (0.2 mg/qd tamsulosin+200 mg/bid celecoxib

Group B). NIH-International Prostate Symptom Score (IPSS) and quality of life (QoL) scores were used to evaluate the symptom improvement before and in 2

4 and 6 weeks after treatments.       Results       Defecography indicated that puborectalis muscle spasm had typical feature of “goose levy” in puborectalis rectum intestinal during defecation. The symptoms of CPⅢb patients were attenuated in those treated by α-blocker either accompanied with Cox-2 inhibitor or not. The IPSS scores of urinary frequency and urgency were greatly declined after the treatment (P0.05). But the clinical effect was much better in urinary frequency

urgency

pain and QoL in group B (P0.05).       Conclusion       α-blocker combined with Cox-2 inhibitor significantly attenuates pubicorectalis muscle spasm and improves the clinical effect than it alone in treatment of CPⅢb. The results indicated that puborectalis spasm may be involved in lower urinary tract symptoms of CPⅢb.