MULTICENTRE STUDY ON THE USEFULNESS OF MANUAL OSTEOPATHIC THERAPY IN CHRONIC PELVIC PAIN SYNDROME. 
C. Rabal Conesa 1,2, E. Cao Avellaneda 3, P. López Cubillana 4, D. Prieto Merino 1, B. Khalus 2, R.Alonso Perea 2.
1.-UCAM, Cartagena, Spain, 2.-Mediterráneo Fisioterapia y Osteopatía, Cartagena, Spain, 3.-C.H.U.Cartagena, Cartagena, Spain, 4.-H.C.U. Virgen de la Arrixaca, Murcia, Spain,

OBJECTIVES
Chronic pelvic pain syndrome (CPPS) includes patients with persistent pain in the pelvic area that lasts more than 6 months and is of unknown origin. According to the European Urology Association’s clinical practice guidelines, there is no single treatment of choice, and a simultaneous multi-modal approach is recommended. 
The aim of this study was to investigate the effectiveness of an osteopathic treatment protocol for improving the pain, quality of life, and urinary symptoms in these patients.
 
MATERIAL AND METHODS	
This work was a clinical efficacy study involving 6 sessions of exclusively external manual therapy, according to the method proposed by osteopathy. The patients were recruited by urologists in the primary and secondary areas of the Murcia Health Service, according to pre-set inclusion criteria and after signing an informed consent form.  
The therapy lasted a total of 9 weeks distributed across 3 weekly sessions and a subsequent 3 fortnightly visits.
The questionnaires used to measure the results are widely used in clinical settings: the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI); the International Prostate Symptom Score (IPSS), the One-Dimensional Pain Scale (VAS); and the Hospital Anxiety Depression Scale (HADS).
The evaluation was conducted by an external researcher after completion of all the therapy sessions. 
RESULTS
23 men with CPPS met the inclusion criteria, with an average age of 45.68 and ranging between 24.21 and 66.32.
A decrease was observed after the therapy sessions (T2) in the NIH-CPSI from 24.87 to 17.18 points (a statistically significant reduction of 30.92% [p<0.0005]). The IPSS improved from 14.43 to 11.23 points, decreasing 22.18% (p=0.009), with the quality of life item showing the greatest improvement, dropping from 5.22 to 3.55 points, a 31.99% change (p<0.0005). The One-Dimensional Pain Scale score decreased from 5.70 to 3.50 points, a 38.6% change (p<0.0005). The differences reported in the HADS questionnaire were not clinically relevant.
In the follow-ups a month and a half after the end of the therapy sessions (T3) and at 3 months (T4), although the effect had decreased, it did not drop back to the initial values, remaining significant in the majority of the measured variables. 
CONCLUSIONS
Manual osteopathic therapy could be useful in the therapeutic approach to these patients.

MULTICENTER STUDY ABOUT THE UTILITY OF THE OSTEOPATHIC MANUAL THERAPY ON THE CRONIC PELVIC PAIN SYNDROME