Effect of allopurinol in chronic nonbacterial prostatitis: a double blind randomized clinical trial

Abstract

Introduction:The exact mechanism of chronic nonbacterial prostatitis has not been yet elucidated and the outcome with the current management is dismal. In this trial, we studied the effect of allopurinol in the treatment of this disease. Materials and Methods:In this randomized double blind controlled trial, a calculated sample size of 56 were grouped into "intervention group" who received allopurinol (100 mg tds for 3 months) with ofloxacin (200 mg tds) for 3 weeks (n = 29) and "control group" who received placebo tablets with ofloxacin (n = 27). Patients' scores based on the National Institute of Health Chronic Prostatitis Symptom Score were recorded before therapy and then every month during the study. A fourglass study was performed before intervention and after 3 months. Results: The 2 groups were similar regarding outcome variables. In the first month of study, a significant but similar improvement in symptom scores was observed in both groups. Microscopic examination of prostate massage and postmassage samples were also similar in both groups. No side effects due to allopurinol were observed in patients. Conclusion: We did not find any advantage for allopurinol in the management of chronic prostatitis versus placebo in patients receiving routine antibacterial treatment.

Celecoxib reduces symptoms in men with difficult chronic pelvic pain syndrome (Category IIIA)

“…Traditionally, therapies for CP/ CPPS include antibiotics, α-blockers, phytotherapy, and other medical agents (3)(4)(5)(6)(7). However, part of the patients have refractory symptoms despite multiple treatment approaches (8).…”

Therapeutic Intervention for Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS): A Systematic Review and Meta-Analysis

“…[8] While all 35 studies were randomized, only 14[18], [22]–[24], [26], [29]–[34], [43]–[45] were categorized as randomized appropriately on the Jadad system (Table S3). Of the 35 randomized studies, 21[18]–[24], [26]–[37], [44], [50] were blinded and 19[18]–[24], [26], [28], [30]–[37], [44], [50] were blinded appropriately. All studies analyzed included descriptions of the statistical methods used and the inclusion and exclusion criteria for study participants (Table S3).…”

“…Several studies did not clearly describe the criteria used for defining the patient population [37], [42], [52]. Studies that failed to use CPCRN or NIH criteria reported greater effectiveness of treatment [37], [42], [48], [50], [52]…”

A systematic review and meta‐analysis of placebo effect in clinical trials on chronic prostatitis/chronic pelvic pain syndrome

“…Importantly, our meta‐analysis shows that uroflowmetry results (Qmax, the most homogenous parameter) were unaffected by placebo – p = 0.74, but, despite this, there are some psychological factors such as observation of private bodily functions by clinical staff which could bias the examination, and could provide us with reliable information on the lower urinary tract symptoms 10 . However, in four out of six studies where Qmax was measured it did not significantly improve not only after placebo intake, but also after treatment 11,16,23,34 . That is not surprising since not every patient with CP/CPPS has bothersome LUTS and urodynamic investigations are usually recommended for those patients to exclude possible urological reasons of pelvic pain.…”