Chronic Prostatitis/Chronic Pelvic Pain Syndrome: Role of Alpha Blocker Therapy

Abstract

Introduction: This article reviews the rationale and data supporting alpha blocker therapy for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), the most common and difficult prostatitis syndrome. Methods: Systematic review identified ten clinical trials evaluating alpha blocker therapy for patients with CP/CPPS, including five open-label or small prospective studies and five double-blinded and placebo-controlled clinical trials. Results: Encouraging results in uncontrolled and small clinical trials led to the development of reasonably powered, double-blinded, placebo-controlled, randomized clinical trials evaluating terazosin, doxazosin, tamsulosin, and alfuzosin. Conclusions: Current data suggest that treatment-naïve and/or newly diagnosed patients appear more likely to respond than long-term, chronic refractory patients. Longer courses of treatment (12 weeks to 6 months) appear superior to shorter courses, and less selective agents appear superior to more selective alpha₁ blockers. These observations outline important questions that must be answered to define optimal treatment strategies for patients with CP/CPPS.

Clinical Efficacy Analysis of Biofeedback Electrical Stimulation Combined with Doxycycline in the Treatment of Type IIIA Chronic Prostatitis

“…The total NIH-CPSI score ranged from 0 to 43, with a total score of 0 to 10 for urinary symptoms, 0 to 21 for pain or discomfort, and 0 to 12 for quality of life, with higher scores indicating more severe symptoms. Efficacy determination: Healed: > 90% reduction in total NIH-CPSI score after treatment; Significantly valid: 60–89% reduction in total NIH-CPSI score after treatment; Valid: 30–59% reduction in total NIH-CPSI score after treatment; Invalid: <30% reduction in total NIH-CPSI score after treatment [ 9 ]. The total effective rate was calculated as healed rate + significantly valid rate + valid rate.…”

Overactive bladder in males

“…Likewise, as smooth muscle contraction in the bladder and prostate mediated by a 1adrenoceptors has been proposed as a possible etiology for CP/CPPS, there may be a role for a 1 -blockers in the treatment of this entity [Nickel, 2008]. A recent systematic review identified 10 clinical trials evaluating a 1 -blocker therapy for men with CP/CPPS [Lee et al 2007]. Encouraging results in five uncontrolled, openlabel, and small prospective clinical trials, led to the development of five reasonably-powered, Therapeutic Advances in Urology 1 (4) double-blinded, placebo controlled, randomized trials evaluating terazosin, doxazosin, tamsulosin, and alfuzosin.…”

Economic Evaluation of Combination Therapy Versus Monotherapy for Treatment of Benign Prostatic Hyperplasia in Hong Kong

“…Similarly, a recent study found that 69.3% of community-dwelling men experienced moderate-to-severe symptoms on International Prostate Symptom Score (IPSS) in Hong Kong ( Yee et al, 2014 ). Without proper treatment, LUTS can present with complications, such as acute urinary retention (AUR), urinary tract infections, or sometimes obstructive uropathy ( Lee et al, 2007 ; McVary et al, 2011 ). In the current era of an increased life expectancy and the aging of baby boomer generation, male LUTS would become an issue of increasing socioeconomic and medical importance ( Lee et al, 2008 ; Kaplan et al, 2015 ; Lee et al, 2017 ).…”