Efficacy of Anticholinergics for Chronic Prostatitis/Chronic Pelvic Pain Syndrome in Young and Middle-Aged Patients: A Single-Blinded, Prospective, Multi-Center Study

Abstract

PurposeChronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) exhibits variable lower urinary tract symptoms (LUTS). The aim of this study was to evaluate the incidence of LUTS and the efficacy of an anticholinergic agent in young and middle-aged CP/CPPS patients.MethodsNinety-six men with CP/CPPS were randomly assigned in a single-blind fashion and received either ciprofloxacin (group 1, 49 patients) or ciprofloxacin and solifenacin (5 mg/day; group 2, 47 patients) for 8 weeks. The National Institutes of Health chronic prostatitis symptom index (NIH-CPSI), the International Prostate Symptom Score (IPSS), and the International Index of Erectile Function-5 (IIEF-5) were used to grade the patients' symptoms and the quality of life impact at the start of the study, and at 4 and 8 weeks from the initiation of the study.ResultsThere was no significant difference between groups 1 and 2 with respect to age, duration of disease, or sub-domains of the IPSS, NIH-CPSI, or IIEF-5 at baseline. Of these patients, 67.4% had LUTS. Statistically significant differences were determined via the NIH-CPSI for total score and the pain and urinary domain scores. Statistically significant differences were determined via the IPSS for total score and the storage domain score. The total score of the IIEF-5 increased, but the change was not significant. There was no statistically significant difference in residual urine.ConclusionsMany CP/CPPS patients had LUTS. Solifenacin in CP/CPPS demonstrated improvements in the NIH-CPSI and the IPSS total score and storage score. Storage factors significantly improved via the NIH-CPSI and IPSS assessments in the solifenacin treatment group.

Assessing psychological factors, social aspects and psychiatric co-morbidity associated with Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) in men — A systematic review

“…An increase in QoL is, therefore, an important therapeutic goal: Research on antibiotics, adrenoceptor antagonists, anti-inflammatory drugs, sodium, alpha-receptor antagonists and SSRI shows an increased QoL after treatment [57,[71][72][73][74][75][76][77][78]. The effect was not, however, always stable over time without treatment.…”

The role of anticholinergic therapy based on the upoint system in the treatment of chronic prostatitis

“…We chose propiverine as an anticholinergic in this study because of it is a competitive antagonist with similar affinity for all muscarinic receptor subtypes (29). Kim et al presented their results about efficacy of anticholinergics for CP/CPSS at American Urological Association's (AUA) 2010 Annual Meeting and then confirmed this finding with a prospective study in 2011 (30,31). In that study, ninety six patients with CP/CPPS were randomly assigned in a single-blind fashion and received either ciprofloxacin or ciprofloxacin and solifenacin (5 mg/d) for 2 months.…”

Oral pharmacological treatments for chronic prostatitis/chronic pelvic pain syndrome: A systematic review and network meta-analysis of randomised controlled trials

“…Following abstract screening and full-text reviews, 25 randomised controlled trials involving 3514 patients with CP/CPPS were included ( Figure 1 ). 9 , 24 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 Overall, the studies were conducted between 1999 and 2019. For the analysis, we compared 18 monotherapies, six combination therapies and placebo.…”