Non‐pharmacological interventions for treating chronic prostatitis/chronic pelvic pain syndrome: a Cochrane systematic review

Abstract

Based on the findings of moderate to high-quality evidence, this review found that some non-pharmacological interventions such as acupuncture and extracorporeal shockwave therapy are likely to result in a decrease in prostatitis symptoms and may not be associated with a greater incidence of adverse event. The QoE for most other comparisons was predominantly low. Future clinical trials should include a full report of their methods including adequate masking, consistent assessment of all patient-important outcomes including potential treatment-related adverse events and appropriate sample sizes. This article is protected by copyright. All rights reserved.

Chronic prostatitis/chronic pelvic pain syndrome: it is time to change our management and research strategy

“…This real‐world management success story, which continues to evolve, clearly shows much greater benefit than that suggested by all the clinical trials assessed in this review. Our similar independent patient data meta‐analysis and comprehensive review of CP/CPPS management strategies [4] described very similar findings to those of Franco et al [1]. What intrigued us was the difference or the lack of correlation between overall symptom improvement (based on mean symptom score changes from baseline in the treated cohort of subjects compared to the placebo‐treated subjects) and the responder analyses which clearly showed some subjects had very significant responses despite the overall dismal mean symptom score differences in the entire population evaluated.…”

“…A urologist who manages patients with prostatitis (or for that matter, a patient with the condition) would read the latest comprehensive review on pharmacological interventions for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) with despair. In the Cochrane Systemic review examining the available clinical evidence for the efficacy of pharmacological interventions for treating CP/CPPS, Franco et al [1] clearly show that low‐ to very‐low‐quality evidence suggests that some treatments may confer at best, only a small and perhaps clinically insignificant benefit for patients. Are we doing something wrong?…”

“…What I have learned from the comprehensive review of CP/CPPS treatments by Franco et al [1] is that we must stop designing and performing these monotherapy treatment trials in which we enroll all subjects with a diagnosis of CP/CPPS. This type of clinical study has been mainly driven by government regulatory rules in attempts to have drugs approved for CP/CPPS treatment.…”

Pelvic pain rehabilitation

“…[40] According to the recently published Cochrane database systematic review, lifestyle modifications, physical activity, and acupuncture had positive effects in chronic prostatitis, while electromagnetic chair therapy was inadequate for the patients with chronic prostatitis. [41] In addition, acupuncture and extracorporeal shockwave therapy had positive effects on chronic prostatitis symptoms and pain. [41] Another study demonstrated that pain complaints of patients with chronic prostatitis/CPP significantly reduced with electroacupuncture.…”

“…[41] In addition, acupuncture and extracorporeal shockwave therapy had positive effects on chronic prostatitis symptoms and pain. [41] Another study demonstrated that pain complaints of patients with chronic prostatitis/CPP significantly reduced with electroacupuncture. [42] Istek et al [43] studied 33 women with CPP randomly assigned to either percutaneous tibial nerve stimulation (PTNS) or control.…”