Abstract
This study aimed to evaluate the efficacy and safety of acupuncture for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). A search of PUBMED, EMBASE, Central Register of Controlled Trials (CENTRAL), Web of Science, Chinese Biomedicine Literature (CBM), China National Knowledge Infrastructure (CNKI), Wang-Fang Database, Chinese Scientific Journal Database (VIP), and other available resources was made for studies (up to February 2019). Searches were limited to studies published in English and Chinese. Only randomized controlled trials (RCTs) related to the efficacy and/or safety of acupuncture for CP/CPPS were included. Two investigators independently evaluated the quality of the studies. A total of 11 studies were included, involving 748 participants. The results revealed that compared with sham acupuncture (MD: −6.53 [95% CI: −8.08 to −4.97]) and medication (MD: −4.72 [95% CI: −7.87 to −1.56]), acupuncture could lower total NIH-CPSI score more effectively. However, there are no significant differences between acupuncture and sham acupuncture in terms of IPSS score. In terms of NIH-CPSI voiding domain subscore, no significant differences were found between acupuncture and medication. Compared with sham acupuncture (OR: 0.12 [95% CI: 0.04 to 0.40) and medication (OR: 3.71 [95% CI: 1.83 to 7.55]), the results showed favorable effects of acupuncture in improving the response rate. Acupuncture plus medication is better than the same medication in improving NIH-CPSI total score and NIH-CPSI pain domain subscore. In conclusion, the evidence suggests that acupuncture may be an effective intervention for patients with CP/CPPS. However, due to the heterogeneity of the methods and high risk of bias, we cannot draw definitive conclusions about the entity of the acupuncture's effect on alleviating the symptoms of CP/CPPS. The adverse events of acupuncture are mild and rare.
Highlights
Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a complex clinical entity consisting of urogenital pain, lower urinary tract symptoms, and/or sexual dysfunction that lasts for at least 3 months in the past 6 months [1]
A search of PUBMED, EMBASE, CENTRAL, Web of Science, Chinese Biomedicine Literature (CBM), China National Knowledge Infrastructure (CNKI), Wang-Fang Database, VIP, and other available resources was made for studies that compared the efficacy and safety of acupuncture with sham acupuncture or medication. e search terms related to acupuncture, chronic prostatitis, chronic pelvic pain syndrome, and randomized controlled trials
Acupuncture may be an effective intervention for patients with CP/CPPS
Summary
Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a complex clinical entity consisting of urogenital pain, lower urinary tract symptoms, and/or sexual dysfunction that lasts for at least 3 months in the past 6 months [1]. CP/CPPS exists in more than 90–95% of patients with prostatitis [2], and it is estimated to affect 2–15% of adult men [3–6]. Ese symptoms, especially chronic pelvic pain syndrome, persist for a long time and are difficult to recover, which seriously affects the quality of life of patients. CP/CPPS is a severe challenge and difficult problem for urologists, and there is no “golden standard” to treat the disease because pathogenesis remains unclear and some researchers think CP/CPPS is a multifactorial disease such as abnormal immune response, genetic predisposition, Pain Research and Management pathogen infection, neuromuscular factors, and intraprostatic ductal reflux [8]. Antibiotics, anti-inflammatory drugs, alphablockers, and neuromodulators are the most commonly used drugs in the treatment of CPPS. More and more attention has been paid to phytotherapy and physiotherapy with less adverse reactions and high acceptance of patients in recent years
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