How effective are pharmacotherapies for chronic prostatitis?

January 01, 0001

How effective are pharmacotherapies for chronic prostatitis?

Chronic prostatitis/chronic pelvic pain syndrome is common, although there is little consensus on optimal treatment. These Thai, Australian, and Canadian researchers performed a systematic review and meta- analysis of treatment for this condition using á-blockers, antibiotics, anti- inflammatory drugs, other pharmaceuticals, and placebo. They searched MEDLINE and EMBASE for randomized controlled trials comparing drug treatments in these conditions

The researchers found: "Twenty-three of 262 studies identified were eligible. Compared with placebo, á-blockers were associated with significant improvement in symptoms with standardized mean differences in total symptom, pain, voiding, and quality-of-life scores of -1.7, -1.1, -1.4, and ?1.0, respectively. Patients receiving á-blockers or anti-inflammatory medications had a higher chance of favorable response compared with placebo, with pooled RRs of 1.6 and 1.8, respectively. Contour-enhanced funnel plots suggested the presence of publication bias for smaller studies of á-blocker therapies. The network meta-analysis suggested benefits of antibiotics in decreasing total symptom scores (?9.8), pain scores (?4.4), voiding scores (?2.8), and quality- of-life scores (?1.9) compared with placebo. Combining á-blockers and antibiotics yielded the greatest benefits compared with placebo, with corresponding decreases of -13.8 for total symptom scores, -5.7 for pain scores, -3.7 for voiding, and -2.8 for quality-of-life scores."

The researchers concluded: "á-Blockers, antibiotics, and combinations of these therapies appear to achieve the greatest improvement in clinical symptom scores compared with placebo. Anti-inflammatory therapies have a lesser but measurable benefit on selected outcomes. However, beneficial effects of á-blockers may be overestimated because of publication bias."

This systematic review and meta-analysis elucidates a starting point for treatment of chronic prostatitis

For the full abstract, click here.

JAMA 305(1):78-86, 5 January 2011 © 2011 American Medical Association
Management of Chronic Prostatitis/ Chronic Pelvic Pain Syndrome. Thunyarat Anothaisintawee, John Attia, J. Curtis Nickel, et al.

Category: U. Urinary System. Keywords: chronic prostatitis, chronic pelvic pain syndrome, symptomatic relief, á-Blockers, antibiotics, systematic review and meta-analysis, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 25 January 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.

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