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

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