Acupuncture for chronic prostatitis/chronic pelvic pain syndrome: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the short-term efficacy, long-term efficacy and safety of acupuncture for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).@*METHODS@#Forty-two patients with CP/CPPS were randomly divided into an acupuncture group (21 cases, 1 case dropped off) and a sham acupuncture group (21 cases). The patients in the acupuncture group were treated with acupuncture at bilateral Zhongliao (BL 33), Huiyang (BL 35), Shenshu (BL 23) and Sanyinjiao (SP 6); the needling depth of Zhongliao (BL 33) and Huiyang (BL 35) was 60 to 80 mm, while Shenshu (BL 23) and Sanyinjiao (SP 6) was directly punctured of 30 mm. The patients in the sham acupuncture group were treated with acupuncture at non-acupoints, including points 2 cm next to Shenshu (BL 23), Zhongliao (BL 33) and Huiyang (BL 35), and the midpoint of the connecting line between the spleen meridian and the kidney meridian. All the non-acupoints were treated with directly puncture of 2 to 3 mm. The needles were left for 30 min in both groups, once every other day in the first four weeks, three times a week, and twice a week in the next four weeks, totally 20 treatments. Before treatment, after treatment and in follow-up of 24 weeks after treatment completion, the National Institutes of Health-chronic prostatitis symptom index (NIH-CPSI) score and urinary flow rate were observed in both groups; the clinical efficacy and safety were evaluated.@*RESULTS@#Compared with those before treatment, the pain and discomfort scores, urination symptoms scores, quality of life scores and total scores of NIH-CPSI in both groups were reduced after treatment in the two groups (P<0.01), while each item score and total score of NIH-CPSI in the acupuncture group were reduced in follow-up (P<0.01, P<0.05). After treatment and in follow-up, each item score and total score of NIH-CPSI in the acupuncture group were lower than those in the sham acupuncture group (P<0.05, P<0.01). After treatment, the maximum and average urinary flow rates in the acupuncture group were higher than those before treatment (P<0.05), and the average urinary flow rate in the acupuncture group was higher than that in the sham acupuncture group (P<0.05). The total effective rate was 75.0% (15/20) in the acupuncture group, which was higher than 42.9% (9/21) in the sham acupuncture group (P<0.05). No significant adverse reactions were observed in the two groups, and there was no significant difference in the incidence of adverse reactions between the two groups (P>0.05).@*CONCLUSION@#Acupuncture could effectively alleviate the clinical symptoms, improve quality of life, and has a sustained, safe and reliable therapeutic effect in patients with CP/CPPS.

Is mild erectile dysfunction associated with severe psychological symptoms in Chinese patients with moderate-to-severe chronic prostatitis/chronic pelvic pain syndrome? / 亚洲男科学杂志(英文版)

This study aimed to assess the association between psychological disorders and erectile dysfunction (ED) in patients with different degrees of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). This was a retrospective study conducted from June 2017 to October 2019 and included 182 outpatients. Patients were interviewed using the Structured Interview on Erectile Dysfunction (SIEDY) for pathogenic quantification. The National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) and the International Index of Erectile Function-5 (IIEF-5) were used for the evaluation of CP/CPPS and ED. The Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) were used to assess anxiety symptoms and depressive symptoms. The number of patients with mild CP/CPPS and mild ED, mild CP/CPPS and moderate-to-severe ED, moderate-to-severe CP/CPPS and mild ED, and moderate-to-severe CP/CPPS and moderate-to-severe ED was 69 (37.9%), 36 (19.8%), 35 (19.2%), and 42 (23.1%), respectively. The corresponding PHQ-9 scores of the four groups were 6.22, 7.19, 10.69, and 7.71, respectively. The corresponding GAD-7 scores of the four groups were 5.26, 6.31, 8.77, and 6.36, respectively. Among patients with moderate-to-severe CP/CPPS, the PHQ-9 and GAD-7 scores of the moderate-to-severe ED group were significantly lower than those of the mild ED group (P = 0.007 and P = 0.010, respectively). The prevalence of ED and premature ejaculation (PE) in patients with moderate-to-severe CP/CPPS was significantly higher than that in patients with mild CP/CPPS (P = 0.001 and P = 0.024, respectively). Our findings proved that the severity of ED was negatively associated with psychological symptoms in outpatients with moderate-to-severe CP/CPPS.

Advances in pathogenesis of chronic prostatitis/chronic pelvic pain syndrome / 中华泌尿外科杂志

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common disease in men. In recent years, it has become younger, which seriously affects the patients＇quality of life. A deep understanding of the pathogenesis of CP/CPPS will help the choice of treatment. Its pathogenesis is not only related to immune factors, but also related to local microcirculation disorders of the prostate, endocrine hormone imbalance, adjacent gut microbes and compression of lumbar intervertebral disc, but it has not been fully elucidated. Therefore, this article aims to review the pathogenesis of CP/CPPS and provide directions for its diagnosis and treatment.

Effect of Essential Oil on Patients with Chronic Prostatitis/Chronic Pelvic Pain Syndrome: A Pilot Randomized Controlled Trial / 中国结合医学杂志

OBJECTIVE@#To evaluate the efficacy and safety of essential oil treatment for type III chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).@*METHODS@#A randomized controlled trial was conducted from December 2014 to October 2015. Seventy type III CP/CPPS patients were assigned to the essential oil group (35 cases) or almond placebo oil control group (35 cases) by a random number table. The oil was smeared by self-massage on the suprapubic and sacral region once a day for 4 weeks. The National Institutes of Health Chronic Prostatitis Syndrome Index (NIH-CPSI) and expressed prostatic secretions (EPS) were examined. The primary outcome was NIH-CPSI pain domain. The secondary outcomes included other NIH-CPSI domains and laboratory examinations of EPS. Adverse events were also observed.@*RESULTS@#Sixty-six subjects completed the full 4-week treatment. There was no significant difference between almond oil control and essential oil groups in terms of the total score of NIH-CPSI, pain, quality of life and urination domain scores of NIH-CPSI and EPS examinations (P>0.05). In the essential oil group, pain between rectum and testicles (perineum) in the domain of pain or discomfort was significantly reduced at week 2 and week 4 compared with almond oil control group (P<0.01). No serious adverse events occurred.@*CONCLUSION@#The essential oil may reduce the pain or discomfort in the perineum region in patients with CP/CPPS. (Registration No. ChiCTR-IPR-14005448).

Research progress on chronic prostatitis / chronic pelvic pain syndrome accompanied by sexual dysfunction / 医学研究生学报

The main symptom of chronicprostatitis/chronic pelvic pain syndrome (CP/CPPS) include perineal pain or discomfort, lower urinary tract symptom, mental and psychological problems, and sexual dysfunction (SD). Numerous studies confirmed a higher probability than normal in people suffering from the CP/CPPS accompanied by SD. It was characterized by repeated attacks and difficulty in curing. As a heterogeneous syndrome, the available evidence fails to indicate its pathogenesis and first-line diagnosis and treatment. This article reviews the epidemiological characteristics, pathogenesis, diagnosis and treatment of CP/CPPS with SD, and further explores the combined treatment of UPOINT(S) clinical phenotype classification system and multimodal therapy.

Acupuncture combined with western medicine for CP/CPPS:a randomized controlled trial / 中国针灸

<p><b>OBJECTIVE</b>To compare the clinical efficacy differences among acupuncture combined with western medicine, acupuncture alone and western medicine alone for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).</p><p><b>METHODS</b>Ninety patients were randomly assigned into a needle-medicine group, an acupuncture group and a western medicine group, 30 patients in each group. The patients in the needle-medicine group were treated with acupuncture combined with western medicine; the scalp points included Shenting (GV 24), Xinhui (GV 22), Qianding (GV 21), Baihui (GV 20), Chengguang (BL 6), Tongtian (BL 7), etc. The body points were Zhongji (CV 3), Guanyuan (CV 4), Pangguangshu (BL 28), Ciliao (BL 32), etc. The acupuncture was given 30 min per treatment, once a day. Besides, oral administration of 0.2g levofloxacin (twice per day) and 0.2 mg tamsulosin (once a day) was applied. The patients in the acupuncture group and western medicine group were treated by acupuncture and western medicine respectively. 12-d treatment was taken as one session, and totally 2 sessions were given. The clinical efficacy of the three groups after treatment was compared as well as the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) total score and pain score, self-rating anxiety scale (SAS) and self-rating depression scale (SDS) before and after treatment.</p><p><b>RESULTS</b>During the trial two patients dropped out, as a result, 30 patients in the needle-medicine group, 29 patients in the acupuncture group and 29 patients in the western medicine group were included in the analysis. After treatment, 21 patients were cured, 6 patients were markedly effective, 2 patients were effective and 1 patient failed in the needle-medicine group;12 patients were cured, 10 patients were markedly effective, 5 patients were effective and 2 patients failed in the acupuncture group; 11 patients were cured, 12 patients were markedly effective, 4 patients were effective and 2 patients failed in the medicine group; the efficacy in the needle-medicine group was superior to those in the acupuncture group and medicine group (both<0.05). Each score was improved after treatment in each group (all<0.01); the total score of NIH-CPSI as well as SAS and SDS scores in the needle-medicine group were superior to those in the acupuncture group and medicine group (<0.05,<0.01); the pain scores of NIH-CPSI in needle-medicine group and acupuncture group were superior to that in the medicine group (<0.05,<0.01), but the difference between the needle-medicine group and acupuncture group was not significant (>0.05).</p><p><b>CONCLUSIONS</b>The efficacy of acupuncture combined with western medicine for CP/CPPS is superior to that of acupuncture alone and western medicine alone, which could improve the symptom of prostatitis as well as status of anxiety and depression.</p>

Depression and Somatic Symptoms May Influence on Chronic Prostatitis/Chronic Pelvic Pain Syndrome: A Preliminary Study

The present study is the first one to investigate the impacts of depression and somatization on the disease severity and quality of life (QoL) in patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). The Korean version of National Institutes of Health (NIH)- Chronic Prostatitis Symptom Index (CPSI) for severity of CP/CPPS. Korean version of Patient Health Questionnaire-9 (PHQ-9) for depression, Korean version of Patient Health Questionnaire-15 (PHQ-15) for somatization, and Korean version of EuroQol Questionnaire-5 Dimensions (EQ-5D)- [(EQ-5D utility index and visual analog scale (EQ-5D VAS)] for QoL, were administered. Eighty patients were enrolled. The NIH-CPSI total scores were significantly higher in those with depression (25.3%, p=0.01) or somatization (23.2%, p=0.03) than in those without. These trends toward significantly negative influence of depression and somatic symptoms on QoL were also observed. Our preliminary results indicate that depression and somatization may have negative influence on the symptom severity and QoL in patients with CP/CPPS. However, adequately-powered and more well-designed studies are mandatory to prove our results.