Cochrane · systematic review · CD012552
Pharmacological interventions for treating chronic prostatitis/chronic pelvic pain syndrome
Franco, JVA, Turk, T, Jung, JH, et al. · Cochrane Database of Systematic Reviews · 2019 · Cochrane Library
UrologyAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
48
current version
GRADE rated
32
No studies
16
Included studies
NR
No studies 16 · 33.3%Ungraded 0 · 0%Very low 3 · 6.3%Low 21 · 43.8%Moderate 8 · 16.7%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Alpha blockers compared to placebo for chronic prostatitis/chronic pelvic pain syndrome
Population: men with chronic prostatitis/chronic pelvic pain syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Prostatitis symptoms Alpha blockers vs placebo | no estimate extracted | 18 studies · 1524 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Prostatitis symptoms Alpha blockers vs placebo | no estimate extracted | 4 studies · 253 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Prostatitis symptoms: 'responders' Number of participants with a 25% or 6‐point decrease in NIH‐CPSI scores Alpha blockers vs placebo | RR 1.23 [0.94, 1.61] | 7 studies · 721 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Adverse events Any adverse event Alpha blockers vs placebo | RR 1.6 [1.09, 2.34] | 19 studies · 1588 participants | Low Downgraded: risk of bias, imprecision |
Sexual dysfunction Alpha blockers vs placebo | no estimate extracted | 4 studies · 452 participants | Moderate Downgraded: risk of bias |
Quality of life Alpha blockers vs placebo | no estimate extracted | 3 studies · 421 participants | Moderate Downgraded: risk of bias |
Anxiety and depression Alpha blockers vs placebo | no estimate extracted | 1 study · 232 participants | Low Downgraded: risk of bias, imprecision |
5‐alpha reductase inhibitors compared to placebo for chronic prostatitis/chronic pelvic pain syndrome
Population: men with chronic prostatitis/chronic pelvic pain syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Prostatitis symptoms 5‐alpha reductase inhibitors vs placebo | no estimate extracted | 1 study · 64 participants | Moderate Downgraded: risk of bias |
Prostatitis symptoms: 'responders' Number of participants with a 25% decrease in NIH‐CPSI scores 5‐alpha reductase inhibitors vs placebo | RR 2.13 [0.82, 5.53] | 1 study · 64 participants | Low Downgraded: risk of bias, imprecision |
Adverse events 5‐alpha reductase inhibitors vs placebo | RR 0.87 [0.33, 2.3] | 2 studies · 105 participants | Low Downgraded: risk of bias, imprecision |
Sexual dysfunction ‐ not reported 5‐alpha reductase inhibitors vs placebo | no estimate extracted | NR | No studies |
Quality of life ‐ not reported 5‐alpha reductase inhibitors vs placebo | no estimate extracted | NR | No studies |
Anxiety and depression ‐ not reported 5‐alpha reductase inhibitors vs placebo | no estimate extracted | NR | No studies |
Antibiotic therapy compared to placebo for chronic prostatitis/chronic pelvic pain syndrome
Population: men with chronic prostatitis/chronic pelvic pain syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Prostatitis symptoms Antibiotic therapy vs placebo | no estimate extracted | 5 studies · 372 participants | Low Downgraded: risk of bias, inconsistency |
Prostatitis symptoms: 'responders' Number of participants with a 25% or 6‐point decrease in NIH‐CPSI scores Follo‐up: range 6 weeks to 3 months Antibiotic therapy vs placebo | RR 1.12 [0.73, 1.74] | 2 studies · 178 participants | Low Downgraded: risk of bias, imprecision |
Adverse events Antibiotic therapy vs placebo | RR 1.01 [0.66, 1.55] | 4 studies · 336 participants | Moderate Downgraded: risk of bias, imprecision |
Sexual dysfunction Antibiotic therapy vs placebo | no estimate extracted | 1 study · 77 participants | Moderate Downgraded: risk of bias |
Quality of life Antibiotic therapy vs placebo | no estimate extracted | 1 study · 87 participants | Moderate Downgraded: imprecision |
Anxiety and depression ‐ not reported Antibiotic therapy vs placebo | no estimate extracted | NR | No studies |
Anti‐inflammatories compared to control for chronic prostatitis/chronic pelvic pain syndrome
Population: men with chronic prostatitis/chronic pelvic pain syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Prostatitis symptoms Anti‐inflammatories vs control | no estimate extracted | 7 studies · 585 participants | Low Downgraded: risk of bias, inconsistency |
Prostatitis symptoms: 'responders' Number of participants with a 25% or 6‐point decrease in NIH‐CPSI scores Anti‐inflammatories vs control | RR 1.44 [0.68, 3.03] | 2 studies · 82 participants | Low Downgraded: risk of bias, imprecision |
Adverse events Anti‐inflammatories vs control | RR 1.27 [0.81, 2] | 7 studies · 540 participants | Low Downgraded: risk of bias, imprecision |
Sexual dysfunction ‐ not reported Anti‐inflammatories vs control | no estimate extracted | NR | No studies |
Quality of life ‐ not reported Anti‐inflammatories vs control | no estimate extracted | NR | No studies |
Anxiety and depression ‐ not reported Anti‐inflammatories vs control | no estimate extracted | NR | No studies |
Phytotherapy compared to placebo or other agents for chronic prostatitis/chronic pelvic pain syndrome
Population: men with chronic prostatitis/chronic pelvic pain syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Prostatitis symptoms Phytotherapy vs placebo or other agents | no estimate extracted | 5 studies · 320 participants | Low Downgraded: risk of bias, imprecision |
Prostatitis symptoms: 'responders' Number of participants with a 25% or 6‐point decrease in NIH‐CPSI scores Phytotherapy vs placebo or other agents | RR 1.78 [1.25, 2.52] | 3 studies · 224 participants | Moderate Downgraded: risk of bias |
Adverse events Phytotherapy vs placebo or other agents | RR 1.13 [0.54, 2.36] | 7 studies · 540 participants | Low Downgraded: risk of bias, imprecision |
Sexual dysfunction Phytotherapy vs placebo or other agents | no estimate extracted | 1 study · 48 participants | Low Downgraded: risk of bias, imprecision |
Quality of life ‐ not reported Phytotherapy vs placebo or other agents | no estimate extracted | NR | No studies |
Anxiety and depression ‐ not reported Phytotherapy vs placebo or other agents | no estimate extracted | NR | No studies |
Botulinum toxin A compared to placebo for chronic prostatitis/chronic pelvic pain syndrome
Population: men with chronic prostatitis/chronic pelvic pain syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Prostatitis symptoms Subgroup: Intraprostatic injection, participants age > 50 years old, basal NIH‐CPSI score > 30 Botulinum toxin A vs placebo | no estimate extracted | 1 study · 60 participants | Low Downgraded: risk of bias, imprecision |
Prostatitis symptoms Subgroup: Pelvic floor muscles injection, participants age < 50 years old, basal NIH‐CPSI score < 30 Botulinum toxin A vs placebo | no estimate extracted | 1 study · 29 participants | Low Downgraded: risk of bias, imprecision |
Adverse events Botulinum toxin A vs placebo | RR 5 [0.25, 99.95] | 2 studies · 89 participants | Low Downgraded: risk of bias, imprecision |
Sexual dysfunction ‐ not reported Botulinum toxin A vs placebo | no estimate extracted | NR | No studies |
Quality of life ‐ not reported Botulinum toxin A vs placebo | no estimate extracted | NR | No studies |
Anxiety and depression ‐ not reported Botulinum toxin A vs placebo | no estimate extracted | NR | No studies |
Allopurinol compared to placebo for chronic prostatitis/chronic pelvic pain syndrome
Population: men with chronic prostatitis/chronic pelvic pain syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Prostatitis symptoms Allopurinol vs placebo | no estimate extracted | 1 study · 56 participants | Low Downgraded: risk of bias, imprecision |
Adverse events Allopurinol vs placebo | no estimate extracted | 2 studies · 110 participants | Low Downgraded: risk of bias, imprecision |
Sexual dysfunction ‐ not reported Allopurinol vs placebo | no estimate extracted | NR | No studies |
Quality of life ‐ not reported Allopurinol vs placebo | no estimate extracted | NR | No studies |
Anxiety and depression ‐ not reported Allopurinol vs placebo | no estimate extracted | NR | No studies |
Traditional Chinese Medicine compared to placebo or usual care for chronic prostatitis/chronic pelvic pain syndrome
Population: men with chronic prostatitis/chronic pelvic pain syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Prostatitis symptoms Traditional Chinese Medicine vs placebo or usual care | no estimate extracted | 7 studies · 835 participants | Low Downgraded: risk of bias, inconsistency |
Adverse events Traditional Chinese Medicine vs placebo or usual care | RR 1.34 [0.22, 8.02] | 4 studies · 584 participants | Low Downgraded: risk of bias, imprecision |
Sexual dysfunction Traditional Chinese Medicine vs placebo or usual care | no estimate extracted | 1 study · 88 participants | Moderate Downgraded: risk of bias |
Quality of life ‐ not reported Traditional Chinese Medicine vs placebo or usual care | no estimate extracted | NR | No studies |
Anxiety and depression: anxiety Traditional Chinese Medicine vs placebo or usual care | no estimate extracted | 1 study · 88 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Anxiety and depression: depression Traditional Chinese Medicine vs placebo or usual care | no estimate extracted | 1 study · 88 participants | Low Downgraded: risk of bias, imprecision |