Chronic Prostatitis / Chronic Pelvic Pain Syndrome

Prostatite chronique et syndrome douloureux pelvien chronique : évaluation de l'acupuncture

Articles connexes: - conduites thérapeutiques -

1. Systematic Reviews and Meta-Analysis

☆☆☆ Evidence for effectiveness and a specific effect of acupuncture
☆☆ Evidence for effectiveness of acupuncture
Limited evidence for effectiveness of acupuncture
Ø No evidence or insufficient evidence

1.1. Generic Acupuncture

1.1.1. Zhang 2021 ☆☆☆

Zhang W, Fang Y, Shi M, Zhang M, Chen Y, Zhou T. Optimal acupoint and session of acupuncture for patients with chronic prostatitis/chronic pelvic pain syndrome: a meta-analysis. Transl Androl Urol. 2021;10(1):143-153. [216691]. doi

BackgroundThe study aims to perform a meta-analysis of published trials and evaluate the efficacy of acupuncture on chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) by symptom score reduction, optimal acupuncture session, and most frequently used acupoints.
MethodsA literature search was performed for randomized controlled trials (RCTs) comparing efficacy of acupuncture with sham acupuncture or standard medication on CP/CPPS. The primary outcome was the reduction of National Institute of Health-Chronic Prostatitis Index (NIH-CPSI) total score and its subscales. The optimal acupuncture session to reach its clinical efficacy and most common compatibility rule of acupoints were also evaluated.
Results Ten trials involving 770 participants were included. Meta-analysis showed compared with sham acupuncture, acupuncture yielded significant reduction in NIH-CPSI total score [weighted mean difference (WMD): 7.28, 95% confidence interval (95% CI): 5.69-8.86), and provided better pain relief (WMD: 3.57, 95% CI: 2.07-5.08), urinary symptoms improvement (WMD: 1.68, 95% CI: 1.13-2.22), and quality of life (QOL) (WMD: 2.38, 95% CI: 1.41-3.36). Compared with standard medication, acupuncture were more efficacious in reducing NIH-CPSI total score (WMD: 3.36, 95% CI: 1.27-5.45), also showed significant greater pain relief (WMD: 2.36, 95% CI: 1.67-3.06), marginal advantage in improving QOL (WMD: 0.98, 95% CI: 0.12-1.83) but no difference in reducing urinary symptom (WMD: -0.03, 95% CI: -1.30 to 1.24). Four acupuncture sessions were the minimum “dose” to reach clinical efficacy, and prolonged acupuncture sessions continuously improved urinary symptoms and QOL. The majority of acupoint selection strategies were based on the combination of any three acupoints from CV3, CV4, BL32, SP6, and SP9.
ConclusionsAcupuncture has promising efficacy for patients with CP/CPPS, especially category IIIB, in aspects of relieving pain and urinary symptoms and improving the QOL. Acupuncture may serve as a standard treatment option when available, and a tailored comprehensive treatment strategy for CP/CPPS is the future trend.

1.1.2. Li 2020 ☆

Li J, Dong L, Yan X, et al. Is Acupuncture Another Good Choice for Physicians in the Treatment of Chronic Prostatitis/Chronic Pelvic Pain Syndrome? Review of the Latest Literature. Pain Res Manag. 2020:5921038. [135945]. doi

ObjectiveThis study aimed to evaluate the efficacy and safety of acupuncture for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).
MethodsA 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.
ResultsA 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.
ConclusionsIn 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.

1.1.3. Qing 2019

Qin Z, Wu J, Xu C, Sang X, Li X, Huang G, Liu Z. Long-term effects of acupuncture for chronic prostatitis/chronic pelvic pain syndrome: systematic review and single-arm meta-analyses. Ann Transl Med. 2019;7(6):113. [197784].

Note Two case series studies included
BackgroundCumulative evidences indicate that acupuncture may ameliorate the symptoms of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). However, the long-lasting effects of acupuncture on CP/CPPS has not been fully evaluated. The objective of this study is to assess the sustained effects of acupuncture on CP/CPPS.
MethodsWe searched PubMed, EMBASE, and CENTRAL databases for studies on the use of acupuncture in patients with CP/CPPS. Studies with long-term follow-up periods were included. Single-arm meta-analyses were performed using random-effects model. The primary outcome was the response rate at the end of follow-up period; the secondary outcomes were changes of the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) scores at the end of follow-up, including total score and 3 sub-scores (pain, urinary, and quality of life).
Results Six studies with 310 patients were performed in data synthesis, among which four studies were randomized controlled trials (RCT) and two were case series studies. At the end of follow-up, the weighted “average” response rate was 68.4% (95% CI: 42.1% to 89.5%, n=226; I2=93.5%); the change of NIH-CPSI total score were -14.8 (95% CI: -17.0 to -12.6, n=310; I2=92.1%); the change of pain, urinary, and quality of life sub-scores were -6.0 (95% CI: -6.9 to -5.2, n=266; I2=83.6%), -2.6 (95% CI: -3.2 to -2.0, n=266; I2=87.9%), and -4.4 (95% CI: -6.2 to -2.6, n=266; I2=98.7%), respectively. The source of heterogeneity could not be identified owing to insufficient studies.
ConclusionsAcupuncture may have clinically long-lasting benefits for CP/CPPS. However, current evidence is limited owing to insufficient data and significant heterogeneity. Further studies with larger sample size and long-term follow-up periods are warranted.

1.1.4. Song 2019 ☆

Song Yanjuan, Liang Fengxia, Wang Hua, Chen Song, Huang Qi, Zhang Yanji. [Acupuncture for Chronic Pelvic Pain Syndrome: A Meta-analysis]. Liaoning Journal of TCM. 2019;46(7):1494-500. [140653]. doi

ObjectiveTo systematically evaluate the clinical efficacy of acupuncture in the treatment of chronic pelvic pain syndrome.
MethodsComputer-based search of Chinese Knowledge Network database, Chinese biomedical literature database, Chongqing Weipu Chinese Sci-tech periodical database, Wanfang database, PubMed, Embase, Cochrane Library and other online database were used to search randomized controlled trials of acupuncture treatment for chronic pelvic pain. A randomized controlled trial(RCT) on acupuncture treatment of chronic pelvic pain published from the establishment of the journal to the publication in March 2018 was conducted. Data on the inclusion criteria was extracted and assessed for quality. Two investigators included exclusion criteria, independent selection of appropriate literature, data extraction and biased risk and the quality assessment of the included studies was used to perform Meta-analysis of the included literature using RevMan 5.2 software.
ResultsA total of 12 studies were included, totally 1027 patients. The results of Meta-analysis showed that the effect of acupuncture on chronic pelvic pain syndrome was better than that of western medicine. The overall effective rate was OR=3.54,95%CI[2.49-5.05](P<0.01)and the funnel plot results showed basic symmetry. Compared with western medicine, acupuncture group’s NIH-CPSI score MD=4.83,95%CI[3.32-6.33](P<0.01).
ConclusionAcupuncture is superior to western medicine in the treatment of chronic pelvic pain syndrome and can improve the clinical symptoms of patients. However, due to the low quality of evidence, the results of the study still need to be verified by large samples and high-quality randomized controlled trials.

1.1.5. Ao 2018

Ao Jin-Bo, Cheng Jian-Ming, Zhang Lei, Weng Hong, Liu Tong-Zu, Zeng Xian-Tao. [Meta-analysis of the effects of acupuncture for chronic prostatitis]. Journal of Modern Urology. 2018;12:937-942. [201743]. 目的 采用Meta分析的方法 探究针刺治疗慢性前列腺炎的效果.方法检索PubMed、Embase、Web of Science,CNKI、VIP、万方和CBM,检索时间范围均从建库至2017年6月15日.由2名评价员根据纳入与排除标准进行文献筛选、资料提取和质量评价后,采用RevMan5.3软件进行Meta分析.结果 最终纳入27项随机对照试验,共计2775例患者.Meta分析结果显示:①在临床疗效方面,除与服用中药汤剂治疗比较效果差异不具有显著性外,与其他疗法治疗效果比较差异均具有显著性[针刺vs..中药汤剂:RR=1.07(0.94~1.23),P=0.31;针刺vs.中成药:RR=1.31(1.13~1.53),P=0.0004;针刺vs.西药:RR=1.27(1.18~1.36),P<0.00001;针刺v s.中药坐浴:R R=1.21(1.09~1.35),P=0.0004;针刺v s.微波:R R=1.22(1.02~1.47),P=0.03].②在治疗前后NIH-CPSI改变量方面:针刺治疗效果均好于其他疗法[针刺vs.西药:SMD=-0.95(-1.40~-0.50),P<0.0001;针刺vs.微波:SMD=-0.39(-0.68~-0.10),P=0.008;针刺vs.假针刺:SMD=-1.67(-2.10~-1.24),P<0.00001].③在白细胞降低有效率方面:针刺治疗与西药治疗效果差异无显著性,但优于中药坐浴治疗效果[针刺v s.西药:R R=1.20(0.88~1.64),P=0.25;针刺v s.中药坐浴:R R=2.74(1.63~4.62),P=0.0002].结论 当前证据表明,除针刺疗法与服用中药汤剂在临床疗效方面无差异、针刺与西药在降低白细胞有效率方面无差异外,针刺治疗的效果均优于其他疗法.

Automatic translation
Objective To explore the effect of acupuncture on chronic prostatitis by means of meta-analysis.
MethodsThe methods were searched for PubMed, Embase, Web of Science, CNKI, VIP, Wanfang and CBM. The retrieval time range was from the establishment of the library to June 15, 2017. Meta-analysis was performed using RevMan5.3 software after 2 reviewers conducted literature screening, data extraction and quality evaluation based on inclusion and exclusion criteria.
ResultsThe results were finally included in 27 randomized controlled trials with a total of 2775 patients. The results of the meta-analysis showed: 1 In terms of clinical efficacy, except for the difference in the effect of treatment with traditional Chinese medicine decoction, there is no significant difference between the treatments and other treatments. [Acupuncture vs Chinese medicine decoction: RR=1.07 (0.94~1.23), P=0.31; acupuncture vs. Chinese patent medicine: RR=1.31 (1.13~1.53), P=0.0004; acupuncture vs. western medicine: RR=1.27 (1.18~1.36), P<0.00001; acupuncture v s. Chinese medicine Bath: RR=1.21 (1.09~1.35), P=0.0004; acupuncture v s. Microwave: RR=1.22 (1.02~1.47), P=0.03].2 In terms of NIH-CPSI change before and after treatment: acupuncture The therapeutic effect is better than other therapies [acupuncture vs. western medicine: SMD=-0.95 (-1.40~-0.50), P<0.0001; acupuncture vs. microwave: SMD=-0.39 (-0.68~-0.10), P= 0.008 Acupuncture vs. sham acupuncture: SMD=-1.67 (-2.10~-1.24), P<0.00001].3 In terms of leukocyte reduction efficiency: there is no significant difference between acupuncture treatment and western medicine treatment, but better than traditional Chinese medicine The effect of sitting bath treatment [acupuncture v s. western medicine: RR = 1.20 (0.88 ~ 1.64), P = 0.25; acupuncture v s. Chinese medicine bath: RR = 2.74 (1.63 ~ 4.62), P = 0.0002].
Conclusion The current evidence shows that there is no difference in the clinical efficacy between acupuncture and traditional Chinese medicine decoction, and there is no difference between acupuncture and western medicine in reducing the efficiency of white blood cells. The effect of acupuncture treatment is better than other therapies.

1.1.6. Franco 2018 ☆☆☆

Franco JV, Turk T, Jung JH, Xiao YT, Iakhno S, Garrote V, Vietto V. Non-pharmacological interventions for treating chronic prostatitis/chronic pelvic pain syndrome. Cochrane Database Syst Rev. 2018. [100563].
Franco JVA , Turk T , Jung JH , Xiao YT , Iakhno S , Garrote V , Vietto V. Non-pharmacological interventions for treating chronic prostatitis/chronic pelvic pain syndrome: a Cochrane systematic review. BJU Int. 2019;124(2):197-208. [206064]. |doi|

BackgroundChronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common disorder in which the two main clinical features are pelvic pain and lower urinary tract symptoms. There are currently many approaches for its management, using both pharmacological and non-pharmacological interventions. The National Institute of Health - Chronic Prostatitis Symptom Index (NIH-CPSI) score is a validated measure commonly used to measure CP/CPPS symptoms.
ObjectivesTo assess the effects of non-pharmacological therapies for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).
Methods SEARCH METHODS: We performed a comprehensive search using multiple databases, trial registries, grey literature and conference proceedings with no restrictions on the language of publication or publication status. The date of the latest search of all databases was August 2017. SELECTION CRITERIA: We included randomised controlled trials. Inclusion criteria were men with a diagnosis of CP/CPPS. We included all available non-pharmacological interventions. DATA COLLECTION AND ANALYSIS: Two review authors independently classified studies and abstracted data from the included studies, performed statistical analyses and rated quality of evidence (QoE) according to the GRADE methods.
Main ResultsWe included 38 unique studies with 3290 men with CP/CPPS across 23 comparisons. 1. Acupuncture: (three studies, 204 participants) based on short-term follow-up, acupuncture reduces prostatitis symptoms in an appreciable number of participants compared with sham procedure (mean difference (MD) in total NIH-CPSI score -5.79, 95% confidence interval (CI) -7.32 to -4.26, high QoE). Acupuncture likely results in little to no difference in adverse events (moderate QoE). It probably also decreases prostatitis symptoms compared with standard medical therapy in an appreciable number of participants (MD -6.05, 95% CI -7.87 to -4.24, two studies, 78 participants, moderate QoE). 2. Circumcision: (one study, 713 participants) based on short-term follow-up, early circumcision probably decreases prostatitis symptoms slightly (NIH-CPSI score MD -3.00, 95% CI -3.82 to -2.18, moderate QoE) and may not be associated with a greater incidence of adverse events compared with control (a waiting list to be circumcised, low QoE).3. Electromagnetic chair: (two studies, 57 participants) based on short-term follow-up, we are uncertain of the effects of the use of an electromagnetic chair on prostatitis symptoms. It may be associated with a greater incidence of adverse events compared with sham procedure (low to very low QoE).4. Lifestyle modifications: (one study, 100 participants) based on short-term follow-up, lifestyle modifications may be associated with a greater improvement in prostatitis symptoms in an appreciable number of participants compared with control (risk ratio (RR) for improvement in NIH-CPSI scores 3.90, 95% CI 2.20 to 6.92, very low QoE). We found no information regarding adverse events.5. Physical activity: (one study, 85 participants) based on short-term follow-up, a physical activity programme may cause a small reduction in prostatitis symptoms compared with control (NIH-CPSI score MD -2.50, 95% CI -4.69 to -0.31, low QoE). We found no information regarding adverse events.6. Prostatic massage: (two studies, 115 participants) based on short-term follow-up, we are uncertain whether the prostatic massage reduces or increases prostatitis symptoms compared with control (very low QoE). We found no information regarding adverse events.7. Extracorporeal shockwave therapy: (three studies, 157 participants) based on short-term follow-up, extracorporeal shockwave therapy reduces prostatitis symptoms compared with control (NIH-CPSI score MD -6.18, 95% CI -7.46 to -4.89, high QoE). These results may not be sustained at medium-term follow-up (low QoE). This treatment may not be associated with a greater incidence of adverse events (low QoE).8. Transrectal thermotherapy compared to medical therapy: (two studies, 237 participants) based on short-term follow-up, transrectal thermotherapy alone or in combination with medical therapy may decrease prostatitis symptoms slightly when compared with medical therapy alone (NIH-CPSI score MD -2.50, 95% CI -3.82 to -1.18, low QoE). One included study reported that participants may experience transient adverse events.9. Other interventions: there is uncertainty about the effects of other interventions included in this review. We found no information regarding psychological support or prostatic surgery.
Authors' ConclusionsSome of the interventions can decrease prostatitis symptoms in an appreciable number without a greater incidence of adverse events. The QoE was mostly low. Future clinical trials should include a full report of their methods including adequate masking, consistent assessment of all patient-important outcomes including potential treatment-related adverse events and appropriate sample sizes.

1.1.7. Chang 2016 ☆☆☆

Chang SC, Hsu CH, Hsu CK, Yang SS, Chang SJ. The efficacy of acupuncture in managing patients with chronic prostatitis/chronic pelvic pain syndrome: A systemic review and meta-analysis. Neurourol Urodyn. 2016;1-8. [52573].

ObjectivesThis study aimed to systemically review published randomized control trials that compared the efficacy of acupuncture with sham acupuncture or standard medical treatment as management for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).
MethodsA systemic search of the PubMED®, Embase, Airiti Library, and China Journal Net was done for all randomized controlled trials that compared the efficacy of acupuncture with sham acupuncture, alpha-blockers, antibiotics, or anti-inflammatory drugs in patients with CP/CPPS. Two investigators conducted the literature search, quality assessment, and data extraction. The data were then analyzed using the Cochrane Collaboration Review Manager (RevMan®, version 5.3). The study endpoints were response rate, the National Institute of Health-Chronic Prostatitis Index (NIH-CPSI), and the International Prostate symptom score (IPSS) reduction.
ResultsThree and four randomized controlled trials compared acupuncture with sham acupuncture (n = 101 vs. 103) and medical treatment (n = 156 vs. 138), respectively. The results revealed that acupuncture was superior to sham acupuncture as regards response rate (OR: 5.15, 95%CI: 2.72-9.75; P < 0.01), NIH-CPSI (WMD: -6.09, 95%CI: -7.85 to -4.33), and IPSS (WMD: -2.44, 95%CI: -4.86 to -0.03; P = 0.05) reductions, therefore, excluding the placebo effect. Compared to standard medical treatments, acupuncture had a significantly higher response rate (OR: 3.57, 95%CI: 1.78-7.15; P < 0.01).
ConclusionsAcupuncture has promising efficacy for patients with CP/CPPS. Compared to standard medical treatment, it has better efficacy. Thus, it may also serve as a standard treatment option when available.

1.1.8. Yu 2017 ☆☆

Yu Li-Zhong, Zhang Guang-Peng, Feng Tao, Zaozhuang. [Comparison of the efficacy of acupuncture and western medicine treatment on chronic prostatitis in China: Meta-analysis]. Chinese Journal of Gerontology. 2017;06. [52321].

Objective To evaluate the efficacy of acupuncture and western medicine treatment on chronic prostatitis (CP) and analyze the present situation of clinical research.
Methods Through retrieving CNKI database, WanFang database, vIP database, Pub Med database, Medline database and manual retrieval, randomized controlled trials (RCT) and controlled clinical trials (CCT) of comparison of acupuncture and western medicine treatment on CP were taken in. According to Jadad standard, the quality of the included literatures was assessed. Meta-analysis was carried out by Rev Man4. 2 statistical software.
Results 13 articles, including 1 428 patients in total, were met the inclusion criteria. Meta-analysis showed that there was statistically significant difference between the total efficiency of the two groups [OR = 4. 11, 95%CI (2. 97, 5. 69), P<0. 000 01〕. There was statistically significant difference between the cure rate of the two groups〔OR = 3. 93, 95%CI (3. 08, 5. 02), P<0. 000 01〕.
Conclusions Acupuncture is effective on the treatment of CP. Compared with oral administration of western medicine, acupuncture treatment has certain advantages on the aspect of the total effective rate and cure rate, which need to be approved by good quality evidence.

1.1.9. Liu 2016 ☆☆☆

Liu BP, Wang YT, Chen SD. Effect of acupuncture on clinical symptoms and laboratory indicators for chronic prostatitis/chronic pelvic pain syndrome: a systematic review and meta-analysis. Int Urol Nephrol. 2016;48(12):1977-199. [195726].

Objectives To systematically review the efficacy and safety of acupuncture for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).
MethodsPubMed, Cochrane library Central, Web of Science, Wang-fang Database, and CNKI were searched from their inception to June 30, 2016. Data of acupuncture for CP/CPPS following randomized controlled trials (RCTs) was included. The data were analyzed using the Cochrane Collaboration Review Manager. The primary data were the National Institute of Health-Chronic Prostatitis Index (NIH-CPSI) score at the end of follow-up.
Results Ten RCTs were enrolled. Acupuncture was superior to the control in NIH-CPSI (MD -3.98, [95 % CI -5.78 to -2.19]; P < 0.0001) and response rate (RR 4.12, [95 % CI 1.67-10.18]; P = 0.002). Acupuncture was superior to sham acupuncture on NIH-CPSI, response rate, pain, urinary, and quality of life (QOL). Standard medication was inferior to acupuncture in terms of NIH-CPSI (MD -3.08, [95 % CI -5.57 to -0.60]; P = 0.02) and response rate (RR 2.03, [95 % CI 1.04-3.97]; P = 0.04), but standard medication was superior to acupuncture on improving urinary symptoms. There was no significant difference in the adverse events. Acupuncture/acupuncture plus standard medication significantly down-regulated IL-1β compared with standard medication in prostatic fluid.
Conclusion Acupuncture treating CP/CPPS is effective and safe. The effects of acupuncture on NIH-CPSI, response rate, pain symptoms, and QOF were superior to the control, but standard medication significantly improved urinary symptoms compared with acupuncture. Acupuncture can decrease the IL-1β in prostatic fluid for CP/CPPS

1.1.10. Qin 2016 (Network Meta-Analysis) ☆☆

Qin Z, Wu J, Tian J, Zhou J, Liu Y, Liu Z. Network Meta-Analysis of the Efficacy of Acupuncture, Alpha-blockers and Antibiotics on Chronic Prostatitis/Chronic Pelvic Pain Syndrome. Sci Rep. 2016. [156150].

ObjectiveAlpha-blockers and antibiotics are most commonly used to treat chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) in clinical practice. Currently, increasing evidence also suggests acupuncture as an effective strategy.
MethodsThis network meta-analysis intended to assess the comparative efficacy and safety of acupuncture, alpha-blockers and antibiotics for CP/CPPS. Twelve trials involving 1203 participants were included.
ResultsBased on decreases in the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) score, a network meta-analysis indicated that electro-acupuncture (standard mean difference [SMD]: 4.29; 95% credible interval [CrI], 1.96-6.65), acupuncture (SMD: 3.69; 95% CrI, 0.27-7.17), alpha-blockers (SMD: 1.85; 95% CrI, 1.07-2.64), antibiotics (SMD: 2.66; 95% CrI, 1.57-3.76), and dual therapy (SMD: 3.20; 95% CrI, 1.95-4.42) are superior to placebo in decreasing this score. Additionally, electro-acupuncture (SMD: 2.44; 95% CrI, 0.08-4.83) and dual therapy (SMD: 1.35; 95% CrI, 0.07-2.62) were more effective than alpha-blockers in decreasing the total NIH-CPSI total score. Other network meta-analyses did not show significant differences between interventions other placebo. The incidence of adverse events of acupuncture was relatively rare (5.4%) compared with placebo (17.1%), alpha-blockers (24.9%), antibiotics (31%) and dual therapy (48.6%).
ConclusionsOverall, rank tests and safety analyses indicate that electro-acupuncture/acupuncture may be recommended for the treatment of CP/CPPS.

1.1.11. Qin 2016 ☆☆☆

Qin Z, Wu J, Zhou J, Liu Z. Systematic Review of Acupuncture for Chronic Prostatitis/Chronic Pelvic Pain Syndrome. Medicine (Baltimore). 2016;95(11):e3095. [166513].

ObjectiveAcupuncture is a promising therapy for relieving symptoms in chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), which affects >15% of adult men worldwide. The aim of the study was to assess the effects and safety of the use of acupuncture for CP/CPPS.
MethodsMEDLINE, EMBASE, CENTRAL, Web of Science, CBM, CNKI, Wang-Fang Database, JCRM, and CiNii were searched from their inception through 30 November 2015. Grey literature databases and websites were also searched. No language limits were applied. Only randomized controlled trials (RCTs) with CP/CPPS treated by acupuncture were included. Two reviewers extracted data and assessed the risk of bias of RCTs using the Cochrane Risk of Bias Tools, respectively.
ResultsSeven trials were included, involving 471 participants. The result of meta-analysis indicated that compared with sham acupuncture (MD: -6.09 [95%CI: -8.12 to -5.68]) and medicine (Levofloxacinand, Ibuprofen, and Tamsulosin) (MD: -4.57 [95%CI: -7.58 to -1.56]), acupuncture was more effective at decreasing the total NIH-CPSI score. Real acupuncture was superior to sham acupuncture in improving symptoms (pain, voiding) and quality of life (Qof) domain subscores. Compared to sham acupuncture and medicine, acupuncture appears to be more effective at improving the global assessment. Two trials found that there is no significant difference between acupuncture and sham acupuncture in decreasing the IPSS score. Acupuncture failed to show more favorable effects in improving both symptoms and the Qof domain compared with medicine.
ConclusionsOverall, current evidence supports acupuncture as an effective treatment for CP/CPPS-induced symptoms, particularly in relieving pain. Based on the meta-analysis, acupuncture is superior to sham acupuncture in improving symptoms and Qof. Acupuncture might be similar to medicine (Levofloxacinand, Ibuprofen, and Tamsulosin) in its long-term effects, but evidence was limited due to high ROB among included trials as well as potential heterogeneity. Acupuncture is associated with rare and slightly adverse events.

1.1.12. He 2015 ☆☆

He Yuan, Xia Chun-Ling, Liu Bu-Ping. [Meta-analysis on acupuncture in treating chronic prostatitis]. China Journal of Traditional Chinese Medicine and Pharmacy. 2015;1:226-229. [186925].

ObjectiveTo evaluate the efficacy and security of acupuncture in treating chronic prostatitis (CP).
MethodsThe clinical articles in Wan Fang database, CNKI, VIP and CBM from January the 1st, 1979 to November the 30 th, 2013 were electronically searched, and some references were also manually searched. The quality of the included studies was assessed. Meta-analysis was performed by using the Rev Man 5. 2 software.
ResultsThere were 235 literatures in accordance with the criteria, and 18 articles met the inclusion criteria. Compared with Chinese medicine group and western medicine group, the results of Meta-analysis showed that the efficacy of acupuncture was significantly better in the acupuncture group. The leukocyte of prostatic fluid was significantly reduced in the acupuncture group than that in the Chinese medicine group and western medicine group. Acupuncture had more effect in reducing the NIH-CPSI score of CP than western medicine.
ConclusionThis study showed the efficacy of acupuncture for CP was higher than western medicine and Chinese medicine, and acupuncture had an advantage in reducing the NIH-CPSI score and the white blood cells in EPS of CP, but it still need higher quality and larger sample sizes of randomized controlled trials to enforce.

1.1.13. Herati 2013 ~

Herati AS, Moldwin RM. Alternative therapies in the management of chronic prostatitis/chronic pelvic pain syndrome. World J Urol. 2013;31(4):761-6. [170763].

Purpose Standard medical therapy for Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) including such agents as nonsteriodal anti-inflammatories, alpha-blockers, antimicrobial therapy, and 5a-reductase inhibitors has not been uniformly effective. The purpose of this review is to focus on the role of alternative therapies available for the management of CP/CPPS.
MethodsWe performed a systematic review of the literature for articles published in PubMed up to 2012 pertaining to commonly employed alternative therapies.
ResultsThe evidence for alternative therapies such as diet and lifestyle modifications, phytotherapy, acupuncture, myofascial physical therapy, and stress management/cognitive behavioral therapy is reviewed.
ConclusionCP/CPPS often requires a multimodal approach and alternative therapies should be considered as adjuncts in the treatment of refractory CP/CPPS patients.
Acupuncture […] it is reasonable to consider […] acupuncture […] as adjuncts in the treatment of refractory CP/CPPS patients.

1.1.14. Liu 2012 ☆

Liu Anguo, Junyan Wang, Lili Dong, Xingke Yan, Tianyou He, Lili Kan. [Efficacy of Acupuncture Treatment on Chronic Prostatitis: Meta-Analysis]. Traditional Chinese Medicine. 2012;1(2):9-14. [198247].

ObjectiveTo assess the efficacy of acupuncture and moxibustion treatment on chronic prostatitis, and evaluate the quality of the literatures.
MethodsRetrieving the published literatures from 2011 Jan to 2012 Jan on the CNKI and PubMed database. Selecting to meet the requirements of the RCT and CCT which study the efficacy of the acupuncture and moxibustion treatment on chronic prostatitis compared with conventional medical treatment. Doing Meta-analysis of the literatures by RevMan 5.1 software.
ResultsA total of 30 literatures and 3108 cases of patients in this study. Meta analysis showed a siginificant difference on overall effectiveness between the acupuncture and moxibus- tion treatment groups and conventional medical treatment [OR = 3.69, 95% CI (2.97, 4.59), Z = 11.76, P < 0.00001]. Also, there is a siginificant difference of the Symptom Score of the two groups comparison [WMD = –4.01, 95% CI (–4.77, –3.25), Z = 10.34, P < 0.00001].
ConclusionFrom overall, the total effectiveness and the symptom score about acupuncture and moxibustion treatment on CP groups have significant difference than conventional medical treatment groups. Therefore, the effectiveness of acupuncture and moxbustion treatment on CP is wroth to affirmation.

1.1.15. Posadzki 2012 ☆

Posadzki P, Zhang J, Lee Ms, Ernst E. Acupuncture for chronic nonbacterial prostatitis/chronic pelvic pain syndrome: a systematic review. J Androl. 2012;33(1):15-21. [168210]

Objective The objective of this systematic review was to assess the effectiveness of acupuncture as a treatment option for chronic prostatitis/chronic pelvic pain syndrome.
Methods Eight databases were searched from their inception to October 2010. Randomized clinical trials (RCT) were considered if they tested acupuncture against any control intervention or no therapy in humans with chronic prostatitis/chronic pelvic pain syndrome. The selection of studies, data extraction, and validation were performed independently by 2 reviewers. The methodologic quality of all included RCTs was assessed using the Jadad scale. Studies of stimulation of acupoints other than by needles were excluded.
Results Nine RCTs met the inclusion criteria. They all suggested that acupuncture is effective as a range of control interventions. Their methodologic quality was variable; most were associated with major flaws. Only one RCT had a Jadad score of more than 3.
Conclusions The evidence that acupuncture is effective for chronic prostatitis/chronic pelvic pain syndrome is encouraging but, because of several caveats, not conclusive. Therefore, more rigorous studies seem warranted.

1.1.16. Cohen 2012 ☆

Cohen JM, Fagin AP, Hariton E, Niska JR, Pierce MW, Kuriyama A, Whelan JS, Jackson JL, Dimitrakoff JD. Therapeutic intervention for chronic prostatitis/chronic pelvic pain syndrome (cp/cpps): a systematic review and meta-analysis. Plos One. 2012;7(8):e41941. [165969].

Background Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) has been treated with several different interventions with limited success. This meta-analysis aims to review all trials reporting on therapeutic intervention for CP/CPPS using the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI).
Methods We searched Medline, PubMed, the Cochrane Pain, Palliative & Supportive Care Trials, the Cochrane Register of Controlled Trials, CINAHL, ClinicalTrials.gov, and the NIDDK website between 1947 and December 31, 2011 without language or study type restrictions. All RCTs for CP/CPPS lasting at least 6 weeks, with a minimum of 10 participants per arm, and using the NIH-CPSI score, the criterion standard for CP/CPPS, as an outcome measure were included. Data was extracted from each study by two independent reviewers. Gillbraith and I-squared plots were used for heterogeneity testing and Eggers and Peters methods for publication bias. Quality was assessed using a component approach and meta-regression was used to analyze sources of heterogeneity.
Results Mepartricin, percutaneous tibial nerve stimulation (PTNS), and triple therapy comprised of doxazosin + ibuprofen + thiocolchicoside (DIT) resulted in clinically and statistically significant reduction in NIH-CPSI total score. The same agents and aerobic exercise resulted in clinically and statistically significant NIH-CPSI pain domain score reduction. Acupuncture, DIT, and PTNS were found to produce statistically and clinically significant reductions in the NIH-CPSI voiding domain. A statistically significant placebo effect was found for all outcomes and time analysis showed that efficacy of all treatments increased over time. Alpha-blockers, antibiotics, and combinations of the two failed to show statistically or clinically significant NIH-CPSI reductions.
ConclusionResults from this meta-analysis reflect our current inability to effectively manage CP/CPPS. Clinicians and researchers must consider placebo effect and treatment efficacy over time and design studies creatively so we can more fully elucidate the etiology and role of therapeutic intervention in CP/CPPS.

1.1.17. Yan 2012 ~

Yan Xing-Ke, Cui Hai-Fu, Chen Cheng, He Tian-You. [Meta-analysis of randomized controlled clinical trials of acupuncture treatment for chronic prostatitis]. Lishizhen Medicine and Materia Medica Research. 2012;10:2592-259. [187045].

Objective To assess the efficacy of the acupuncture and moxibustion treatment on chronic prostatitis and to evaluate the quality of the literature.
Methods Retrieving the 2000-2011 VIP, CNKI, PubMed database; collecting the clinical RCT on the acupuncture treatment of chronic prostatitis; selecting to meet the requirements of the randomized controlled trials (RCT), controlled clinical trials (CCT); doing Meta-analysis of the literature according to the principles of evidence-based medicine.
Results A total of 27 the clinical RCT and 2828 cases of patients in this study. Meta-analysis showed that the efficacy of the acupuncture and moxibustion treatment on chronic prostatitis had significant difference as compared to the control group, [OR=1. 21, 95% CI (2. 90, 4. 61), Z=10. 99, P<0. 00001]; After acupuncture treatment of chronic prostatitis, the symptom score of the two groups had significant difference in comparison, [WMD=-3. 96, 95% CI (-4. 79, -3. 13), Z=9. 37, P<0. 00001].
Conclusion The therapeutic effect of acupuncture and moxibustion for chronic prostatitis is more obvious than control group in the aspects of total effectiveness and symptom scores. But because the quantity of documents in the aspects of RCT and CCT is not enough, especially, it is less on high quality, large sample and multicenter randomized clinical study reports. And some of the publications have faults which exist bias, lack of random, blinding, adverse reactions and follow-up reports, which result in the incomplete clinical evaluation. Therefore, it is need to do more further study.

1.1.18. Li 2010 ☆☆

Li Ying, Xiong Jun, Du Yuan-Ha, Li Bo, Shi Lei. [Acupuncture versus medicine for chronic prostatitis: a systematic review]. Liaoning Journal of Traditional Chinese Medicine. 2010;8:1567-157. [187040].

ObjectiveTo assess the efficacy of acupuncture versus medicine on the treatment of chronic prostatitis.
Methods Randomized controlled trials (RCTs)involving acupuncture versus medicine on the treatment of chronic prostatitis were identified from PUBMED, Embase, OVID, Cochrane library, CBM, CNKI, VIP, WANFANG Database. We also hand searched relevant journals from the library of Tianjin University of Traditional Chinese Medicine.
ResultsA total of 9 trials involving 943 patients were included. Meta-analyses showed that the total effective rate in the acupuncture group was difference when compared with Minocin [RR=1. 26, 95% CI (1. 10, 1. 44)], plant preparations (Prostat and QIANLIE KANG Tablets) [RR=1. 39, 95% CI (1. 23, 1. 58)], but similiar with traditional Chinese drug [RR=1. 13, 95% CI (0. 99, 1. 29)]; As for the content of Zn difference was noted between acupuncture and Minocin [WMD=1. 76, 95% CI (1. 48, 2. 03)]; for the content of SOD, difference was observed between acupuncture and Minocin [WMD=259. 64, 95% CI (230. 06, 289. 22)]; for the content of IgE, acupuncture had similar effects to norfloxacin [WMD=-0. 01, 95% CI (-0. 01, 0. 00)].
ConclusionAcupuncture is superior to medicine, and associated with few adverse reactions. Further large-scale trials are required to define the role of acupuncture in the treatment of chronic prostatitis.

1.1.19. Wang 2008 ~

Wang CY, Han RF. [Acupuncture for chronic prostatitis: a meta-analysis]. National Journal of Andrology [Zhonghua Nan Ke Xue]. 2008;14(9):853-6. [156229].

ObjectiveTo determine the effect of acupuncture on chronic prostatitis.
Methods We retrieved all the case-control studies on acupuncture for chronic prostatitis before August 2007 in MEDLINE and CNKI databases, screened the eligible literature according to the selection and exclusion criteria, and performed meta-analyses of the included studies with the software Revman 4. 2.
ResultsThirteen eligible reports were identified in this study, including 861 cases and 738 controls. The effectiveness and cure rates were significantly higher in the acupuncture therapy group than in the control, with pooled RR as 1.20 (95% CI, 1.14, 1.25; P < 0.01) and 1.85 (95% CI, 1.63, 2.11; P < 0.01), respectively.
ConclusionAcupuncture therapy exhibited a definite effect in the treatment of chronic prostatitis

1.2. Special Acupuncture Techniques

1.2.1. Moxibustion

1.2.1.1. Chen 2015 (Heat Sensitive Moxibustion) ☆☆

Chen Si-da, Liu Bu-ping, Gian Li-huan, et al. [Meta Analysis on Heat Sensitive Moxibustion Therapy for Chronic Prostatitis]. Journal of Clinical Acupuncture and Moxibustion. 2015;31 (12):54. [187720].

ObjectiveTo evaluate the efficacy and security of heat sensitive moxibustion (HSM)for treating chronic prostatitis (CP).
Methods We searched China National Knowledge Infrastructure, Wanfang Data, VIP China Science and Technology Journal Database, Chinese Biomedica1 Literature Database, Pubmed, Embase, MEDLINE, BIOSIS Preview for published studies on HSM therapy for chronic prostatitis from 1979 10 2015. The quality of the included studies was assessed. Meta-analysis was performed by using the RevMan 5. 2 software.
ResultsThere were 7 literatures in accordance with the criteria, and 3 articles met the high inclusion criteria, and not any side reactions were reported. The curative rate of HSM was significantly higher than that of western medicine and warm acupuncture (P < 0. 05). There was no significant difference in the curative rate between HSM and traditional moxibustion (TM), HSM + radio frequency (RF) and RF, HSM + RF and traditional moxibustion + RF, HSM + enema and TM + enema (P > 0. 05). The effective rate between HSM and warm acupuncture, HSM + RF and RF, HSM + RF. And TM + RF, HSM + enema and TM + enema was that the former was significantly higher than the latter (P<0. 05 or P<0. 01), but between HSM and western medicine, HSM and TM there was not a significant difference (P > 0. 05). As to the improvement of NIH -CPSI, HSM and western medicine, HSM and warm acupuncture, HSM + RF and RF, HSM + RF and TM + RF, E-ISM + enema and TM + enema, the former was significantly better than the latter (P < 0. 0 1), but HSM and TM were not significant (P>0. 05). As to the improvement of TCM symptoms, HSM and western medicine, HSM + enema and TM + enema, the former was significantly better than the latter (P<0. 05 or P<0. 01),and as to the comparison of HSM and TM there was no significant difference (P >0.05).
ConclusionHSM therapy for CP with high quality literatures and safely clinical application, and has an obvious advantage in reducing the NIH -CPSI score and improving the curative rate. HSM combined with other therapies can improve the efficacy, and has the same efficacy as the western medicine and TM.

1.3. Specific outcomes

1.3.1. Effect duration

1.3.1.1. Qin 2019☆

Qin Z, Wu J, Xu C , Sang X, Li X , Huang G , Liu Z. Long-term effects of acupuncture for chronic prostatitis/chronic pelvic pain syndrome: systematic review and single-arm meta-analyses. Ann Transl Med. 2019;7(6):113.[197784] .

Background Cumulative evidences indicate that acupuncture may ameliorate the symptoms of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). However, the long-lasting effects of acupuncture on CP/CPPS has not been fully evaluated. The objective of this study is to assess the sustained effects of acupuncture on CP/CPPS.
MethodsWe searched PubMed, EMBASE, and CENTRAL databases for studies on the use of acupuncture in patients with CP/CPPS. Studies with long-term follow-up periods were included. Single-arm meta-analyses were performed using random-effects model. The primary outcome was the response rate at the end of follow-up period; the secondary outcomes were changes of the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) scores at the end of follow-up, including total score and 3 sub-scores (pain, urinary, and quality of life).
ResultsSix studies with 310 patients were performed in data synthesis, among which four studies were randomized controlled trials (RCT) and two were case series studies. At the end of follow-up, the weighted “average” response rate was 68.4% (95% CI: 42.1% to 89.5%, n=226; I2=93.5%); the change of NIH-CPSI total score were -14.8 (95% CI: -17.0 to -12.6, n=310; I2=92.1%); the change of pain, urinary, and quality of life sub-scores were -6.0 (95% CI: -6.9 to -5.2, n=266; I2=83.6%), -2.6 (95% CI: -3.2 to -2.0, n=266; I2=87.9%), and -4.4 (95% CI: -6.2 to -2.6, n=266; I2=98.7%), respectively. The source of heterogeneity could not be identified owing to insufficient studies.
ConclusionsAcupuncture may have clinically long-lasting benefits for CP/CPPS. However, current evidence is limited owing to insufficient data and significant heterogeneity. Further studies with larger sample size and long-term follow-up periods are warranted.

1.3.2. Dose-effect

1.3.2.1. Qin 2019

Effet-dose : Qin Z, Wu J, Xu C, Liu Z. Using meta-regression approach to explore the dose-response association between acupuncture sessions and acupuncture effects on chronic prostatitis/chronic pelvic pain syndrome. Ann Transl Med. 2019;7(6):116. [197850]. doi

BackgroundThe benefits of acupuncture on chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) have been well established according to previous studies. However, uncertainty exists regarding the dose-response relationship between acupuncture sessions and acupuncture effects for CP/CPPS.
ObjectiveThe objective of this study is to explore the association between the acupuncture sessions and its effects based on previously published data.
Methods A non-linear meta-regression approach with restricted cubic spline (RCS) was used to investigate the dose-response relationship between acupuncture sessions and its effects on the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI). PubMed, EMBASE, and Cochrane CENTRAL were searched up to May 20, 2018. Randomized controlled trials (RCTs) and case series studies (CSSs) reported the treatment sessions of acupuncture for CP/CPPS with at least two categories were eligible for inclusion.
ResultsTen studies involving 329 participants were included, the results showed a J-shaped dose-response association between acupuncture sessions and NIH-CPSI score (range 0 to 43, with higher score indicating greater CP/CPPS symptoms). Overall, more acupuncture sessions received for CP/CPPS patients is associated with increased symptom relieving. After 6 acupuncture sessions, the NIH-CPSI decreased from 26.1 (95% CI: 25.3-27.0) to 18.5 (95% CI: 11.6-25.4), with a between-session difference of -7.6 (95% CI: -14.6 to -0.7). Considering the 95%CI, both robust-error meta-regression modeling [MD: -8.3 (95% CI: -10.4 to -6.3)] and sensitivity analysis without CSSs [MD: -8.1 (95% CI: -9.5 to -6.7)] demonstrated that 18 acupuncture sessions could reach a clinically meaningful improvement regarding NIH-CPSI score.
ConclusionsThere appear to be dose-response relationship between acupuncture sessions and CP/CPPS outcome. Prolonged acupuncture sessions were associated with less NIH-CPSI score. According to current evidence, six acupuncture sessions might be the minimal required 'dose' to reach its clinical effects.

2. Clinical Practice Guidelines

⊕ positive recommendation (regardless of the level of evidence reported)
Ø negative recommendation (or lack of evidence)

2.1. National Institute for Health and Clinical Excellence (NICE, UK) 2019 ⊕

Prostatitis - chronic. NICE Clinical knowledge summaries. 2019 . [197427]. URL

Most men with CP/CPPS require multimodal treatment aimed at the main symptoms (taking comorbidity into account). Options include offering: […] acupuncture […]

2.2. European Association of Urology (EAU) 2018 ⊕

Engeler D, Baranowski AP, Borovicka J et al. EAU Guidelines on Chronic Pelvic Pain, European Association of Urology (EAU). 2018. [207489].

Summary of evidence: Acupuncture is superior to sham acupuncture in improving symptoms and QoL. Level of evidence : 1a
Recommendations: Offer acupuncture in PPS. Strength rating: Strong.

2.3. European Association of Urology (EAU) 2015 ⊕

Engeler D , Baranowski AP, Borovicka J et al. EAU Guidelines on Chronic Pelvic Pain, European Association of Urology (EAU). 2015. [205895].

Conclusions : There are limited data on the effectiveness of electro-acupuncture for the treatment of Prostatic Pain Syndrome (PPS). Level of evidence: 2b. Recommendations: Electro-acupuncture might be considered for the treatment of PPS. Grade of evidence: B

2.4. Prostate Cancer UK 2014 ⊕

Rees J, Abrahams M, AbuV, AllanT, Doble A, Neale T et al. Diagnosis and treatment of chronic bacterial prostatitis and chronic prostatitis/chronic pelvic pain syndrome: a consensus guideline. Prostate Cancer UK. 2014:54P. [197134].
Rees J, Abrahams M, Doble A, Cooper A; Prostatitis Expert Reference Group (PERG). Diagnosis and treatment of chronic bacterial prostatitis and chronic prostatitis/chronic pelvic pain syndrome: a consensus guideline. BJU Int. 2015;116(4):509–525. [001]. DOI

The following specialist physiotherapy treatment options may be considered in CBP and CP/CPPS patients (Level 5):, Pelvic floor re-education, Local pelvic floor relaxation, Biofeedback, General relaxation, Deep relaxation/mindfulness, Trigger point release, Myofascial release, Stretches, Daily exercise encouraged for pain management, TENS, Acupuncture for trigger point release and pain management, Bladder retraining. It should be noted that the following specialist physiotherapy techniques for possible use in treating CBP and CP/CPPS were put to the Delphi panel, but a consensus on their suitability was not achieved: Core stability training, Diaphragmatic breathing exercises, Acupuncture for urgency and abdominal massage for constipation, Defecation techniques.

2.5. European Association of Urology (EAU) 2010 ⊕

Fall M , Baranowski AP, Elneil S et al. EAU Guidelines on Chronic Pelvic Pain, European Association of Urology (EAU). 2010. [42445].

Acupuncture. Level of evidence: 2a-3. Grade of recommendation: B. Comments: As supportive, second-line therapy.

2.6. National Institute for Health and Clinical Excellence (NICE, UK) 2010 Ø

National Clinical Guideline Centre for Acute and Chronic Conditions. Lower urinary tract symptoms in men: assessment and management. London (UK): National Institute for Health and Clinical Excellence (NICE). 2010; :38P. [168794].

1.8.1 Do not offer homeopathy, phytotherapy or acupuncture for treating LUTS in men. [2010].

2.7. European Association of Urology (EAU) 2003 ⊕

Fall M , Baranowski AP, Fowler CJ et al. EAU Guidelines on Chronic Pelvic Pain, European Association of Urology (EAU). 2003. [109003].

Acupuncture. level of evidence: 3, Grade of recommendation: C. Comments: Data contradictory.

3. Randomized Controlled Trials

3.1. Sources

  1. Acudoc2 : Base de données du GERA, ECR non cités dans les sources.
  2. Li 2020 : Li J, Dong L, Yan X, et al. Is Acupuncture Another Good Choice for Physicians in the Treatment of Chronic Prostatitis/Chronic Pelvic Pain Syndrome? Review of the Latest Literature. Pain Res Manag. 2020;:5921038. [135945] (n=11)
  3. Qin 2019: Qin Z, Wu J, Xu C , Sang X, Li X , Huang G , Liu Z. Long-term effects of acupuncture for chronic prostatitis/chronic pelvic pain syndrome: systematic review and single-arm meta-analyses. Ann Transl Med. 2019;7(6):113.[197784] . (N=4)
  4. Song 2019: Song Yanjuan, Liang Fengxia, Wang Hua, Chen Song, Huang Qi, Zhang Yanji. [Acupuncture for Chronic Pelvic Pain Syndrome: A Meta-analysis]. Liaoning Journal of TCM. 2019;46(7):1494-500. [140653].
  5. Franco 2018: Franco JV, Turk T, Jung JH, Xiao YT, Iakhno S, Garrote V, Vietto V. Non-pharmacological interventions for treating chronic prostatitis/chronic pelvic pain syndrome. Cochrane Database Syst Rev. 2018. [100563]. |doi|. (N=5)
  6. Chang 2016: Chang SC, Hsu CH, Hsu CK, Yang SS, Chang SJ. The efficacy of acupuncture in managing patients with chronic prostatitis/chronic pelvic pain syndrome: A systemic review and meta-analysis. Neurourol Urodyn. 2016;1-8. [52573]. (N=7)
  7. Liu 2016: Liu BP, Wang YT, Chen SD. Effect of acupuncture on clinical symptoms and laboratory indicators for chronic prostatitis/chronic pelvic pain syndrome: a systematic review and meta-analysis. Int Urol Nephrol. 2016;48(12):1977-199. [195726]. (N=10).
  8. Qin 2016a: Qin Z, Wu J, Tian J, Zhou J, Liu Y, Liu Z. Network Meta-Analysis of the Efficacy of Acupuncture, Alpha-blockers and Antibiotics on Chronic Prostatitis/Chronic Pelvic Pain Syndrome. Sci Rep. 2016. [156150]. (N=4)
  9. Qin 2016b: Qin Z, Wu J, Zhou J, Liu Z. Systematic Review of Acupuncture for Chronic Prostatitis/Chronic Pelvic Pain Syndrome. Medicine (Baltimore). 2016;95(11):e3095. [166513]. (N=7).
  10. Herati 2013: Herati AS, Moldwin RM. Alternative therapies in the management of chronic prostatitis/chronic pelvic pain syndrome. World J Urol. 2013;31(4):761-6. [170763]. (N=2)
  11. Posadzki 2012: Posadzki P, Zhang J, Lee Ms, Ernst E. Acupuncture for chronic nonbacterial prostatitis/chronic pelvic pain syndrome: a systematic review. J Androl. 2012;33(1):15-21. [168210] (N=9)

3.2. List

2018 Qin Z, Zang Z, Zhou K, Wu J, Zhou J, Kwong JSW, Liu Z. Acupuncture for Chronic Prostatitis/Chronic Pelvic Pain Syndrome: A Randomized, Sham Acupuncture Controlled Trial. J Urol. 2018;200(4):815-822. [197939]. Li 2020, Qin 2019,
Yin Jing, Sun Jungang, Zhang Peihai, et al. [ Treatment of Chronic Prostate with Acupuncture Combined with External Microshort Wave of chronic inflammation / chronic pelvic pain syndrome], Journal of Sichuan TCM. 2017;35(1):204-6. [152545]. Song 2019
2017 Zhou M, Yang M, Chen L, Yu C, Zhang W, Ji J, Chen C, Shen X, Ying J. The effectiveness of long-needle acupuncture at acupoints BL30 and BL35 for CP/CPPS: a randomized controlled pilot study. BMC Complement Altern Med. 2017;17:263. [195111]. Qin 2019,
2016 Chen G, Xiang J, Ouyang L, Wang X, Zhang S, Chen H, Chen J, Li T. [Acupuncture combined with western medicine for CP/CPPS:a randomized controlled trial]. Chinese Acupuncture and Moxibustion. 2016;36(12):1247-1251. [42648] Li 2020
Gen Q, Zhao Y and Ouyang B. [Therapeutic effect of acupuncture at acupoint selection on type IIIB prostatitis]. Lishizhen Medicine and Materia Medica Research. 2016;275(8):1916-7. [166002]. Li 2020, Song 2019
2015 Jin Ye, Zhao Tonglan, Jiang Shouxin. [Acupuncture and moxibustion treatment of type Ⅲ prostatitis of damp-heat syndrome : the influence of SIgA], Modern Journal of Integrated Traditional Chinese and Western Medicine. 2015;24(3):288-90. [185519]. Song 2019
Ke Weifu. [Clinical Observation on Non-inflammatory Chronic Prostatitis Treated by Integrated Traditional Chinese and Western Medicine], Jiangxi Medicine. 2015;50(10):1027-8. [180541]. Song 2019
Kuçuk EV, Suçeken FY, Bindayı A, Boylu U, Onol FF, Gumus E. Effectiveness of acupuncture on chronic prostatitis–chronic pelvic pain syndrome category IIIB patients: a prospective, randomized, nonblinded, clinical trial. Urology 2015; 85: 636–40. [177797]. Li 2020, Song 2019, Franco 2018, Chang 2017, Liu 2016, Qin 2016a, Qin 2016b
Li Shilin, Tang Liang, Ye Haixia. [Clinical study of “Qing Zhtio Qu Du” Pills combined acupuncture for chronic ] Journal of Guangzhou University of TCM. 2015;6:1035-9+46. [188372]. Liu 2016
Ma Y, Li X, Li F, Yu W, Wang Z. [Clinical research of chronic pelvic cavity pain syndrome treated with acupoint catgut embedding therapy]. Chinese Acupuncture and Moxibustion. 2015;35(6):561-6. [174087]. , Liu 2016
Sahin S, Bicer M, Eren GA, Tas S, Tugcu V, Tasci AI, Cek M. Acupuncture relieves symptoms in chronic prostatitis/chronic pelvic pain syndrome: a randomized, sham-controlled trial. Prostate Cancer Prostatic Dis. 2015;18(3):249-54. [186475]. Li 2020, Qin 2019, Franco 2018, Chang 2017, Liu 2016, Qin 2016a, Qin 2016b
Rending Wu, Yonghong Gui, Wenchang Lin, Liqiong Zhang. [Clinical Observation of Type III Prostatitis Treated with Acupuncture and Isolated-Ginger Moxibustion]. Chinese Acupuncture and Moxibustion. 2015;35(12):1239-42. [203981]. Song 2019
2014 Lee SW, Liong ML, Yuen KH, Krieger JN. Acupuncture and immune function in chronic prostatitis/chronic pelvic pain syndrome: a randomized, controlled study. Complementary Therapies in Medicine. 2014;22(6):965-9. [183004]. Liu 2016
Ma Y, Wang ZL, Sun ZX, Men B, Shen BQ. [Efficacy observation on chronic pelvic pain syndrome of damp-heat stagnation pattern treated with acupoint catgut embedding therapy]. Chinese Acupuncture and Moxibustion. 2014;34(4):351-4. [157432]. Li 2020, Chang 2017
Zhao JY, Song CS. [Clinical observation of Jiao Xue acupuncture treatment on IIIB prostatitis]. Chinese Journal of Human Sexuality. 2014;23(12):57-9. [188456]. Li 2020, Song 2019, Liu 2016, Qin 2016b
2013 Gou Meng. [60 cases of type Ⅲ prostatitis treated with acupuncture and moxibustion], Traditional Chinese Medicinal Research. 2013;26(12):68-9. [190999]. Song 2019
2012 Liu JM, Huang GF, Li HT, et al. [Clinical observation of ‘‘Shuang Gu Yi Tong’’ acupuncture for chronic prostatitis accompany with depression]. Guide of China Medicine. 2012;10(32):610-612. [201042]. Li 2020, Qin 2016b
Qi XL, Pan FT, Wu WZ. [Effect of acupuncture on cytokine in patients with chronic nonbacterial prostatitis]. Shandong Journal of TCM. 2012;31(6):418-20. [201164]. Li 2020, Liu 2016, Qin 2016b
2011 Lee SW, Liong ML, Yuen KH, Leong WS, Khan NK, Krieger JN. Validation of a sham acupuncture procedure in a randomised, controlled clinical trial of chronic pelvic pain treatment. Acupuncture in Medicine. 2011;29(1):40-6. [158372]. Liu 2016
2010 Zhang J, Liu CD, Ding Y, Tang QB. [Clinical observation on therapeutic effect of electroacupuncture on chronic prostatitis and detection of urethral sphincter EMG]. Chinese Acupuncture and Moxibustion. 2010;30(1):13-7. [155763]. Song 2019
2009 Chen ZX. [Observation on therapeutic effect of warm needle moxibustion on chronic non-bacterial prostatitis]. Chinese Acupuncture and Moxibustion. 2009;29(4):275-8. [154757]. Song 2019, Franco 2018
Lee SH, Lee BC. Electroacupuncture relieves pain in men with chronic prostatitis/chronic pelvic pain syndrome: three-arm randomized trial. Urology 2009; 73: 1036–41 [152815]. Li 2020, Franco 2018, Chang 2017, Liu 2016, Qin 2016a, Qin 2016b, Herati 2014
Zhang Xue-Jian. [Observations on the efficacy of point-through-point acupuncture with elongate needles in treating chronic prostatitis]. Shanghai Journal of Acupuncture and Moxibustion. 2009;28(10):589. [179842]. Posadzki 2012
2008 Jin Xiaofei, Ji Laixi. [Clinical study on acupuncture for the treatment of chronic non-bacterial prostatitis and prostatodynia]. China's Naturopathy. 2008;5:9. [204017]. Posadzki 2012
Lee SW, Liong ML, Yuen KH et al. Acupuncture versus sham acupuncture for chronic prostatitis/chronic pelvic pain. Am J Med 2008; 121: 79.e1–7 [147616]. Li 2020, Qin 2019, Franco 2018, Chang 2017, Liu 2016, Qin 2016a, Qin 2016b, Herati 2014, Posadzki 2012
Song Rixin, Jiang Guohong, Cui Yan. [Clinical study of CPPS type Ⅲ B treated by acupuncture together with rectal microwave radiation therapy], Beijing Journal of TCM. 2008;27(11): 838-841. [182499]. Acudoc2
2007 Xu Yan Long, He Tian You. [Clinical observation on acupuncture at “sanyin points assisting “yinsan points” for treatment of chronic prostatitis]. Journal of Clinical Acupuncture and Moxibustion. 2007;23(9):12. [147253]. Posadzki 2012
2006 Li Chen, Wang Hongzhao. [Clinical Study on Acupuncture Treatment of Chronic Nonbacterial Prostatitis]. Beijing Journal of TCM. 2006;25(10):680. [204054]. Chang 2017, Posadzki 2012
Xue YP, Zhang SB, Gao T. [Observation on therapeutic effect of chronic prostatitis treated mainly by warming needle moxibustion]. Chinese Acupuncture and Moxibustion. 2006;26(5):335-6. [125845]. Song 2019
2005 Huang Yingjie, Fan Xiaohong, Du Meng. [Acupuncture for the treatment of chronic prostatitis in 42 cases]. Journal of Clinical Acupuncture and Moxibustion. 2005;21(4):8. [150650]. Chang 2017, Posadzki 2012
Hu BC, Wang S, Zhou ZK, Cai YY. [Point-through-point acupuncture for the treatment of chronic non-bacterial prostatitis]. Cap Med. 2005;18:47. [204000]. Posadzki 2012
Wang Runsheng. [Clinical observation of 92 patients with chronic pelvic pain syndrome treated by electroacupuncture]. Forum on TCM. 2005;20(3):27. [204155]. Song 2019
2004 He Tian-You, Zhao Yao-Dong, Luo Cheng-Lin . [Clinical observation on acupuncture at ” sanyin points“ for treatment of chronic prostatitis ]. Chinese Acupuncture and Moxibustion. 2004;24(10):697. [134238]. Posadzki 2012
1997 Wang Runsheng. [Clinical observation of acupuncture in Huiyin (CV1) and hegu (LI4) points for the treatment of chronic prostatitis in 84 cases]. Chinese Acupuncture and Moxibustion. 1997;17(7):397. [203999]. Posadzki 2012