What is effective pharmacologic therapy for the treatment of chronic bacterial prostatitis (CBP) and chronic pelvic pain syndrome (CPPS)?

Updated: Jan 15, 2019
  • Author: Samantha D Kraemer, MD; Chief Editor: Edward David Kim, MD, FACS  more...
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Answer

In a meta-analysis of randomized, controlled trials of pharmacologic therapy for the treatment of chronic prostatitis and chronic pelvic pain syndrome, Anothaisintawee et al concluded that alpha blockers and antibiotics, as well as combinations of these therapies, appear to achieve the greatest improvement in NIH-CPSI scores (total, pain, voiding symptoms, and quality of life) compared with placebo. Anti-inflammatory therapies had a lesser, but measurable, benefit on selected outcomes; however, the investigators noted that sample sizes in many studies were small and that publication bias might have overestimated the benefits reported. [48]

Another systemic review and meta-analysis on therapuetic interventions for patients with chronic prostatitis and chronic pelvic pain syndrome, concluded that the macrolide antibiotic mepartricin, percutaneous tibial nerve stimulation, and triple therapy (with doxazosin, ibuprofen, and the muscle relaxant thiocolchicoside) resulted in both clinically and statistically significant improvements in total NIH-CPSI scores. But they did not find statistically or clinically significant reductions in NIH-CPSI with alpha blockers, antibiotics, or combinations of the two. [49] Many of these studies included mostly patients with CPPS (negative cultures), and therefore more studies with patients who have CBP are needed.


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