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Hu J, Xiao Y, Jiang G, Hu X. Research Trends of Acupuncture Therapy on Chronic Pelvic Pain Syndrome from 2000 to 2022: A Bibliometric Analysis. J Pain Res 2023; 16:4049-4069. [PMID: 38054110 PMCID: PMC10695139 DOI: 10.2147/jpr.s434333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 11/17/2023] [Indexed: 12/07/2023] Open
Abstract
Background Acupuncture is considered an important means of analgesic, which has been widely used in chronic pelvic pain syndrome (CPPS) management and treatment in recent years, published a large number of related documents. However, the relevant literature in this field has not been summarized and quantitatively analyzed. Therefore, this study aims to analyze the hotspots and predicting future research trends of acupuncture on pelvic pain syndrome. Methods Search for the relevant publications of the web of science database from 2000 to 2022 about the treatment of acupuncture on chronic pelvic pain syndrome. The Citespace software and VosViewer software are used to analyze the visualization of the countries, institutions, authors, keywords and references and references in the literature. Results A total of 173 publications were included. The annual number of essays gradually showed an overall growth trend over time. Medicine magazine is the most published journal in this field. J UROLOGY and Acupunct Med are the most cited journals and the most influential magazines; The most active and influential country is China, and the most produced institutions are Beijing University of Chinese Medicine; The most produced authors are Liu Zhishun. The most cited and most influential authors are Nickel JC and Armour M; keywords and cited reference analysis show that the quality of life, mechanism research, alternative medicine and electro-acupuncture will be the scientific hotspot of acupuncture treatment for chronic pelvic pain syndrome. Conclusion This study shows that acupuncture on CPPS is increasingly valued and recognized. The future research hotspots will focus on the effects and mechanisms. In the future, more high-quality animal basic research will be required to explore the exact mechanism of acupuncture on CPPS. In addition, different parameters of acupuncture such as electric-acupuncture, stimulating frequency, duration and strength are also the focus of future research. More clinical trials are required to verify its safety and effectiveness.
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Affiliation(s)
- Jinyu Hu
- School of Graduate and Clinical Medicine, Jiangxi University of Chinese Medicine, Nanchang City, People’s Republic of China
| | - Yuanyi Xiao
- School of Graduate and Clinical Medicine, Jiangxi University of Chinese Medicine, Nanchang City, People’s Republic of China
| | - Guilin Jiang
- Department of Clinical Medicine, The Affiliated Hospital of Jiangxi University of Chinese Medicine, Nanchang City, People’s Republic of China
| | - Xiaorong Hu
- Department of Clinical Medicine, The Affiliated Hospital of Jiangxi University of Chinese Medicine, Nanchang City, People’s Republic of China
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Wang H, Zhang J, Ma D, Zhao Z. The Role of Acupuncture and Its Related Mechanism in Treating Chronic Prostatitis/Chronic Pelvic Pain Syndrome. Int J Gen Med 2023; 16:4039-4050. [PMID: 37700742 PMCID: PMC10493142 DOI: 10.2147/ijgm.s417066] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 07/28/2023] [Indexed: 09/14/2023] Open
Abstract
Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is one of the most common diseases in urology, and its prevalence has been increasing, causing serious urogenital problems in men. Several targeted oral drug therapies exist to treat the pelvic pain experienced in this disease. However, these therapies may have potential adverse effects, and due to the unique location of the prostate, delivery of medications to the target lesion is difficult. Consequently, many patients seek alternative therapies. Acupuncture is a well-established treatment method in traditional Chinese medicine that can improve CP/CPPS symptoms and reduce pain. However, previous systematic reviews overlooked the significance of the characteristics and mechanisms of acupuncture therapy. This study aimed to summarize the characteristics and benefits of acupuncture therapy for CP/CPPS based on relevant literature and predict and analyze its related mechanisms.
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Affiliation(s)
- Hao Wang
- Department of Andrology, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, People’s Republic of China
| | - Jiwei Zhang
- Department of Andrology, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, People’s Republic of China
| | - Dongyue Ma
- Department of Andrology, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, People’s Republic of China
| | - Ziwei Zhao
- Department of Andrology, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, People’s Republic of China
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Wazir J, Ullah R, Li S, Hossain MA, Diallo MT, Khan FU, Ihsan AU, Zhou X. Efficacy of acupuncture in the treatment of chronic prostatitis-chronic pelvic pain syndrome: a review of the literature. Int Urol Nephrol 2019; 51:2093-2106. [DOI: 10.1007/s11255-019-02267-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Accepted: 08/22/2019] [Indexed: 12/18/2022]
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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. ANNALS OF TRANSLATIONAL MEDICINE 2019; 7:116. [PMID: 31032271 DOI: 10.21037/atm.2018.11.45] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Background The 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. The 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. Results Ten 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. Conclusions There 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.
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Affiliation(s)
- Zongshi Qin
- Department of Acupuncture, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China.,School of Chinese Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Jiani Wu
- Department of Acupuncture, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
| | - Chang Xu
- Chinese Evidence-Based Medicine Center and Chinese Cochrane Center, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Zhishun Liu
- Department of Acupuncture, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
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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. ANNALS OF TRANSLATIONAL MEDICINE 2019; 7:113. [PMID: 31032268 PMCID: PMC6465443 DOI: 10.21037/atm.2018.06.44] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 06/19/2018] [Indexed: 02/05/2023]
Abstract
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. METHODS We 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. CONCLUSIONS Acupuncture 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.
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Affiliation(s)
- Zongshi Qin
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing 100029, China
- Department of Acupuncture, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
| | - Jiani Wu
- Department of Acupuncture, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
| | - Chang Xu
- Chinese Evidence-Based Medicine Center and Chinese Cochrane Center, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Xiaopu Sang
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Xiao Li
- Department of Urology, Jiangsu Cancer Hospital& Jiangsu Institute of Cancer Research& Nanjing Medical University Affiliated Cancer Hospital, Nanjing 210000, China
| | - Guangrui Huang
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Zhishun Liu
- Department of Acupuncture, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
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Zhou J, Liu Y, Li C, Liu Z. Comparison of 3 assessment modes of acupuncture effect on patients with chronic prostatitis/chronic pelvic pain syndrome: A study protocol for a randomized controlled trial. Medicine (Baltimore) 2018; 97:e12887. [PMID: 30335011 PMCID: PMC6211918 DOI: 10.1097/md.0000000000012887] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Accepted: 09/26/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common disorder. Some studies have indicated that acupuncture may ameliorate the symptoms of CP/CPPS. However, results are varied and range widely, perhaps due to different modes of assessment including timepoints, places of assessment, and especially subjective scales. We propose to determine the efficacy of acupuncture relative to sham acupuncture for patients with CP/CPPS, and compare different modes of assessment regarding the therapeutic effects of acupuncture. METHODS Sixty patients with CP/CPPS will be randomly assigned to receive either acupuncture or sham-acupuncture (30 patients, each). Treatment will be conducted 3 times/week, for 4 weeks. The coprimary outcomes will each be the change from baseline of the total NIH (National Institutes of Health) CPSI (Chronic Prostatitis Symptom Index) score associated with 3 modes of assessment: Mode 1, the scale recorded at the hospital within 10 minutes after the last session of 4 weeks of acupuncture treatment, in the company of the outcome assessors; Mode 2, the scale recorded the same day, but not at the hospital; and Mode 3, the scale recorded at the hospital 1 to 3 days after the last acupuncture session. The 3 key secondary outcomes include will be the 3 modes assessment of the changes from baseline of the NIH-CPSI total scores in the acupuncture group at week 4 after treatment. Analysis was by intention-to-treat, and multiplicity was controlled for with a step-down closed-testing procedure. DISCUSSION To our knowledge, previous studies did not include the details of assessment scales when determining the efficacy of acupuncture in CP/CPPS. Furthermore, it is not clear which mode was used to assess the effect. The answers provided by the proposed study may improve the reproducibility of acupuncture research and the reliability of results.
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Affiliation(s)
- Jing Zhou
- Department of Acupuncture, Guang’anmen Hospital, China Academy of Chinese Medical Sciences
- China Academy of Chinese Medical Sciences
| | - Yan Liu
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Chunbin Li
- Department of Acupuncture, Guang’anmen Hospital, China Academy of Chinese Medical Sciences
- China Academy of Chinese Medical Sciences
| | - Zhishun Liu
- Department of Acupuncture, Guang’anmen Hospital, China Academy of Chinese Medical Sciences
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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 COMPLEMENTARY AND ALTERNATIVE MEDICINE 2017; 17:263. [PMID: 28499367 PMCID: PMC5429564 DOI: 10.1186/s12906-017-1768-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 04/19/2017] [Indexed: 01/26/2023]
Abstract
BACKGROUND The chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is one of the commonest chronic inflammatory diseases in adult men, for which acupuncture has been used to relieve related symptoms. The present study aimed to evaluate the therapeutic effect of the long-needle acupuncture on CP/CPPS. METHODS A randomized traditional acupuncture-controlled single blind study was conducted on 77 patients who were randomized into long-needle acupuncture (LA) and traditional acupuncture (TA) groups. The patients received six sessions of acupuncture for 2 weeks and a follow-up was scheduled at week 24. The primary outcome was measured by the total National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) score at week 2. Four domains of the NIH-CPSI (urination, pain or discomfort, effects of symptoms, and quality of life) and the clinical efficacy score served as the secondary outcome. RESULTS The total NIH-CPSI score at week 2 and week 24 was significantly improved in the LA group compared with the TA group. LA significantly improved urination, pain or discomfort, the effects of symptoms, and the quality of life at week 2 and week 24 and patients undergoing LA treatment had a higher clinical efficacy score. CONCLUSION Needling at the BL30 and BL35 using LA benefits patients with CP/CPPS. TRIAL REGISTRATION The study was registered at the Chinese Clinical Trial Register ( ChiCTR-ICR-15006138 ).
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Affiliation(s)
- Minjie Zhou
- Shanghai Qigong Research Institute, Shanghai, China
- Shanghai TCM-INTEGRATED Hospital, Shanghai, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Mingyue Yang
- The Department of Pain Management, Luoyang Central Hospital, Luoyang, China
| | - Lei Chen
- The Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Chao Yu
- The Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wei Zhang
- Shanghai Qigong Research Institute, Shanghai, China
- Graduate School, The Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jun Ji
- Shanghai Qigong Research Institute, Shanghai, China
- Graduate School, The Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Chi Chen
- Shanghai Qigong Research Institute, Shanghai, China
| | - Xueyong Shen
- Graduate School, The Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jian Ying
- Shanghai Qigong Research Institute, Shanghai, China
- The Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
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8
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Abstract
Acupuncture 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. MEDLINE, 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. Seven 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. Overall, 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. Protocol registration PROSPERO CRD42015027522.
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Affiliation(s)
- Zongshi Qin
- From the Department of Acupuncture (ZQ, JW, JZ, ZL), Guang'anmen Hospital, China Academy of Chinese Medical Sciences; and Beijing University of Chinese Medicine (ZQ, JZ), Beijing, China
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Rees J, Abrahams M, Doble A, Cooper A. Diagnosis and treatment of chronic bacterial prostatitis and chronic prostatitis/chronic pelvic pain syndrome: a consensus guideline. BJU Int 2015; 116:509-25. [PMID: 25711488 PMCID: PMC5008168 DOI: 10.1111/bju.13101] [Citation(s) in RCA: 150] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Objectives To improve awareness and recognition of chronic bacterial prostatitis (CBP) and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) among non‐specialists and patients. To provide guidance to healthcare professionals treating patients with CBP and CP/CPPS, in both non‐specialist and specialist settings. To promote efficient referral of care between non‐specialists and specialists and the involvement of the multidisciplinary team (MDT). Patients and Methods The guideline population were men with CBP or CP/CPPS (persistent or recurrent symptoms and no other urogenital pathology for ≥3 of the previous 6 months). Consensus recommendations for the guidelines were based on a search to identify literature on the diagnosis and management of CBP and CP/CPPS (published between 1999 and February 2014). A Delphi panel process was used where high‐quality, published evidence was lacking. Results CBP and CP/CPPS can present with a wide range of clinical manifestations. The four main symptom domains are urogenital pain, lower urinary tract symptoms (LUTS – voiding or storage symptoms), psychological issues and sexual dysfunction. Patients should be managed according to their individual symptom pattern. Options for first‐line treatment include antibiotics, α‐adrenergic antagonists (if voiding LUTS are present) and simple analgesics. Repeated use of antibiotics, such as quinolones, should be avoided if there is no obvious symptomatic benefit from infection control or cultures do not support an infectious cause. Early use of treatments targeting neuropathic pain and/or referral to specialist services should be considered for patients who do not respond to initial measures. An MDT approach (urologists, pain specialists, nurse specialists, specialist physiotherapists, general practitioners, cognitive behavioural therapists/psychologists, and sexual health specialists) is recommended. Patients should be fully informed about the possible underlying causes and treatment options, including an explanation of the chronic pain cycle. Conclusion Chronic prostatitis can present with a wide variety of signs and symptoms. Identification of individual symptom patterns and a symptom‐based treatment approach are recommended. Further research is required to evaluate management options for CBP and CP/CPPS.
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Affiliation(s)
- Jon Rees
- Backwell and Nailsea Medical Group, Bristol, UK
| | - Mark Abrahams
- Department of Pain Medicine, Addenbrooke's Hospital, Cambridge, UK
| | - Andrew Doble
- Department of Urology, Addenbrooke's Hospital, Cambridge, UK
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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; 18:249-54. [PMID: 25939517 DOI: 10.1038/pcan.2015.13] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2014] [Revised: 01/12/2015] [Accepted: 02/06/2015] [Indexed: 12/14/2022]
Abstract
BACKGROUND There are multiple approaches to the management of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS); and lately the data suggesting the ability of acupuncture treatment to decrease pain, positively impact quality of life and potentially modulate inflammation has suggested it as a potential therapeutic option for men with CP/CPPS. We conducted this study to determine whether acupuncture is really an effective therapeutic modality for CP/CPPS in terms of >50% decrease in total National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) score from baseline compared with sham. METHODS One hundred patients with CP/CPPS (category III B) in an outpatient urology clinic were randomized to receive acupuncture at either seven acupoints bilaterally or sham points adjacent to these points. NIH-CPSI was completed by each patient before and 6, 8, 16, 24 weeks after the treatment. Mean values of total CPSI score and subscores after the treatment and on follow-up following the treatment were compared. RESULTS Of the acupuncture participants, 92% were NIH-CPSI responders (>50% decrease in total NIH-CPSI score from baseline) compared with 48% of sham participants, 8 weeks after the end of the therapy. Both groups experienced significant decrease in CPSI subscores throughout the whole follow-up period; however, the decline remained significantly greater in the active acupuncture group as compared with the sham group. CONCLUSIONS Our results show that the use of acupuncture in treatment of men with CP/CPPS symptoms resulted in a significant decrease in total NIH-CPSI scores.
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Affiliation(s)
- S Sahin
- Department of Urology, Bakirkoy Dr Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - M Bicer
- Department of Physical Treatment and Rehabilitation, Bakirkoy Dr Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - G A Eren
- Department of Anesthesiology, Bakirkoy Dr Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - S Tas
- Department of Urology, Bakirkoy Dr Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - V Tugcu
- Department of Urology, Bakirkoy Dr Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - A I Tasci
- Department of Urology, Bakirkoy Dr Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - M Cek
- Department of Urology, Trakya University, Edirne, Turkey
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Assessing psychological factors, social aspects and psychiatric co-morbidity associated with Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) in men -- a systematic review. J Psychosom Res 2014; 77:333-50. [PMID: 25300538 DOI: 10.1016/j.jpsychores.2014.09.012] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Revised: 09/17/2014] [Accepted: 09/21/2014] [Indexed: 01/13/2023]
Abstract
OBJECTIVE Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) is a chronic pain disease with high prevalence rates and substantial health care costs. An interdisciplinary classification system is commonly used (UPOINT) which includes psychosocial factors. Nevertheless, psychosocial influences on CP/CPPS only recently became a research focus. Therefore, we aimed to synthesize the existing data and to identify further research topics. Then, based on our results, diagnosis and treatment can be improved. METHODS In a systematic review conducted according to the PRISMA reporting guidelines we searched different databases (MEDLINE, EMBASE, PsychINFO) using the broad search terms "chronic pelvic pain syndrome AND men". Two raters independently screened the literature and assessed the risk of bias. RESULTS We included 69 original research articles which considered psychosocial variables. We found studies investigating different psychosocial factors (pain catastrophizing, stress, personality factors, social aspects), co-morbid psychiatric disorders (depression, anxiety and trauma-related disorders, somatization disorder, substance abuse) and Quality of Life (QoL). In addition, there is a high risk of bias in most studies e.g. concerning the study design or the measures. CONCLUSIONS There is evidence suggesting that psychological factors are important in understanding CP/CPPS. However, research concentrated on a few aspects while the others were not covered adequately. We found evidence of a higher number of psychosocial factors and psychiatric co-morbidities than is currently included in the UPOINT system. More high quality research is needed to understand the interplay of psychosocial factors in CP/CPPS. Furthermore, these factors should be incorporated into treatment approaches.
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Carinci AJ, Pathak R, Young M, Christo PJ. Complementary and alternative treatments for chronic pelvic pain. Curr Pain Headache Rep 2013; 17:316. [PMID: 23315022 DOI: 10.1007/s11916-012-0316-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Chronic pelvic pain (CPP) is a significant clinical entity that affects both men and women alike. The etiologies of CPP are multifactorial, and treatments are myriad. Complementary and Alternative Medicine (CAM) refers to non-allopathic health systems, and its use is popular in the United States. In particular, several recent studies have investigated the efficacy of various CAM practices in the treatment of CPP. The authors systematically evaluated recent literature in this area by searching the PubMed database for English-language studies published between January 2007 and August 2012.
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Affiliation(s)
- Adam J Carinci
- Harvard Medical School, Division of Pain Medicine, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, 15 Parkman Street, Room 330, Boston, MA 02114, USA.
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14
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Abstract
Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common male pain condition that is associated with significant discomfort and disability. Despite significant efforts, there remains no definitive etiology or treatment of the spectrum of pelvic symptoms reported by these patients. The purpose of this review is to summarize important clinical and scientific findings related to CP/CPPS from the previous 2 years, and to evaluate their impact on our understanding of, and approach to, the disease.
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Affiliation(s)
- Katy S Konkle
- Department of Urology, University of Michigan Medical Center, Ann Arbor, USA
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Lee SH, Lee BC. Use of acupuncture as a treatment method for chronic prostatitis/chronic pelvic pain syndromes. Curr Urol Rep 2011; 12:288-96. [PMID: 21472420 DOI: 10.1007/s11934-011-0186-0] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is the most common category of clinical prostatitis. The etiologic factors of CP/CPPS still remain unknown, and standard therapies often fail to achieve sustainable amelioration of symptoms; therefore, various treatment therapies have been approached. Recently, there is increasing evidence that acupuncture could be a safe and effective treatment in managing CP/CPPS. However, acupuncture therapy still is ranked as low-priority treatment, which results from the fact that the studies, mostly reported in nontraditional medical journals, had not employed standard definitions of the condition or validated-outcome parameters, and that the mechanism of acupuncture effects on CP/CPPS remains to be elucidated. In this article, we review the recent clinical research using acupuncture to reveal its clinical utility for CP/CPPS and the possible mechanisms of action. This article could encourage health care providers and urologists to apply acupuncture for managing pains of CP/CPPS with standard treatment.
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Affiliation(s)
- Sang-Hun Lee
- Department of Internal Medicine, Integrative Cancer Center, East-West Neo Medical Center, Kyung Hee University, Sangil-dong, Gangdong-Ku, Seoul, Republic of Korea
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Abstract
Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a prevalent disease for which there is no standardized therapy. Traditional treatments have included antibiotics, α-blockers, and anti-inflammatories, but those have not proven to be efficacious therapies through many clinical trials. Alternative therapies, such as phytotherapy, acupuncture, and pelvic floor physical therapy, have grown in popularity for the treatment of CP/CPPS. As clinicians continue to explore these alternative therapies, there is an accumulation of strong evidence demonstrating the success of these alternative therapies.
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Affiliation(s)
- Lara K Suh
- Department of Urology, Columbia University Medical Center, NY 10032, USA
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Current world literature. Curr Opin Support Palliat Care 2011; 5:174-83. [PMID: 21521986 DOI: 10.1097/spc.0b013e3283473351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Anderson RU, Wise D, Sawyer T, Glowe P, Orenberg EK. 6-day intensive treatment protocol for refractory chronic prostatitis/chronic pelvic pain syndrome using myofascial release and paradoxical relaxation training. J Urol 2011; 185:1294-9. [PMID: 21334027 DOI: 10.1016/j.juro.2010.11.076] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2010] [Indexed: 01/26/2023]
Abstract
PURPOSE Chronic prostatitis/chronic pelvic pain syndrome continues to elude conventional therapy. Evidence supports the concept that phenotypes of pelvic muscular tenderness and psychosocial distress respond to myofascial trigger point release and specific relaxation training. This case series reports long-term outcomes of a 6-day intensive combination of such therapies in refractory cases. MATERIALS AND METHODS A total of 200 men with pain for a median of 4.8 years referred themselves to Stanford University Urology for participation in an established protocol. Daily 3 to 5-hour sessions including intrapelvic/extrapelvic physiotherapy, self-treatment training and paradoxical relaxation training provided a solid introduction to facilitate self-management. Subjects answered baseline and followup questionnaires at variable intervals after initiation of therapy including the National Institutes of Health Chronic Prostatitis Symptom Index, global response assessment and a psychological query. RESULTS We followed 116 men for a median of 6 months. Baseline total symptom index was 26 out of a maximum 43 points. Scores decreased by 30% (p <0.001) at followup with 60% of subjects demonstrating a 6-point or greater decrease (range 6 to 30). Domains of pain, urinary dysfunction and quality of life showed significant improvement (p <0.001). Global response assessment revealed that 82% of subjects reported improvement (59% marked to moderate, 23% slight). CONCLUSIONS Men with chronic pelvic pain refractory to traditional treatment benefit from intensive myofascial trigger point therapy and concomitant paradoxical relaxation training. Education in techniques for self-administered trigger point release and continued pelvic muscle relaxation help patients reduce pain and dysfunction. Refinement of clinical phenotyping and selection of patients with pelvic muscle tenderness should enhance the success rate with this treatment modality.
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Affiliation(s)
- Rodney U Anderson
- Department of Urology, School of Medicine, Stanford University, Stanford, California 94305-5118, USA.
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Acupuncture in urological practice—A survey of urologists in England. Complement Ther Med 2011; 19:27-31. [DOI: 10.1016/j.ctim.2010.10.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2010] [Revised: 09/27/2010] [Accepted: 10/19/2010] [Indexed: 11/20/2022] Open
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Westesson KE, Shoskes DA. Chronic Prostatitis/Chronic Pelvic Pain Syndrome and Pelvic Floor Spasm: Can We Diagnose and Treat? Curr Urol Rep 2010; 11:261-4. [DOI: 10.1007/s11934-010-0111-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Advancements in the Management of Urologic Chronic Pelvic Pain: What is New and What Do We Know? Curr Urol Rep 2010; 11:286-91. [DOI: 10.1007/s11934-010-0121-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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