Acupuncture Improves Symptoms in Chronic Prostatitis/Chronic Pelvic Pain Syndrome

by | Jan 27, 2022 | Alternative Therapies, Men's Health

Written by Chrystal Moulton, Staff Writer. 60.6% of participants in the acupuncture group had improvement in CP/CPPS symptom score.

acupunctureAcupuncture is an alternative medical approach used to manage pain most related to pelvic discomfort 1. Effects of acupuncture has been shown to last up to 12 months 2. Chronic prostatitis/chronic pelvic pain syndrome affects 2-16% of men in affluent countries and 11% of men in middle to low-income countries 3, 4. Common symptoms of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) include urogenital pain, sexual dysfunction, lower urinary tract symptoms, and psychological issues 5. Individuals with this syndrome rely on alpha-blockers, anti-inflammatory medication and antibiotics 6. However, relief lasts only with use of medication 7. In a pilot trial, researchers found that 8 weeks treatment with acupuncture effectively relieved symptoms of chronic prostatitis and chronic pelvic pain syndrome (CP/CPPS), an effect that lasted up to 32 weeks 8. In the current trial, the same researchers conducted a randomized, sham controlled, large scale clinical trial to investigate the long-term effects of acupuncture on chronic prostatitis and chronic pelvic pain syndrome (CP/CPPS) 9.

Eligible participants were between the ages of 18 to 50 years old who have experienced pelvic discomfort or pain without infection for at least 3 months and scoring at least 15 points on the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI). Upon inclusion, participants were randomized to receive either acupuncture or sham acupuncture (placebo). Both true and sham acupuncture was conducted by licensed and experienced professionals who were not blinded to the treatment allocation. Both groups received designated treatment in the lumbosacral and posterior tibial regions.  In the sham procedure, the needle was not placed at therapeutic depth. Participants started treatment the same day as randomization and received 20 sessions for 30 minutes over an 8-week period. Participants were then followed up 24 weeks later (at week 32). Volunteers were encouraged not to use medications or other therapies for CP/CPPS during the trial period (for 32 weeks). Various assessments were conducted to measure primary and secondary outcome during the trial. The NIH-CPSI was conducted on weeks 1 to 8, 20, and 32. This tool measures urinary function, pain, and effect on quality of life. The Global Response Assessment (GRA) measures subjective improvement. The International Index of Erectile Function-5 (IIEF-5) together with the GRA was administered at week 4, 8, 20, and 32. The International Prostate Symptom Score (IPSS), the EuroQol 5 Dimension 5 Level (EQ-5D-5L) [measuring general health status], and the Hospital Anxiety and Depression Scale (HADS) [measuring anxiety and depression] were given at weeks 8, 20, and 32. Adverse events were documented by both participants and researchers. Response to treatment was assessed via NIH-CPSI following treatment at week 8 and at the end of follow up at week 32. Significant between- group difference had to be observed at both week 8 and week 32 to determine efficacy of treatment. A six-point reduction in NIH-CPSI score from baseline was the primary outcome.

A total of 440 eligible males were randomly assigned to receive either sham acupuncture or acupuncture, of which 414 participants completed the trial. At week 8, 60.6% of participants in the acupuncture group experienced a decrease of 6 points or more on the NIH-CPSI versus 36.8% of participants in the sham group (OR= 2.6, p<0.001). By week 32, 61.5% of participants in the acupuncture group experienced a decrease of 6points of more on the NIH-CPSI versus 38.3% of participants in the sham group (OR= 2.6, p<0.001). The average reduction in NIH-CPSI score was more than 6 points in the treatment group and continued through the follow-up period. Participants in the treatment group showed improvement in their GRA, IPSS, EQ-5D-5L, and HADS assessments. No changes were observed in the IIEF-5 assessment. Mild adverse events occurred in both the acupuncture (n=20) and sham (n=14) groups. Serious adverse events were not reported in either group.

This trial showed that 20 sessions of acupuncture for 30 minutes over 8 weeks was effective in relieving symptoms of chronic prostatitis and chronic pelvic pain syndrome in men. Also, treatment effects persisted even 24 weeks after treatment. Further studies are needed to verify these findings.

Source: Sun, Yuanjie, Yan Liu, Baoyan Liu, Kehua Zhou, Zenghui Yue, Wei Zhang, Wenbin Fu et al. “Efficacy of acupuncture for chronic Prostatitis/Chronic pelvic pain syndrome: a randomized trial.” Annals of Internal Medicine 174, no. 10 (2021): 1357-1366.

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Posted January 27, 2022.

Chrystal Moulton BA, PMP, is a 2008 graduate of the University of Illinois at Chicago. She graduated with a bachelor’s in psychology with a focus on premedical studies and is a licensed project manager. She currently resides in Indianapolis, IN.

References:

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