Little evidence for drugs in prostatitis

There is very little evidence of benefit for pharmacological interventions in the management of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), according to a Cochrane meta-analysis.

The analysis included 99 unique studies of 16 treatments in 9119 men with CP/CPPS.

The authors found low‐ to very low‐quality evidence that alpha-blockers, antibiotics, finasteride, anti‐inflammatories, phytotherapy, intraprostatic botulinus toxin injection, and traditional Chinese medicine may cause a reduction in prostatitis symptoms.

There were few studies for most of the interventions, the highest number being for alpha-blockers with 24 studies. There were few trials with active comparators and little evidence of the effects of the drugs on sexual dysfunction, quality of life or anxiety and depression.

Although of low efficacy most of the interventions were well tolerated, except for alpha-blockers which were associated with an increase in mild adverse events.

CP/CPPS is a relatively common disorder in men in which the two main clinical features are pelvic pain and lower urinary tract symptoms. It can be debilitating and difficult to manage in practice. The review authors call for better and higher quality studies.

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