Chronic Prostatitis/Chronic Pelvic Pain Syndrome: Treatment Options with Neuromodulatory Pharmacotherapy and Acupuncture

Abstract

Chronic prostatitis (CP)/chronic pelvic pain syndrome (CPPS) is a prevalent condition with complex pathogenesis, and the most effective treatment is still unknown. The negative impact of CP/CPPS on patient quality of life (QoL) is significant and represents a challenge for many clinicians. Additionally, studies have indicated a potential association between prostatitis and prostate cancer. Many pharmacologic and nonpharmacologic therapies have been utilized in everyday clinical practice, but the majority have demonstrated limited effectiveness in reducing symptoms. Current “firstline” pharmacology treatment options include antibiotics, anti-inflammatory, alpha-blockers, and 5-alpha reductase inhibitors as monoterapy or their combination, despite the fact that systematic reviews and meta-analyses show that many treatments for CP/CPPS are largely ineffective. Thus far, no highly effective therapy has been identified, and treatment strategies have focused on symptomatic relief. Evidence indicates that CP/CPPS may involve neuropathic pain to varying degrees, and neuromodulatory pharmacotherapy and acupuncture could therefore be considered as potential treatments for cases that are refractory to standard therapies.

Keywords

• Chronic prostatitis
• Chronic pelvic pain syndrome
• Neuromodulatory pharmacotherapy
• Acupuncture