Skip to main content

Advertisement

SpringerLink
Log in

Alternative therapies in the management of chronic prostatitis/chronic pelvic pain syndrome

  • Topic Paper
  • Published:
World Journal of Urology Aims and scope Submit manuscript

Abstract

Purpose

Standard medical therapy for Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) including such agents as nonsteriodal anti-inflammatories, alpha-blockers, antimicrobial therapy, and 5a-reductase inhibitors has not been uniformly effective. The purpose of this review is to focus on the role of alternative therapies available for the management of CP/CPPS.

Methods

We performed a systematic review of the literature for articles published in PubMed up to 2012 pertaining to commonly employed alternative therapies.

Results

The evidence for alternative therapies such as diet and lifestyle modifications, phytotherapy, acupuncture, myofascial physical therapy, and stress management/cognitive behavioral therapy is reviewed.

Conclusion

CP/CPPS often requires a multimodal approach and alternative therapies should be considered as adjuncts in the treatment of refractory CP/CPPS patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. McNaughton Collins M, Pontari MA, O’Leary MP, Calhoun EA, Santanna J, Landis JR, Kusek JW, Litwin MS (2001) Quality of life is impaired in men with chronic prostatitis: the chronic prostatitis collaborative research network. J Gen Intern Med 16(10):656–662

    Article  PubMed  CAS  Google Scholar 

  2. Schaeffer AJ (2006) Clinical practice. Chronic prostatitis and the chronic pelvic pain syndrome. N Engl J Med 355(16):1690–1698. doi:10.1056/NEJMcp060423

    Article  PubMed  CAS  Google Scholar 

  3. Shoskes DA, Katz E (2005) Multimodal therapy for chronic prostatitis/chronic pelvic pain syndrome. Curr Urol Rep 6(4):296–299

    Article  PubMed  Google Scholar 

  4. Nickel JC, Downey J, Ardern D, Clark J, Nickel K (2004) Failure of a monotherapy strategy for difficult chronic prostatitis/chronic pelvic pain syndrome. J Urol 172(2):551–554. doi:10.1097/01.ju.0000131592.98562.16

    Article  PubMed  Google Scholar 

  5. Herati AS, Shorter B, Tai J, Lesser M, Moldwin RM (2009) Differences in food sensitivities between female interstitial cystitis/painful bladder syndrome (IC/PBS) and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) patients. In: American Urological Association Chicago, p 22

  6. Shorter B, Lesser M, Moldwin RM, Kushner L (2007) Effect of comestibles on symptoms of interstitial cystitis. J Urol 178(1):145–152. doi:10.1016/j.juro.2007.03.020

    Article  PubMed  Google Scholar 

  7. Richards SC, Scott DL (2002) Prescribed exercise in people with fibromyalgia: parallel group randomised controlled trial. BMJ 325(7357):185

    Article  PubMed  Google Scholar 

  8. Giubilei G, Mondaini N, Minervini A, Saieva C, Lapini A, Serni S, Bartoletti R, Carini M (2007) Physical activity of men with chronic prostatitis/chronic pelvic pain syndrome not satisfied with conventional treatments–could it represent a valid option? The physical activity and male pelvic pain trial: a double-blind, randomized study. J Urol 177(1):159–165. doi:10.1016/j.juro.2006.08.107

    Article  PubMed  Google Scholar 

  9. Sato M, Miyazaki T, Kambe F, Maeda K, Seo H (1997) Quercetin, a bioflavonoid, inhibits the induction of interleukin 8 and monocyte chemoattractant protein-1 expression by tumor necrosis factor-alpha in cultured human synovial cells. J Rheumatol 24(9):1680–1684

    PubMed  CAS  Google Scholar 

  10. Loschen G, Ebeling L (1991) Inhibition of arachidonic acid cascade by extract of rye pollen. Arzneimittelforschung 41(2):162–167

    PubMed  CAS  Google Scholar 

  11. Wagenlehner FM, Bschleipfer T, Pilatz A, Weidner W (2011) Pollen extract for chronic prostatitis-chronic pelvic pain syndrome. Urol Clin North Am 38(3):285–292. doi:10.1016/j.ucl.2011.04.004

    Article  PubMed  Google Scholar 

  12. Guardia T, Rotelli AE, Juarez AO, Pelzer LE (2001) Anti-inflammatory properties of plant flavonoids. Effects of rutin, quercetin and hesperidin on adjuvant arthritis in rat. Farmaco 56(9):683–687

    Article  PubMed  CAS  Google Scholar 

  13. Wagenlehner FM, Schneider H, Ludwig M, Schnitker J, Brahler E, Weidner W (2009) A pollen extract (Cernilton) in patients with inflammatory chronic prostatitis-chronic pelvic pain syndrome: a multicentre, randomised, prospective, double-blind, placebo-controlled phase 3 study. Eur Urol 56(3):544–551. doi:10.1016/j.eururo.2009.05.046

    Article  PubMed  Google Scholar 

  14. Elist J (2006) Effects of pollen extract preparation Prostat/Poltit on lower urinary tract symptoms in patients with chronic nonbacterial prostatitis/chronic pelvic pain syndrome: a randomized, double-blind, placebo-controlled study. Urology 67(1):60–63. doi:10.1016/j.urology.2005.07.035

    Article  PubMed  Google Scholar 

  15. Buck AC, Rees RW, Ebeling L (1989) Treatment of chronic prostatitis and prostatodynia with pollen extract. Br J Urol 64(5):496–499

    Article  PubMed  CAS  Google Scholar 

  16. Monden K, Tsugawa M, Ninomiya Y, Ando E, Kumon H (2002) A Japanese version of the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI, Okayama version) and the clinical evaluation of cernitin pollen extract for chronic non-bacterial prostatitis. Nihon Hinyokika Gakkai Zasshi 93(4):539–547

    PubMed  Google Scholar 

  17. Shoskes DA, Zeitlin SI, Shahed A, Rajfer J (1999) Quercetin in men with category III chronic prostatitis: a preliminary prospective, double-blind, placebo-controlled trial. Urology 54(6):960–963

    Article  PubMed  CAS  Google Scholar 

  18. Paubert-Braquet M, Mencia Huerta JM, Cousse H, Braquet P (1997) Effect of the lipidic lipidosterolic extract of Serenoa repens (Permixon) on the ionophore A23187-stimulated production of leukotriene B4 (LTB4) from human polymorphonuclear neutrophils. Prostaglandins Leukot Essent Fatty Acids 57(3):299–304

    Article  PubMed  CAS  Google Scholar 

  19. Kaplan SA, Volpe MA, Te AE (2004) A prospective, 1-year trial using saw palmetto versus finasteride in the treatment of category III prostatitis/chronic pelvic pain syndrome. J Urol 171(1):284–288. doi:10.1097/01.ju.0000101487.83730.80

    Article  PubMed  Google Scholar 

  20. Plosker GL, Brogden RN (1996) Serenoa repens (Permixon). A review of its pharmacology and therapeutic efficacy in benign prostatic hyperplasia. Drugs Aging 9(5):379–395

    Article  PubMed  CAS  Google Scholar 

  21. Weisser H, Tunn S, Behnke B, Krieg M (1996) Effects of the sabal serrulata extract IDS 89 and its subfractions on 5 alpha-reductase activity in human benign prostatic hyperplasia. Prostate 28(5):300–306. doi:10.1002/(SICI)1097-0045(199605)28:5<300:AID-PROS5>3.0.CO;2-F

    Article  PubMed  CAS  Google Scholar 

  22. Nickel JC, Downey J, Pontari MA, Shoskes DA, Zeitlin SI (2004) A randomized placebo-controlled multicentre study to evaluate the safety and efficacy of finasteride for male chronic pelvic pain syndrome (category IIIA chronic nonbacterial prostatitis). BJU Int 93(7):991–995. doi:10.1111/j.1464-410X.2003.04766.x

    Article  PubMed  CAS  Google Scholar 

  23. Schaeffer AJ (2005) A randomized placebo-controlled multicentre study to evaluate the safety and efficacy of finasteride for male chronic pelvic pain syndrome (category IIIA chronic nonbacterial prostatitis). J Urol 173(3):845

    Google Scholar 

  24. Chen R, Nickel JC (2003) Acupuncture ameliorates symptoms in men with chronic prostatitis/chronic pelvic pain syndrome. Urology 61(6):1156–1159 discussion 1159

    Article  PubMed  Google Scholar 

  25. Lee SW, Liong ML, Yuen KH, Leong WS, Chee C, Cheah PY, Choong WP, Wu Y, Khan N, Choong WL, Yap HW, Krieger JN (2008) Acupuncture versus sham acupuncture for chronic prostatitis/chronic pelvic pain. Am J Med 121(1):79 e71–79 e77. doi:10.1016/j.amjmed.2007.07.033

    Article  Google Scholar 

  26. Lee SH, Lee BC (2009) Electroacupuncture relieves pain in men with chronic prostatitis/chronic pelvic pain syndrome: three-arm randomized trial. Urology 73(5):1036–1041. doi:10.1016/j.urology.2008.10.047

    Article  PubMed  Google Scholar 

  27. Zermann DH, Ishigooka M, Doggweiler R, Schmidt RA (1999) Neurourological insights into the etiology of genitourinary pain in men. J Urol 161(3):903–908

    Article  PubMed  CAS  Google Scholar 

  28. Hetrick DC, Ciol MA, Rothman I, Turner JA, Frest M, Berger RE (2003) Musculoskeletal dysfunction in men with chronic pelvic pain syndrome type III: a case-control study. J Urol 170(3):828–831. doi:10.1097/01.ju.0000080513.13968.56

    Article  PubMed  Google Scholar 

  29. Clemens JQ, Nadler RB, Schaeffer AJ, Belani J, Albaugh J, Bushman W (2000) Biofeedback, pelvic floor re-education, and bladder training for male chronic pelvic pain syndrome. Urology 56(6):951–955

    Article  PubMed  CAS  Google Scholar 

  30. Cornel EB, van Haarst EP, Schaarsberg RW, Geels J (2005) The effect of biofeedback physical therapy in men with chronic pelvic pain syndrome type III. Eur Urol 47(5):607–611. doi:10.1016/j.eururo.2004.12.014

    Article  PubMed  Google Scholar 

  31. Lavelle ED, Lavelle W, Smith HS (2007) Myofascial trigger points. Anesthesiol Clin 25(4):841-851, vii-iii. doi:10.1016/j.anclin.2007.07.003

    Google Scholar 

  32. Anderson RU, Sawyer T, Wise D, Morey A, Nathanson BH (2009) Painful myofascial trigger points and pain sites in men with chronic prostatitis/chronic pelvic pain syndrome. J Urol 182(6):2753–2758. doi:10.1016/j.juro.2009.08.033

    Article  PubMed  Google Scholar 

  33. Anderson RU, Wise D, Sawyer T, Chan C (2005) Integration of myofascial trigger point release and paradoxical relaxation training treatment of chronic pelvic pain in men. J Urol 174(1):155–160. doi:10.1097/01.ju.0000161609.31185.d5

    Article  PubMed  Google Scholar 

  34. Anderson RU, Wise D, Sawyer T, Chan CA (2006) Sexual dysfunction in men with chronic prostatitis/chronic pelvic pain syndrome: improvement after trigger point release and paradoxical relaxation training. J Urol 176(4 Pt 1):1534–1538. doi:10.1016/j.juro.2006.06.010 discussion 1538-1539

    Article  PubMed  Google Scholar 

  35. FitzGerald MP, Anderson RU, Potts J, Payne CK, Peters KM, Clemens JQ, Kotarinos R, Fraser L, Cosby A, Fortman C, Neville C, Badillo S, Odabachian L, Sanfield A, O’Dougherty B, Halle-Podell R, Cen L, Chuai S, Landis JR, Mickelberg K, Barrell T, Kusek JW, Nyberg LM (2009) Randomized multicenter feasibility trial of myofascial physical therapy for the treatment of urological chronic pelvic pain syndromes. J Urol 182(2):570–580. doi:10.1016/j.juro.2009.04.022

    Article  PubMed  Google Scholar 

  36. Anderson R, Wise D, Sawyer T, Nathanson BH (2011) Safety and effectiveness of an internal pelvic myofascial trigger point wand for urologic chronic pelvic pain syndrome. Clin J Pain 27(9):764–768. doi:10.1097/AJP.0b013e31821dbd76

    Article  PubMed  Google Scholar 

  37. Clemens JQ, Brown SO, Calhoun EA (2008) Mental health diagnoses in patients with interstitial cystitis/painful bladder syndrome and chronic prostatitis/chronic pelvic pain syndrome: a case/control study. J Urol 180(4):1378–1382. doi:10.1016/j.juro.2008.06.032

    Article  PubMed  Google Scholar 

  38. Walz J, Perrotte P, Hutterer G, Suardi N, Jeldres C, Benard F, Valiquette L, Karakiewicz PI (2007) Impact of chronic prostatitis-like symptoms on the quality of life in a large group of men. BJU Int 100(6):1307–1311. doi:10.1111/j.1464-410X.2007.07250.x

    Article  PubMed  Google Scholar 

  39. Ullrich PM, Turner JA, Ciol M, Berger R (2005) Stress is associated with subsequent pain and disability among men with nonbacterial prostatitis/pelvic pain. Ann Behav Med 30(2):112–118. doi:10.1207/s15324796abm3002_3

    Article  PubMed  Google Scholar 

  40. Miller HC (1988) Stress prostatitis. Urology 32(6):507–510

    Article  PubMed  CAS  Google Scholar 

  41. Nickel JC, Mullins C, Tripp DA (2008) Development of an evidence-based cognitive behavioral treatment program for men with chronic prostatitis/chronic pelvic pain syndrome. World J Urol 26(2):167–172. doi:10.1007/s00345-008-0235-6

    Article  PubMed  Google Scholar 

  42. Tripp DA, Nickel JC, Katz L (2011) A feasibility trial of a cognitive-behavioural symptom management program for chronic pelvic pain for men with refractory chronic prostatitis/chronic pelvic pain syndrome. Can Urol Assoc J 5(5):328–332. doi:10.5489/cuaj.10201

    Article  PubMed  Google Scholar 

  43. Yavascaoglu I, Oktay B, Simsek U, Ozyurt M (1999) Role of ejaculation in the treatment of chronic non-bacterial prostatitis. Int J Urol 6(3):130–134

    Article  PubMed  CAS  Google Scholar 

Download references

Conflict of interest

The authors have no conflict of interest to disclose.

Author information

Authors and Affiliations

  1. Smith Institute for Urology, Hofstra North Shore LIJ School of Medicine, Lake Success, New York, NY, USA

    Amin S. Herati & Robert Miles Moldwin

Authors
  1. Amin S. Herati
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Robert Miles Moldwin
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Robert Miles Moldwin.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Herati, A.S., Moldwin, R.M. Alternative therapies in the management of chronic prostatitis/chronic pelvic pain syndrome. World J Urol 31, 761–766 (2013). https://doi.org/10.1007/s00345-013-1097-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00345-013-1097-0

Keywords

Search

Navigation