Acupuncture may improve symptoms of chronic prostatitis/chronic pelvic pain syndrome
A trial in China found significantly more symptom improvements among men randomized to 20 sessions of acupuncture over eight weeks compared to those who received sham treatment.
Twenty sessions of acupuncture over eight weeks were associated with greater improvement in symptoms of moderate to severe chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) compared with sham therapy, a study found.
To assess the long-term efficacy of acupuncture for CP/CPPS, researchers conducted a trial at 10 tertiary hospitals in China. A total of 440 men with moderate to severe CP/CPPS, regardless of prior exposure to acupuncture, were randomized to either 20 sessions of acupuncture or sham acupuncture over eight weeks, with 24-week follow-up after treatment. The treatment was considered effective if a reduction of at least 6 points from baseline was achieved on the National Institutes of Health Chronic Prostatitis Symptom Index at weeks 8 and 32. Results were published by Annals of Internal Medicine on Aug. 17.
At all assessment points, more men in the acupuncture group reported marked or moderate improvements in symptoms. At week 8, a treatment response was seen in 60.6% (95% CI, 53.7% to 67.1%) of the acupuncture group and 36.8% (95% CI, 30.4% to 43.7%) of the sham group (adjusted difference, 21.6 percentage points [95% CI, 12.8 to 30.4 percentage points]; adjusted odds ratio, 2.6 [95% CI, 1.8 to 4.0]; P<0.001). At week 32, the proportions were 61.5% (95% CI, 54.5% to 68.1%) in the acupuncture group and 38.3% (95% CI, 31.7% to 45.4%) in the sham acupuncture group (adjusted difference, 21.1 percentage points [95% CI, 12.2 to 30.1 percentage points]; adjusted odds ratio, 2.6 [95% CI, 1.7 to 3.9]; P<0.001).
Twenty adverse events were reported in the acupuncture group and 14 were reported in the sham group (9.1% vs. 6.4%). None were serious, and no significant difference was seen in changes in International Index of Erectile Function 5 score at any assessment time points or in peak and average urinary flow rates at week 8. Treatment effects persisted during 24 weeks of follow-up.
The authors noted that the sham treatment exceeded the threshold for minimal clinically important difference (4 points) and that placebo effects are common due to interactions among patients, clinicians, and the treatment environment. Also, superficial needling at nonacupoints may still have physiologic effects, they noted. However, they concluded that the trial “showed long-term efficacy of acupuncture and provides high-quality evidence for clinical practice and guideline recommendations.”