Prostatitis is a common inflammatory condition that accounts for over two million doctor visits in the United States each year, but it receives little attention. Certain types of infections are caused by bacteria that are easily detectable and treatable with antibiotics. However, over 90% of the time, prostatitis symptoms (painful urination and ejaculation, pelvic pain, and sexual dysfunction) have no obvious cause. This condition is referred to as chronic nonbacterial prostatitis/chronic pelvic pain syndrome, abbreviated as CP/CPPS. Treatments are numerous. Antibiotics are sometimes prescribed first if the condition was preceded by a urinary tract infection. Additionally, they may recommend anti-inflammatory pain medications, stress-reduction techniques, pelvic floor exercises, and occasionally, drugs such as alpha-blockers, which relax the prostate and bladder muscles.
Acupuncture is another treatment option for some men. According to a 2018 review article, acupuncture has the potential to alleviate CP/CPPS symptoms without the side effects associated with drug treatments.
Now, results from a recently published clinical trial demonstrate that acupuncture-induced symptom relief is long-lasting. The findings, which were published in the prestigious journal Annals of Internal Medicine, are encouraging for people who suffer from CP/CPPS.
Acupuncture is a treatment that involves inserting single-use needles into "acupoints" throughout the body and manipulating them manually, with heat, or with electrical stimulation. The researchers at ten institutions in China randomly assigned 440 men with prostatitis to receive either real acupuncture or a control sham procedure in which the needles were inserted away from traditional acupoints for twenty sessions (over eight weeks).
Although the researchers were doctors, the treatments were administered by certified acupuncturists with a minimum of five years of undergraduate education and two years of clinical experience. The National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) was used to assess treatment benefits. The NIH-CPSI assigns scores for pain, urinary function, and quality of life. After eight weeks of treatment, the men were tracked for 24 weeks.
By week eight, slightly more than 60% of men in the acupuncture group reported significant symptom improvements (except for sexual dysfunction), compared to 37% of men in the sham group. Notably, these differences remained stable at week 32, indicating that the benefits of acupuncture remained consistent months after treatments began.
It is unclear precisely how acupuncture alleviates prostatitis symptoms. The authors of the study suggest several possible explanations, including that stimulation of acupoints induces the release of naturally occurring opioid-like chemicals (enkephalins, endorphins, and dynorphins) with pain-killing properties. Acupuncture may also have anti-inflammatory properties, and the psychological benefits of treatment may result in symptom improvement, the authors speculated.
This article from practitioners who are also experts in acupuncture is extremely welcome because research on prostatitis CPPS has been sparse and often disappointing," said Dr.Marc Garnick, Gorman Brothers Harvard Medical School, and Beth Israel Deaconess Medical Center Professor of Medicine, editor of the Harvard Health Publishing Annual Report on Prostate Diseases, and editor in chief of HarvardProstateKnowledge.org. Prostatitis can be caused by a variety of factors, many of which are unknown. Additionally, we do not fully understand how and why interventions that occasionally help alleviate troubling symptoms work. If someone is considering acupuncture, my advice is to ensure that the acupuncturist they choose is well trained and qualified to perform this potentially life-saving procedure."