Le Brian, Schaeffer Anthony J
Department of Urology, Northwestern University Medical Centre, Chicago, USA.
BMJ Clin Evid. 2011 Jul 4;2011:1802.
Chronic prostatitis can cause pain and urinary symptoms, and usually occurs without positive bacterial cultures from prostatic secretions (known as chronic abacterial prostatitis or chronic pelvic pain syndrome [CP/CPPS]). Bacterial infection can result from urinary tract instrumentation, but the cause and natural history of CP/CPPS are unknown.
We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatments for chronic bacterial prostatitis? What are the effects of treatments for chronic abacterial prostatitis/chronic pelvic pain syndrome? We searched: Medline, Embase, The Cochrane Library, and other important databases up to August 2010 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
We found 33 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
In this systematic review, we present information relating to the effectiveness and safety of the following interventions: 5 alpha-reductase inhibitors, allopurinol, alpha-blockers, biofeedback, local injections of antimicrobial drugs, mepartricin, non-steroidal anti-inflammatory drugs (NSAIDs), oral antimicrobial drugs, pentosan polysulfate, prostatic massage, quercetin, radical prostatectomy, sitz baths, transurethral microwave thermotherapy, and transurethral resection.
慢性前列腺炎可导致疼痛和泌尿系统症状，通常在前列腺分泌物细菌培养无阳性结果时发生（称为慢性非细菌性前列腺炎或慢性盆腔疼痛综合征[CP/CPPS]）。尿路感染可由尿路器械操作引起，但CP/CPPS的病因和自然病程尚不清楚。
我们进行了一项系统评价，旨在回答以下临床问题：慢性细菌性前列腺炎的治疗效果如何？慢性非细菌性前列腺炎/慢性盆腔疼痛综合征的治疗效果如何？我们检索了：截至2010年8月的医学期刊数据库（Medline）、循证医学数据库（Embase）、考克兰图书馆及其他重要数据库（《临床证据》综述会定期更新；请查阅我们的网站获取本综述的最新版本）。我们纳入了来自美国食品药品监督管理局（FDA）和英国药品及医疗保健产品监管局（MHRA）等相关组织的危害警示。
我们找到了33项符合我们纳入标准的系统评价、随机对照试验或观察性研究。我们对干预措施的证据质量进行了GRADE评估。
在本系统评价中，我们提供了以下干预措施有效性和安全性的相关信息：5α还原酶抑制剂、别嘌醇、α受体阻滞剂、生物反馈疗法、局部注射抗菌药物、甲帕霉素、非甾体抗炎药（NSAIDs）、口服抗菌药物、戊聚糖多硫酸酯、前列腺按摩、槲皮素、根治性前列腺切除术、坐浴、经尿道微波热疗和经尿道切除术。
