Bowen Diana K, Dielubanza Elodi, Schaeffer Anthony J
Department of Urology, Northwestern University, Feinberg School of Medicine, Chicago, US.
BMJ Clin Evid. 2015 Aug 27;2015:1802.
Chronic prostatitis can cause pain and urinary symptoms, and can occur either with an active infection (chronic bacterial prostatitis [CBP]) or with only pain and no evidence of bacterial causation (chronic pelvic pain syndrome [CPPS]). Bacterial prostatitis is characterised by recurrent urinary tract infections or infection in the prostate with the same bacterial strain, which often results from urinary tract instrumentation. However, the cause and natural history of CPPS are unknown and not associated with active infection.
We conducted a systematic overview 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 pelvic pain syndrome? We searched: Medline, Embase, The Cochrane Library, and other important databases up to February 2014 (Clinical Evidence overviews are updated periodically; please check our website for the most up-to-date version of this overview).
At this update, searching of electronic databases retrieved 131 studies. After deduplication and removal of conference abstracts, 67 records were screened for inclusion in the overview. Appraisal of titles and abstracts led to the exclusion of 51 studies and the further review of 16 full publications. Of the 16 full articles evaluated, three systematic reviews and one RCT were included at this update. We performed a GRADE evaluation for 14 PICO combinations.
In this systematic overview, we categorised the efficacy for 12 interventions based on information relating to the effectiveness and safety of 5 alpha-reductase inhibitors, allopurinol, alpha-blockers, local injections of antimicrobial drugs, mepartricin, non-steroidal anti-inflammatory drugs (NSAIDs), oral antimicrobial drugs, pentosan polysulfate, quercetin, sitz baths, transurethral microwave thermotherapy (TUMT), and transurethral resection of the prostate (TURP).
慢性前列腺炎可导致疼痛和泌尿系统症状，可在存在活动性感染时发生（慢性细菌性前列腺炎[CBP]），也可仅有疼痛而无细菌感染的证据（慢性盆腔疼痛综合征[CPPS]）。细菌性前列腺炎的特征是复发性尿路感染或前列腺感染相同的细菌菌株，这通常由泌尿系统器械操作引起。然而，CPPS的病因和自然病史尚不清楚，且与活动性感染无关。
我们进行了一项系统综述，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？慢性盆腔疼痛综合征的治疗效果如何？我们检索了：截至2014年2月的Medline、Embase、Cochrane图书馆及其他重要数据库（临床证据综述会定期更新；请查看我们的网站获取本综述的最新版本）。
在本次更新时，检索电子数据库共获得131项研究。经过去重和去除会议摘要后，筛选了67条记录以纳入综述。对标题和摘要进行评估后排除了51项研究，并对16篇全文进行了进一步审查。在评估的16篇全文中，本次更新纳入了3篇系统评价和1项随机对照试验。我们对14种PICO组合进行了GRADE评估。
在本系统综述中，我们根据与5α还原酶抑制剂、别嘌醇、α受体阻滞剂、局部注射抗菌药物、美帕曲星、非甾体抗炎药（NSAIDs）、口服抗菌药物、戊聚糖多硫酸盐、槲皮素、坐浴、经尿道微波热疗（TUMT）和经尿道前列腺切除术（TURP）的有效性和安全性相关的信息，对12种干预措施的疗效进行了分类。
