Interventions for chronic abacterial prostatitis

  • Review
  • Intervention




Chronic abacterial prostatitis is a common disabling but enigmatic condition with a symptom complex of pelvic area pain and lower urinary tract symptoms. The scope of treatments recommended for chronic abacterial prostatitis is a testament to how little is known about what causes the condition and how to treat it. As a result, chronic abacterial prostatitis often causes physician frustration, patient confusion and dissatisfaction, variable thresholds for referral, and potentially inappropriate antibiotic use.


Examine the evidence regarding the effectiveness of therapies for chronic abacterial prostatitis.

Search methods

Studies were identified through a search of MEDLINE (1966 to 2000), the Cochrane Library, bibliographies of identified articles and reviews, and contact with an expert.

Selection criteria

Studies were eligible if they: (1) are randomized controlled trials (RCTs) or controlled clinical trials (CCTs) (2) involve men with chronic abacterial prostatitis (3) control group receives placebo, sham intervention, active pharmacologic or device therapy for chronic abacterial prostatitis and (4) outcomes data are provided. Eligibility was assessed by at least two independent observers.

Data collection and analysis

Study information on patients, interventions, and outcomes was extracted independently by two reviewers. The main outcome was the efficacy of treatment for chronic abacterial prostatitis versus control in improving urologic symptom scale scores or global report of urinary tract symptoms. Secondary outcomes included changes in the prostate examination, uroflowmetry, urodynamics, analysis of urine, expressed prostatic secretions and seminal fluid, and prostate ultrasonography.

Main results

The 15 treatment trials involved: medications used to treat benign prostatic hyperplasia (n = 4 trials); anti-inflammatory medications (n = 2 trials); antibiotics (n = 1 trial); thermotherapy (n = 5 trials); and miscellaneous medications (n = 3 trials). The disparity between studies did not permit quantitative analysis. There were a total of 600 enrollees (age range 38 to 45). All but one of the trials were done outside the United States.

Authors' conclusions

The treatment trials are few, weak methodologically, and involve small sample sizes. The routine use of antibiotics and alpha blockers for chronic abacterial prostatitis is not supported by the existing evidence. The small studies examining thermal therapy appear to demonstrate benefit of clinical significance and merit further evaluation. Additional treatment trials are required and they should report important patient characteristics (e.g., race), study design details and utilize clinically relevant and validated assessment measures.










文獻選擇條件如下: (1)隨機對照試驗或對照性臨床試驗、(2)參與者需為慢性非細菌性前列腺炎之男性患者、(3)對照組要接受安慰劑治療,或是接受與慢性非細菌性前列腺炎同樣的積極藥物與治療措施、(4)有治療結果的資料。所有的資料皆由至少兩位獨立的審查者來審查。




15組治療試驗包含:治療良性前列腺肥大的藥物(4組);抗發炎藥物(2組);抗生素(1組);熱療法(5組)及其它藥物治療(3組)。而不同研究之間的差異是無法做量化比較。總共有600受試者參加(年齡範圍 38−45),只有一個試驗不在美國執行,其他試驗都在美國境內執行。


這治療試驗的理論基礎很薄弱,且樣本數也很小。並無現有證據來支持例行性使用抗生素及α阻斷劑來治療慢性非細菌性前列腺炎。一小部分熱療法的研究發現,臨床上似乎有一些效果,值得進一步的評估。進一步的臨床試驗是有需要的,而且必須要報告病人的重要特徵(例如: 種族)、詳細的實驗設計、臨床上的相關運用,和效度的評估方法。



此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。


只有少數的證據顯示,抗生素及α阻斷劑可以幫助緩解慢性非細菌性前列腺炎,但是,熱療法似乎比較有效,可是還是需要更多的研究證明。 慢性非細菌性前列腺炎是指前列腺組織發炎,並且常常影響各種年紀的男人。慢性非細菌性前列腺炎能引起的尿路症狀,包括不舒服和排尿疼痛、頻尿和急尿、或膀胱排空有問題。對大多數的病人而言,慢性非細菌性前列腺炎都查不出病因。慢性非細菌性前列腺炎的治療,包括熱療法(使用微波)和使用許多不同種類的藥物。調查發現只有少數的證據支持例行性抗生素及α阻斷劑,來治療慢性非細菌性前列腺炎,比較起來,熱療法是比較有效的治療方式。然而, 這少數有關熱療法的研究品質通常都不好,因此,更多有關熱療法的研究是有需要的。

Plain language summary

Little evidence that antibiotics or alpha-blocker drugs help to relieve chronic abacterial prostatitis, but heat treatments might be effective and more research is needed.

Chronic abacterial prostatitis (CAP) involves inflammation of the prostate gland and commonly affects men of all ages. It can cause problems urinating, including discomfort and pain, increased frequency and urge, or problems emptying the bladder. In most cases, the cause is unknown. Treatments for CAP include heat treatments (using microwaves) and several different types of drugs. The review found that there is little evidence to support the routine use of antibiotic or alpha-blocking drugs for CAP. Heat treatments in comparison may be useful. However, the few studies that have been performed are generally of poor quality. More studies are needed.