From the publishers of The New England Journal of Medicine

Save time and stay informed. Our physician-editors offer you clinical perspectives on key research and news.

  1. Home>
  2. Specialties>
  3. General Medicine>
  4. Summary and Comment

Pharmacotherapy for Chronic Prostatitis/Pelvic Pain

Researchers tested antibiotic, {alpha}-blocker, and combination therapy in a randomized placebo-controlled trial.

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is common, but the cause often is unknown, and treatment usually is unsuccessful. In a North American trial, researchers enrolled 196 men at 10 urology outpatient clinics; all men had pelvic pain or discomfort for at least 3 months, but none had known genitourinary infections or cancers, prior prostate or bladder surgery, or inflammatory-bowel disease. Subjects were assigned randomly to receive the {alpha}-blocker tamsulosin (Flomax; 0.4 mg once daily), ciprofloxacin (500 mg twice daily), both drugs, or matching placebo for 6 weeks.

At 6 weeks, the groups did not differ significantly in pain, urinary symptoms, or quality of life, as assessed with a validated chronic prostatitis symptom index.

Comment: In 2000, the National Institutes of Health reached a consensus on how to categorize cases of chronic prostatitis (Journal Watch Nov 3 2000). At that time, no clear evidence existed that pharmacotherapy was helpful for CP/CPPS (Journal Watch Sep 26 2000). Data from the current, well-conducted study show that neither antibiotics nor {alpha}-blockers -- or at least not 6-week courses of ciprofloxacin or tamsulosin -- help patients with CP/CPPS. An editorialist notes that the results for the antibiotic confirm prior findings, but that two earlier studies of {alpha}-blockers (one lasting for 6 weeks, the other for 6 months) showed those drugs to be effective. Therefore, {alpha}-blockers still might have a role in CP/CPPS treatment.

— Richard Saitz, MD, MPH, FACP, FASAM

Published in Journal Watch General Medicine November 9, 2004

Citation(s):

Alexander RB et al. Ciprofloxacin or tamsulosin in men with chronic prostatitis/chronic pelvic pain syndrome: A randomized, double-blind trial. Ann Intern Med 2004 Oct 19; 141:581-9.

Weidner W. Treating chronic prostatitis: Antibiotics no, {alpha}-blockers maybe. Ann Intern Med 2004 Oct 19; 141:639-40.

Search

Advanced

Related Content

Sign-In

Forgot your password?

New to Journal Watch?

E-mail Alerts

Delivered to your inbox.
Tailored to your interests. Free.

Sign Up Now!

Journal Watch Newsletters

Available in 13 specialties with convenient delivery and 10 free online CME exams.

Subscribe Now!

Copyright © 2004. Massachusetts Medical Society. All rights reserved.