The effect of alpha blockers monotherapy vs. combination antibiotic therapy on symptom alleviation in patients with chronic prostattitis/chronic pelvic pain syndrome

Abstract

Prostatitis is a pathologic state of prostate inflammation accompanied by lower urinary tract symptoms and pelvic pain, reducing the quality of life in males of all ages. There is currently no established treatment modality for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). In this review, alpha-blocker monotherapy was compared with combination antibiotic therapies. Alpha- blockers are the most commonly used medications to treat CPPS, administered to over 40% of CPPS patients. The use of antibiotics in CP/CPPS is an alternative treatment option. There are no studies showing the efficacy of antibiotics in CP/CPPS patients. However, antibiotics are commonly prescribed to patients with CP/CPPS, often leading to patient improvement. A combined regimen of alpha-blocker, antibiotic, and anti-inflammatory therapy showed improvement in patient symptoms; however, the results were similar to monotherapy with alpha-blockers. When alpha-blocker monotherapy was compared with three multidrug therapies via randomized controlled trials, monotherapy was shown to be more effective than multidrug treatment. There is no definite treatment for CP/CPPS because it is caused by various factors, and symptoms are different for each patient. CP/CPPS patient care should be managed in a manner that identifies and treats all symptoms simultaneously and appropriately. Recently, urinary, psychosocial, organ-specific, infection, neurologic/systemic, and tenderness (UPOINT) was introduced in order to better treat patients. However, UPOINT has not been extensively studied in clinical trials, and the mechanical principles of UPOINT have yet to be elucidated. Alpha-blocker monotherapy and antibiotic combination therapy showed considerable improvement in CP/CPPS patients (by National Institutes of Health Chronic Prostatitis Symptom Index scores).