A systematic review and meta-analysis of alpha-adrenergic antagonists for the treatment of pain in chronic prostatitis.

Abstract

Background: Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) is a debilitating condition affecting 2-10% of men globally. Its symptoms, including pelvic pain, urinary problems, and reduced quality of life, vary widely. Despite extensive research, a definitive treatment remains elusive. Alpha-adrenergic antagonists are frequently used to manage urinary symptoms, while analgesics are employed for pain. However, the long-term efficacy of alpha-adrenergic antagonists for pelvic pain requires further investigation. CP/CPPS places a significant burden on healthcare systems and the economy. This systematic review aims to evaluate the effectiveness of alpha-adrenergic antagonists in reducing pain symptoms in men with CP/CPPS compared to placebo.

Methods: A systematic search of randomized, placebo-controlled trials evaluating the effectiveness of alpha-adrenergic antagonists for the treatment of pain in CP/CPPS was conducted and captured all available studies (n = 680). After application of exclusion criteria, five studies were identified as suitable for inclusion.

Results: Four papers consisting of five studies, containing a total of 578 participants, were evaluated. The combined effects found no difference in pain relief between treated and control subjects for the data from the five studies in the meta-analysis (P = 0.106), with the 95% CI for the random effects model containing a value of 0.00.

Conclusion: In adults with CP/CPPS, alpha-adrenergic antagonists were ineffective as monotherapy to treat pain. Further studies are needed to address possible confounding variables for alpha-adrenergic antagonist efficacy. These findings suggest that alpha-adrenergic antagonists as monotherapy are not effective for pain reduction in CP/CPPS and highlight the need for further research to explore combination therapies or other treatment modalities.