The prostate is a small gland in men located at between the penis and bladder. The prostate can be inflamed called prostatitis which can be very painful and distressing. Prostatitis can develop in men of all ages. However, it commonly affects men aged between 30 and 50. It can be acute or chronic and it also can be caused by infection and non-infection. Chronic nonbacterial prostatitis is most common. It happens to about 20% men. About 90% men with chronic prostatitis have chronic prostatitis/chronic pelvic pain syndrome(CPPS). Chronic bacterial prostatitis is much less compared with chronic prostatitis/CPPS. The main symptoms of CPPS are pelvic and perineal pain lasting longer than 3 month. Pain can be in the perineum, testicles, tip of penis, pubic or bladder area and may spread out to the back and rectum. Post ejaculatory pain may be present. The cause of CP/CPPs is not clear, but it may be related to hormonal changes, autonomic nervous system imbalance , abnormal local or systemic inflammation, altered immune function and genetic factors. Stress could be a contributing factor for CP/CPPS. The treatments can be challenging with limited success.
The idea of acupuncture treatment for CP/CPPS has been accepted in Western countries. Capodice JL et al in USA investigated the effect of acupuncture on CP/CPPS. There were 10 men aged between 18-65 participated the study. They have been diagnosed with chronic prostatitis for greater 6 months, had at least 1 conventional therapy antibiotics, anti-inflammatory agents, 5-α reductase inhibitors or α-1 blockers), scoring >4 on the pain subset of the NIH-CPSI which was used to assess the severity of the CP/CPPS. After 3 weeks, 6 weeks of acupuncture treatment and 6 weeks of followup the NIH-CPSI scores were significantly decreased. Pain and urinary symptoms and quality of life were also significantly improved. No side effects were reported. They suggested that acupuncture cold be the effective treatment option for patients with CP/CPPS.
A case report: Acupuncture and TCM for the treatment of a 35 year old man with chronic prostatitis with chronic pelvic pain syndrome. A 35 year old man had chronic prostatitis with chronic pelvic pain syndrome. This man’s symptoms are very severe. He had 38 out of 43 scores on the NIH?CPSI which is the National Institutes of Health/Chronic Prostatis Symptom In dex. The Index is used for rating pain, urinary symptoms and quality of life impact. He also had experienced recurrent episodes of nonbacterial prostatitis over 3 years. This patient was given 8 acupuncture treatments over 8 weeks and plus some herb medicine Ba Zheng San and Yi Guan Jian daily. His symptoms scored 9 on the NIH/CPSI. After this he was advised to drink green tea. 4 months later his symptoms scored 4; 8 month later scored 2; and 1 year later scored 0. This patient had long term relief from chronic prostatitis with chronic pelvic pain syndrome benefited from 8 sessions of acupuncture treatments and herbs. This suggested acupuncture and herb medicine could be a treatment option for chronic prostatitis and chronic pelvic pain syndrome.
Why can acupuncture be used to treat chronic prostatitis/CPPS?
Acupuncture has been proved in effectively treating chronic prostatitis/CPPS. The mechanisms are also studied in current research to provide scientific evidence for the treatment and it is suggested that acupuncture reduces local inflammation and improves local microcirculation. Acupuncture was seen to increase immunoglobulin A in the prostatic fluids and improve local immune function of the prostate. It was also seen that interleukin-2 and testosterone, tumor necrosis factor-α (TNF-α) and the expression of intercellular adhesion molecule 1 (ICAM-1) were altered which were involved in inflammatory reaction. For example a recent study participated by 47 patients with CP/CPPS. After received acupuncture treatments pain or discomfort score decreased remarkably as compared with that before treatment. The levels of IL-8, IL-10 and TNF-alpha which were inflammatory markers were lower than those before treatment. The positive correlation was obtained between IL-10 level and pain score. They suggested that acupuncture has significant efficacy on CP/CPPS through reducing IL-10 level to ease pain, and reducing the levels of IL-8 and TNF-alpha to relieve inflammatory reaction.
Recently, a small sample clinic trial was conducted to investigate the mechanism of acupuncture underlying the treatment of chronic prostatitis/CPPS. 12 patients participated the study. Immune function tests were performed before and after 10 weeks acupuncture treatment. At the end of study 67% responded the treatments. The acupuncture group averaged a 5% increase in natural killer cell levels compared to control group. Similarly, patients randomized to acupuncture reported a reduction in other white blood cell parameters examined. This study supported the possibility that immunity might be important in the pathophysiology of CP/CPPS and suggested potential mechanism of acupuncture treatment.
Acupuncture helps to release pain and other symptoms of chronic prostatitis
There are two types of prostatitis: acute and chronic. chronic prostatitis is the most common type – where the symptoms come and go over a period of several months or longer. The symptoms of chronic prostatitis are the symptoms last at least three months. The symptoms include pain in and around the penis, testicles, anus, lower abdomen or low back; pain when urinating, frequent or urgent need to urinate; prostate can be enlarged and tender; sexual problems, such as erectile dysfunction, pain when ejaculating, or pelvic pain after intercourse. All of these symptoms have great impacts on quality of life.
Acupuncture is effective for prostatitis/chronic pelvic pain syndrome
Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is urologic pain or discomfort in the pelvic region lasting for at least 3 months during the preceding 6 months that is associated with urinary symptoms, and not accompanied by a urinary tract bacterial infection. CP/CPPS can impair both the physical and psychological function of patients and frequently diminishes their quality of life. There is lack of effective treatment for CP/CPPS, though a wide range of therapies have been routinely used to treat this condition; alpha-blockers and antibiotics are most commonly used in the clinic. Acupuncture is suggested to be effective for CP/CPPS. Recently an efficiency of acupuncture, alpha-blockers and antibiotics was compared. The results have shown that these treatments were better than placebo effect. Acupuncture has no side effect for the treatment.
Another research compared acupuncture with medication for chronic prostatitis. In this study, ninety patients were allocated into three groups: acupuncture, medication and acupuncture plus medication group. The acupuncture was given 30 min per treatment, once a day. Besides, oral administration of 0.2g levofloxacin (twice per day) and 0.2 mg tamsulosin (once a day) was applied. The patients in the acupuncture group and western medicine group were treated by acupuncture and western medicine respectively. 2 course acupuncture were applied. They found that acupuncture was effective to improve pain and other symptoms. Acupuncture had better effect than medication. Combination of acupuncture and medication had best effect.
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