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Cited by 50Urinary Bladder and Prostate ResearchPelvic floor disorders treatmentsSexual function and dysfunction studies

The DOI matches its Crossref record; 32 of the 32 references it cites were found in a registry or an index.

Chronic Prostatitis and/or Chronic Pelvic Pain as a Psychoneuromuscular Disorder—A Meta-analysis

Anderson, Rodney U., Wise, David, Nathanson, Brian H.·2018·Urology
DOI 10.1016/j.urology.2018.07.022
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Abstract

Objective To evaluate effectiveness of physical therapy, biofeedback, and/or cognitive behavioral therapy for chronic prostatitis/chronic pelvic pain syndrome (CP and/or CPPS). This symptom complex has resisted resolution from conventional urologic treatment of the prostate, which includes antibiotics, alpha-blockers, and analgesics. Beginning in 1995, a new paradigm was introduced viewing CP and/or CPPS as a psychoneuromuscular disorder driven by protective pelvic floor guarding and psychosocial stress.Methods A literature search (PubMed, Google Scholar, and the Cochran Library) was conducted from inception through December 2017 using key words related to CP and/or CPPS (eg, prostatitis and pelvic pain) with physical therapy (eg, myofascial trigger point release) and/or biofeedback or cognitive behavioral treatment. Studies were required to include pre- and post-treatment with the National Institutes of Health Chronic Prostatitis Symptom Index (CPSI) scores.Results Eight studies inclusive of 280 patients met primary inclusion criteria. Study sample sizes ranged from 8 to 116 men (mean = 35); treatment duration ranged from 8 to 26 weeks (mean = 14). Pretreatment mean CPSI scores ranged from 21.7 to 33.5. The nonstandardized weighted mean reduction of CPSI score from baseline was 8.8 points; 95% confidence interval (7.5, 11.1); P <.001. The I 2 statistic = 18.5% indicating little heterogeneity between studies. A sensitivity analysis including an additional multimodal intervention study of with 100 patients produced similar findings.Conclusion Conventional medical treatment often fails to resolve CP and/or CPPS. A 6-point reduction in CPSI score is considered a clinically meaningful improvement of symptoms. This meta-analysis shows that treating CP and/or CPPS as a psychoneuromuscular disorder can significantly exceed this clinical threshold.

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Crossref · 10.1016/j.urology.2018.07.022

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Metadata

Authors
Anderson, R. U., Wise, D., & Nathanson, B. H.
Affiliations
Stanford Medicine (US)
Corresponding author
Anderson, Rodney U.
ORCID
Venue
Urology
Publisher
Elsevier BV
Published
2018-10
Volume
120
Pages
23-29
ISSN
0090-4295 (ISSN-L)
DOI
10.1016/j.urology.2018.07.022
OpenAlex
W2884475019
Cited by
50
References
32
Citations by year
2026: 5 · 2025: 1 · 2024: 9 · 2023: 14 · 2022: 2 · 2021: 5 · 2020: 8 · 2019: 6
FWCI
1.12
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Urology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Urology › Urinary Bladder and Prostate Research
  • Health Sciences › Medicine › Urology › Pelvic floor disorders treatments
  • Health Sciences › Medicine › Psychiatry and Mental health › Sexual function and dysfunction studies
Keywords
chronic prostatitis, physiotherapy, biofeedback, cognitive behavioral therapy, Chronic Prostatitis Symptom Index, psychosocial stress
MeSH terms
Biofeedback, Psychology, Chronic Disease, Exercise Therapy, Humans, Male, Pain Measurement, Prostatitis, Severity of Illness Index, Cognitive Behavioral Therapy, Treatment Outcome, Pelvic Pain, Chronic Pain, Pain Management

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