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Alternative therapies for chronic prostatitis.

Prostatitis, characterized by pelvic discomtort, urinary symptoms, and/or sexual dysfunction, affects an estimated 9% of US men. Bacterial infection is the most prevalent cause of prostatitis; however, a case report from India shows that fungal infections can also cause the condition. When conventional treatment--typically antibiotics and/or anti-inflammatory drugs--fails to resolve the problem and other conditions such as cancer have been ruled out, conventional doctors have nothing more to offer. Men either continue to suffer or look for alternative therapies. Research studies support the use of pelvic floor muscle therapy and acupuncture for chronic prostatitis (CP), also known as chronic pelvic pain syndrome (CPPS). In addition, some doctors have had clinical success with elimination diets.

For some men, chronic pelvic discomfort is due to spasms of pelvic floor muscles. Biofeedback helps patients gain awareness and control over these muscles. In a 2011 review article, Lara K. Suh and Franklin C. Lowe present a 2005 study in which 31 men with CP/CPPS took part in 6 to 8 weeks of biofeedback physical therapy. Mean score on the National Institutes of Health Chronic Prostatitis Symptoms Index (NIH-CPSI) fell from 23.6 to 11.4 (p < 0.001). In addition, the research team, led by E. B. Cornel, used a rectal electromyography probe to measure pelvic floor muscle tonus. Mean pelvic floor muscle tonus fell from 4.9 mV to 1,7 mV (p < 0.001). Normal resting tone is <2mV. Myofascial trigger point release can also reduce pain caused by pelvic floor muscle spasms.

Acupuncture is another option for reducing CP/CPPS pain, according to Suh and Lowe. They cite a 2010 study, led by V. Tugcu, in which men with chronic pelvic pain syndrome were given weekly acupuncture sessions for six weeks. Total NIH-CPSI scores for 92.5% of the participants (86 of 93) declined by over 50% from baseline. Suh and Lowe report that the response rate "was unchanged" at the 12-week and 24-week follow-ups.

Although an elimination challenge diet has not been tested (to my knowledge) as a therapy for CP/CPPS, Mark W. McClure, MD, and Eric Yarnell, ND, have found the technique clinically useful for identifying foods that trigger pelvic pain. McClure says, "I often see a connection between some gastric malfunction, whether it is irritable bowel syndrome or a mild case of Crohn's disease, and prostatitis. So, I try to do an elimination-challenge diet to see what foods might be culprits in causing gastric problems and, directly or indirectly, causing pelvic discomfort."

When antibiotics (or antifungals) fail to help a patient with CPPS, it may be time to consider an alternative.

Srivastava SC, Srivastava AK. Homoeopathy a resonable [sic] alternative for treatment of fungal prostatitis-a case report. J Recent Adv Appl Sci. 2010;25:25-27. Available at www.jraas.org/25(7)25-27.pdf. Accessed April 25, 2012.

Suh LK, Lowe EC. Alternative therapies for the treatment of chronic prostatitis. Curr Urol Rep. 2011;12:284-287. Available at www.pnei_it.com/1/upload/alternative_therapies_for_chronic_prostatitis.pclf. Accessed April 25, 2012.

Tugcu V, Tas S, Eren G, et al. Effectiveness of acupuncture in patients with category IIIb chronic pelvic pain syndrome: a report of 97 patients [abstract]. Pain Med. April 2010:11(4):518-522. Available at www.ncbi.nlm.nih.gov/pubmed/20113410. Accessed May 6, 2012

Yarnell E, Espinosa G, McClure MW. Roundtable discussion--focus on men's health. Ahern Complement Ther. April 2010;16(2):77-82. Accessed from CINAHL database. April 18, 2012.
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Title Annotation:Shorts
Author:Klotter, Jule
Publication:Townsend Letter
Geographic Code:1USA
Date:Jul 1, 2012
Words:582
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