Management of chronic prostatitis/chronic pelvic pain syndrome

1.7 (95% confidence interval [CI], 2.8 to 0.6), 1.1 (95% CI, 1.8 to 0.3), 1.4 (95% CI, 2.3 to 0.5), and 1.0 (95% CI, 1.8 to 0.2), respectively. Patients receiving -blockers or anti-inflammatory medications had a higher chance of favorable response compared with placebo, with pooled RRs of 1.6 (95% CI, 1.1-2.3) and 1.8 (95% CI, 1.2-2.6), respectively. Contour-enhanced funnel plots suggested the presence of publication bias for smaller studies of -blocker therapies. The network meta-analysis suggested benefits of antibiotics in decreasing total symptom scores (9.8; 95% CI, 15.1 to 4.6), pain scores (4.4; 95% CI, 7.0 to 1.9), voiding scores (2.8; 95% CI, 4.1 to 1.6), and quality-of-life scores (1.9; 95% CI, 3.6 to 0.2) compared with placebo. Combining-blockers and antibiotics yielded the greatest benefits compared with placebo, with corresponding decreases of 13.8 (95% CI, 17.5 to 10.2) for total symptom scores, 5.7 (95% CI, 7.8 to 3.6) for pain scores, 3.7 (95% CI, 5.2 to 2.1) for voiding, and 2.8 (95% CI, 4.7 to 0.9) for quality-of-life scores. Conclusions -Blockers,antibiotics,andcombinationsofthesetherapiesappeartoachieve the greatest improvement in clinical symptom scores compared with placebo. Antiinflammatory therapies have a lesser but measurable benefit on selected outcomes. However, beneficial effects of -blockers may be overestimated because of publication bias.