title: [Chronic prostatitis/chronic pelvic pain syndrome. Influence of osteopathic treatment - a randomized controlled study].
abstract: BACKGROUND
  Prostatitis is the most common urological disease in males under [corrected] the age of 50 years old. As bacteria are detected in only <5% of cases the disease can mostly be classified as chronic nonbacterial prostatitis. The symptoms of this problem complex, often described as chronic prostatitis and chronic pelvic pain syndrome (CP-CPPS), seem to be multifactorial so that an improvement can only rarely be achieved with conventional forms of therapy.
  
  
  METHODS
  The aim of this study was to investigate whether osteopathic treatment can influence the symptoms of CP-CPPS (randomized controlled study, 5 sessions, follow-up after 6 weeks and 1.5 years without treatment). The study was carried out in a practice for osteopathy. Patients were recruited by referral from urologists, newspaper articles and lectures on the topic. A total of 35 males with medically diagnosed CP-CPPS aged 29-70 years old took part in the study. Of the patients 20 were allocated to the treatment group and 15 to the placebo group whereby 2 patients had to retire from the study prematurely. Patients in the treatment group received 5 osteopathic treatment sessions separated by 1 week at the beginning and by up to 3 weeks at the end (total period 8 weeks). The osteopathic dysfunctions of the patients were treated according to the principles of osteopathy. The placebo treatment in the control group consisted of a training program with simple gymnastic and physiotherapeutic exercises. Improvements of the complaints by urination (LUTS), chronic pelvic pain (CPPS) and quality of life (QOL) were measured using the questionnaires for international prostate symptom score (IPSS), the National Institutes of Health chronic prostatitis symptom index (NIH-CPSI) and the quality of life index (QOL).
  
  
  RESULTS
  Comparison of the results from the osteopathy and placebo groups revealed statistically significant differences in favor of the osteopathy group (p<0.0005). During the study period the average IPSS in the osteopathy group improved from 19.7 to 10.3 points (48%, p<0.0005), the NIH from 26.0 to 12.0 (54%; p<0.0005) and the QOL from 4.4 to 1.9 points (58%, p<0.0005). In contrast the corresponding values in the placebo group remained relatively constant. At the follow-up 6 weeks after the last session the improvements in the osteopathy group were found to be stabile and remained so at least up to the second follow-up after 1.5 years.
  
  
  CONCLUSIONS
  The positive results of this study indicate that osteopathic treatment can be considered a genuine alternative to the conventional treatment of CP-CPPS and a closer cooperation between urologists/internists and osteopaths would be desirable. Further studies with larger numbers of patients should be carried out to substantiate these results.
authors.affiliation: Praxis Osteopathie und Naturheilkunde, Alte Talstrasse, Esslingen, Deutschland. info@osteopathie-marx.de
authors.forename: S
authors.initials: S
authors.lastname: Marx
authors.forename: U
authors.initials: U
authors.lastname: Cimniak
authors.forename: R
authors.initials: R
authors.lastname: Beckert
authors.forename: F
authors.initials: F
authors.lastname: Schwerla
authors.forename: K L
authors.initials: KL
authors.lastname: Resch
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D026301:Manipulation, Osteopathic / Q000379:methods*; D008875:Middle Aged; D010348:Patient Care Team; D017060:Patient Satisfaction; D017699:Pelvic Pain / Q000523:psychology / Q000628:therapy*; D011472:Prostatitis / Q000523:psychology / Q000628:therapy*; D011788:Quality of Life / Q000523:psychology; D011795:Surveys and Questionnaires
references.citation: Br J Urol. 1990 Jun;65(6):598-605
references.pmid: 2196972
references.citation: Urology. 2003 Jun;61(6):1156-9; discussion 1159
references.pmid: 12809886
references.citation: J Endourol. 2004 Apr;18(3):227-31
references.pmid: 15225385
references.citation: Clin Microbiol Rev. 1998 Oct;11(4):604-13
references.pmid: 9767058
references.citation: Curr Urol Rep. 2000 Aug;1(2):155-8
references.pmid: 12084330
references.citation: Int J Urol. 2003 Dec;10(12):636-42
references.pmid: 14633066
references.citation: J Urol. 2004 Sep;172(3):839-45
references.pmid: 15310980
references.citation: Dtsch Arztebl Int. 2009 Mar;106(11):175-83
references.pmid: 19568373
references.citation: Pain. 1997 Feb;69(3):213-218
references.pmid: 9085294
references.citation: J Eur Acad Dermatol Venereol. 2002 May;16(3):253-6
references.pmid: 12195565
references.citation: Ann Intern Med. 2000 Sep 5;133(5):367-81
references.pmid: 10979882
references.citation: Curr Urol Rep. 2002 Aug;3(4):330-4
references.pmid: 12149166
references.citation: Br J Urol. 1989 Nov;64(5):496-9
references.pmid: 2692777
references.citation: J Am Osteopath Assoc. 1982 Dec;82(4):267-71
references.pmid: 6185460
references.citation: Urologe A. 2001 Jan;40(1):4-8
references.pmid: 11225430
references.citation: Postgrad Med. 1975 Nov;58(6):96-104
references.pmid: 1181582
references.citation: Can J Urol. 2001 Jun;8 Suppl 1:24-8
references.pmid: 11442994
references.citation: Urologe A. 2004 Mar;43(3):254-60
references.pmid: 15045182