title: Acupuncture for benign prostatic hyperplasia: A systematic review and meta-analysis.
abstract: OBJECTIVE
  This systematic review and meta-analysis aims to assess the therapeutic and adverse effects of acupuncture for benign prostatic hyperplasia (BPH) in randomized controlled trials (RCTs).
  
  
  METHODS
  We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library, MEDLINE, EMBASE, the Chinese Biomedical Database, the China National Knowledge Infrastructure, the VIP Database and the Wanfang Database. Parallel-group RCTs of acupuncture for men with symptomatic BPH were included. Data from the included trials were extracted by two independent reviewers and were analyzed with The Cochrane Collaboration Review Manager software (RevMan 5.3.5) after risk of bias judgments. The primary outcome measure of this review was a change in urological symptoms.
  
  
  RESULTS
  Eight RCTs, which involved 661 men with BPH, were included. Follow-up varied from 4 weeks to 18 months. Pooling of the data from three trials that compared acupuncture with sham-acupuncture revealed that in the short term (4-6 weeks), acupuncture can significantly improve IPSS (MD -1.90, 95% CI -3.58 to -0.21). A sensitivity analysis of the short-term endpoint showed the same result (MD -3.01, 95% CI -5.19 to -0.84) with a borderline minimal clinical important difference (MCID). Qmax of the short-term endpoint indicated statistically positive beneficial effects of acupuncture (MD -1.78, 95%CI -3.43, -0.14). A meta-analysis after medium-term follow-up (12-18 weeks) indicated no significant effect on IPSS when the data from two trials were combined (MD -2.04, 95% CI -4.19, 0.10).
  
  
  CONCLUSIONS
  Statistically significant changes were observed in favor of acupuncture in moderate to severe BPH with respect to short-term follow-up endpoints. The clinical significance of these changes needs to be tested by further studies with rigorous designs and longer follow-up times.
  
  
  BACKGROUND
  PROSPERO CRD42014013645.
authors.affiliation: Department of Acupuncture, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
authors.forename: Wei
authors.identifier: http://orcid.org/0000-0001-8541-8788
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Clinical Laboratory Center. Beijing Friendship Hospital, Capital Medical University, Beijing, China.
authors.forename: Liyan
authors.initials: L
authors.lastname: Ma
authors.affiliation: Department of Medicine. Mayo Clinic, Rochester, Minnesota, United States of America.
authors.forename: Brent A
authors.initials: BA
authors.lastname: Bauer
authors.affiliation: Department of Acupuncture, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
authors.forename: Zhishun
authors.initials: Z
authors.lastname: Liu
authors.affiliation: Department of Acupuncture, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
authors.forename: Yao
authors.initials: Y
authors.lastname: Lu
mesh_terms: D015670:Acupuncture Therapy / Q000009:adverse effects / Q000379:methods; D006801:Humans; D008297:Male; D011470:Prostatic Hyperplasia / Q000503:physiopathology / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome