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Objective: To estimate the minimum clinically important difference (MCID) of the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) and the International Consultation on Incontinence Questionnaire-Lower Urinary Tract Symptoms Quality of Life (ICIQ-LUTSqol) using both anchor-based and distribution-based methods for women with stress urinary incontinence undergoing nonsurgical treatment.Materials and Methods: Data from a randomized clinical trial evaluating efficacy of a nonsurgical intervention in women with stress urinary incontinence were used for analyses. The overall score of ICIQ-UI SF ranges from 0 to 21, with greater values indicating increased severity. The ICIQ-LUTSqol ranges from 19 to 76, with greater values indicating increased impact on quality of life. Instruments used in the anchor-based method were the Patient Global Impression of Improvement, patient satisfaction, 1-hour pad test and the incontinence episode frequency. The distribution-based method used an effect size of 0.5 standard deviation. Triangulation of findings was used to converge on a single value of MCID.Results: At 12-month post-treatment, 106 (88.3%) participants completed the follow-up and were included in the analysis. Anchor-based MCIDs of the ICIQ-UI SF were between 3.4 and 4.4, while the distribution-based MCID was 1.7. Anchor-based MCIDs of the ICIQ-LUTSqol were between 4.8 and 6.9, while the distribution-based MCID was 5.2. Triangulation of findings showed that MCIDs of 4 for ICIQ-UI SF and 6 for ICIQ-LUTSqol were the most appropriate.Conclusion: For women undergoing nonsurgical treatments for incontinence, reductions of 4 and 6 points in ICIQ-UI SF and ICIQ-LUTSqol, respectively are perceived as clinically meaningful. [ABSTRACT FROM AUTHOR]

Objective To review measures used in recent randomised controlled trials (RCTs) evaluating stress urinary incontinence (SUI) treatments and to propose the most relevant outcome measure that should be included in future trials. Materials and methods We identified RCTs for SUI interventions published between January 2015 and July 2017. We listed the objective and subjective outcome measures used in eligible trials in the literature search. Using data from our RCT conducted from 2013 to 2016 evaluating pulsed magnetic stimulation for SUI, we analysed the correlation between all measures. Results A total of 45 RCTs were included; 28 (62%) involved surgical interventions. The most frequently used objective and subjective measures were the cough stress test and International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF), respectively. In all, 24 different validated questionnaires were administered in the 42 studies that used subjective outcome measure. Analyses of measures used in our trial showed that all measures were significantly correlated with each other except for pelvic floor muscle function. The ICIQ-UI SF showed the highest correlation coefficients (0.587-0.733) with all outcome measures. Conclusion The outcome measures used in recent trials were inconsistent. The ICIQ-UI SF had the highest correlation with all measures in our trial; however, further studies evaluating correlation of measures in other patient cohorts are needed to corroborate our present results. We propose the use of ICIQ-UI SF, as the most relevant outcome measure, in future trials evaluating efficacy of SUI interventions. [ABSTRACT FROM AUTHOR]

We prospectively evaluated the effects of pulsed magnetic stimulation (PMS) on sexual function of couples with stress urinary incontinence (SUI) partners. Female SUI subjects received 16 or 32 biweekly PMS sessions, depending on treatment response. Prior to, immediately after, and at 6-months posttreatment, couples completed the Golombok Rust Inventory of Sexual Satisfaction (GRISS) questionnaire. Fifty-three (80.3%) of 66 couples completed reassessments. Based on the overall GRISS score, there were significant improvements in sexual function in both female subjects (Mdiff -5.05, SE 1.34, p = 0.001) and their partners (Mdiff -3.42, SE 1.24, p = 0.026). Our findings suggest that PMS improved sexual function of SUI patients and their partners. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the correlation between sexual function of couples with and without stress urinary incontinence (SUI) partners, and to identify predictors of poor sexual function.Materials and Methods: A cross-sectional survey was conducted involving sexually active women with or without SUI aged at least 21 years old, and their respective partners. Both partners completed the Golombok Rust Inventory of Sexual Satisfaction (GRISS), a 28-item multidimensional measure with separate forms for male and female designed to assess sexual satisfaction of both partners. Spearman rank correlation coefficient was used to analyze bivariate association, whereas multiple regression analysis was used to identify predictors for overall sexual function as measured using GRISS score.Results: Sixty-six couples with SUI partners and 95 couples with continent partners were recruited. Overall GRISS scores and thus sexual function of men and women were strongly correlated. The correlation coefficient was higher in couples with SUI partners (r = 0.702, P <.001) compared with couples with continent partners (r = 0.629, P <.001), indicating a stronger correlation in the sexual function of couples with SUI partners. In multivariate analysis, poorer sexual function (lower GRISS score) in women, increasing age, and less frequency of sexual intercourse were significant predictors of poorer overall GRISS score in couples (P <.001).Conclusion: Female sexual function is strongly correlated with male partners' sexual function, with a stronger correlation observed in couples with SUI partners. Poorer sexual function in women, increasing age, and less frequency of sexual intercourse are predictive of poorer sexual function in a couple. [ABSTRACT FROM AUTHOR]

Objective To assess the impact of stress urinary incontinence (SUI) on individual components of quality of life (QoL) using both condition-specific and generic questionnaires, and to compare the results of the 2 instruments with a control group. Methods Women with or without SUI aged ≥21 years old were recruited. Subjects completed the International Consultation of Incontinence-Urinary Incontinence Short Form (ICIQ-UI-SF), International Consultation of Incontinence-Lower Urinary Tract Symptoms Quality of Life (ICIQ-LUTSqol), and EQ-5D questionnaires. Results A total of 120 women with SUI and 145 controls participated. The ICIQ-LUTSqol total score (mean ± standard deviation) was significantly higher in the SUI group (38.96 ± 10.28) compared with the control group (20.78 ± 2.73) ( P  <.001). When adjusted for significant confounders, the SUI group continued to have significantly poorer QoL compared with the control group ( P  <.001). The negative effect of SUI on “physical activities” and “jobs” were the 2 most frequently reported and burdensome components of the ICIQ-LUTSqol, with approximately 50% of women with SUI affected “moderately” or “a lot.” When measured using the EQ-5D questionnaire, there were significantly higher percentages of patients with SUI who had problems with usual activities, pain or discomfort, and anxiety or depression ( P  <.05). Conclusion Women suffering from SUI have significantly poorer QoL compared with continent women when measured using both condition-specific and generic QoL measures. Clinicians should pay closer attention to the impact of SUI on individual components of QoL, particularly limitations on physical activities and jobs, which were the 2 most impairing and frequently reported components of QoL. [ABSTRACT FROM AUTHOR]

Purpose Despite significant differences in success rates between surgical and nonsurgical treatments for female stress urinary incontinence, a few cross-sectional surveys showed that most patients still prefer the latter. We evaluated the efficacy of the under studied nonsurgical treatment using pulsed magnetic stimulation for female stress urinary incontinence. Materials and Methods This randomized, double-blind, sham controlled study was performed in 120 female subjects at least 21 years old with stress urinary incontinence. Treatment involved pulsed magnetic stimulation for 2 sessions per week for 2 months (16 sessions). After 2 months, subjects could opt for 16 additional sessions regardless of initial randomization. The primary response criterion was a 5-point reduction in the ICIQ-UI SF (International Consultation on Incontinence Questionnaire for Urinary Incontinence-Short Form) score. Key secondary response criteria included objective and subjective cure, supplemented by other secondary criteria. Followups were performed at months 1, 2, 5, 8 and 14. Results At 2 months 45 of 60 subjects (75%) in the active arm vs 13 of 60 (21.7%) in the sham arm were treatment responders (p <0.001). After 2 months 24 subjects (40%) in the active arm and 41 (68%) in the sham arm elected additional active pulsed magnetic stimulation. At 14 months, subjects who received 32 sessions of active pulsed magnetic stimulation had the highest percentage of treatment responders (18 of 24 or 75.0%), followed by those who received 16 sessions (26 of 36 or 72.2% and 28 of 41 or 68.3%) and those who did not receive any active pulsed magnetic stimulation (4 of 19 or 21.1%) (p <0.001). Conclusions The encouraging long-term response rates show that pulsed magnetic stimulation is an attractive nonsurgical alternative for patients who do not want to undergo surgery. [ABSTRACT FROM AUTHOR]

There is currently no published information on the validity and reliability of the Golombok Rust Inventory of Sexual Satisfaction in the Asian population, specifically in patients with stress urinary incontinence, which limits its use in this region. Our study aimed to evaluate the psychometric properties of this questionnaire in the Malaysian population. Ten couples were recruited for the pilot testing. The agreement between the English and Chinese or Malay versions were tested using the intraclass correlation coefficients, with results of more than 0.80 for all subscales and overall scores indicating good agreement. Sixty-six couples were included in the subsequent phase. The following data are presented in the order of English, Chinese, and Malay. Cronbach's alphas for the male total score were 0.82, 0.88, and 0.95. For the female total score, Cronbach's alphas were 0.76, 0.78, and 0.88. Intraclass correlation coefficients for the male total score were 0.93, 0.94, and 0.99, while intraclass correlation coefficients for the female total score were 0.89, 0.86, and 0.88. In conclusion, the English, Chinese, and Malay versions each proved to be valid and reliable in our Malaysian population. [ABSTRACT FROM AUTHOR]

Aims To enable the use of the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) and ICIQ-Lower Urinary Tract Symptoms Quality of Life (ICIQ-LUTSqol) in Southeast Asia, we translated and subsequently evaluated their validity (content and discriminant validity), reliability (internal consistency and test-retest reliability), and responsiveness in female patients with stress urinary incontinence. Methods Permission was obtained to translate the English versions into Malay and subsequently validate them, and to validate the existing Chinese versions. The translated questionnaires were taken for pilot testing. Validation was carried out for the face/content and discriminant validity. Reliability was assessed for test-retest and internal consistency using Cronbach's alpha and intraclass correlation coefficient respectively. The responsiveness was calculated via effect size and standardized response mean. Results Ten patients were recruited for the pilot testing. The English and Chinese versions had 'substantial' or 'almost perfect' agreement as measured by weighted Kappa. 284 participants (139 patients with stress urinary incontinence and 145 healthy volunteers) were included in the subsequent phases. The ICIQ-UI SF and ICIQ-LUTSqol had good discriminant validity. The ICIQ-UI SF had moderate internal consistency although the ICIQ-LUTSqol had good internal consistency. Both questionnaires had high test-retest reliability. Responsiveness was established with a moderate to large effect size and a standardized response mean. Conclusions The English, Chinese, and Malay versions each proved to be valid and reliable in our Malaysian population, thereby enabling more cross-cultural research in this region. Neurourol. Neurourol. Urodynam. 36:438-442, 2017. © 2015 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

There is currently no published information on the validity and reliability of the Golombok Rust Inventory of Sexual Satisfaction in the Asian population, specifically in patients with stress urinary incontinence, which limits its use in this region. Our study aimed to evaluate the psychometric properties of this questionnaire in the Malaysian population. Ten couples were recruited for the pilot testing. The agreement between the English and Chinese or Malay versions were tested using the intraclass correlation coefficients, with results of more than 0.80 for all subscales and overall scores indicating good agreement. Sixty-six couples were included in the subsequent phase. The following data are presented in the order of English, Chinese, and Malay. Cronbach's alphas for the male total score were 0.82, 0.88, and 0.95. For the female total score, Cronbach's alphas were 0.76, 0.78, and 0.88. Intraclass correlation coefficients for the male total score were 0.93, 0.94, and 0.99, while intraclass correlation coefficients for the female total score were 0.89, 0.86, and 0.88. In conclusion, the English, Chinese, and Malay versions each proved to be valid and reliable in our Malaysian population. [ABSTRACT FROM AUTHOR]

Aims To review whether patients with urinary incontinence (UI) treated with magnetic stimulation (MS) have a higher continence rate compared to sham. Methods Computerized search of electronic databases was performed using the keywords magnetic stimulation therapy and urinary incontinence. Inclusion criteria were randomized, blinded and sham-controlled. Results Eight studies involving 494 patients were included (285 patients received active MS and 209 patients received sham MS). Sample size ranged from 20 to 151 participants. Three studies were on stress UI, two studies on urgency UI, two studies on mixed UI and one study on overactive bladder. The primary outcome (cure) was not reported since only one study reported this outcome. Meta-analysis of the secondary outcome (improvement) showed patients who received active treatment were 2.3 times more likely to experience improved continence compared to sham treatment (95% confidence interval: 1.60-3.29; P < 0.001), but was subject to bias due to varying inclusion criteria, poor reporting and variable time points. There were conflicting results in the treatment effect on quality of life (QOL). Twenty out of 494 patients (5%) experienced mild side effects. The longest follow up period was six months. Conclusions There is no firm evidence to support the benefits of using MS in the management of UI, although short-term outcomes suggests that MS improves UI symptoms in women. The applicability of MS as a treatment option for UI remains uncertain until larger, high-quality trials with longer follow-up periods using comparable and relevant outcomes are conducted. Neurourol. Urodynam. 34:713-722, 2015. © 2014 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Objective: The immune system has been implicated as one mechanism underlying the benefits of acupuncture therapy. Evidence suggests that acupuncture can ameliorate symptoms of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), but the association between clinical response and the immune system has not been investigated.Design/setting: We investigated 12 CP/CPPS patients participating in a prospective randomized clinical trial comparing acupuncture versus sham acupuncture for effects on cellular immunity. Blood samples were taken before the first needling and after the last of 20 treatment sessions (week 10). Patients also completed questionnaires examining their CP/CPPS symptoms and mood status at the baseline and end of study visits.Results: At the end of study 8 of 12 participants (67%) were classified as treatment responders, four participants each from the acupuncture and sham groups. The acupuncture group averaged a 5% increase in natural killer cell levels compared to corresponding sham (-13%; p=0.03). Similarly, patients randomized to acupuncture reported a reduction in other white blood cell parameters examined, supporting the possibility that immunity might be important in the pathophysiology of CP/CPPS.Conclusions: The specific effect of acupuncture on CP/CPPS remains unclear. Further research is warranted to examine the mechanisms by which acupuncture therapy may improve clinical symptoms in patients with CP/CPPS.Trial Registration: ClinicalTrials.gov number, NCT00260637). [ABSTRACT FROM AUTHOR]

Purpose: To report the efficacy and safety of percutaneous ultrasonography-guided endoscopic lavage in the management of perinephric abscesses. Patients and Methods: This is a retrospective review of patients in a single center who had perinephric abscesses and were treated by percutaneous ultrasonography-guided endoscopic lavage during the period of March 2001 to March 2013. Information including the demographics, comorbid medical conditions, presenting symptoms, size of abscesses, operation information, and postoperative information were retrieved for review. Results: There were 37 patients (40 operations) identified during the study period. The mean age was 56.8 years (21-91 years). Eighteen (48.9%) patients presented with loin pain (48.6%) and/or fever (18, 48.6%), and the mean diameter of the abscesses was 10.8 cm (5-22 cm). Thirty-one (77.5%) procedures were performed under general anesthesia. The mean operative time was 49.4 minutes (15-140 min). Thirty-one (77.5%) patients had their percutaneous track dilated to 32F. Only two of 37 (5.4%) patients needed repeated drainage. The average postoperative drainage time was 8.35 days (3-21 days). The median postoperative hospital stay for our patients was 10 days (4-101 days). There was no mortality related to the abscess in this cohort. Conclusion: Percutaneous Ultrasonography-guided endoscopic lavage was shown to be an effective and safe approach for patients with perinephric abscesses. [ABSTRACT FROM AUTHOR]

Objective: To determine the efficacy of a combination of simultaneous shock wave lithotripsy (SWL), hydration with controlled inversion therapy compared with SWL with hydration alone in patients with lower pole calyx stones. Methods: Patients with lower pole stones (4-20 mm) were randomized to SWL or SWL with simultaneous inversion therapy (30° head down Trendelenburg position). Standardized shock waves were given to all patients stratified according to stone size. Subsequent standardized shock waves were given to patients with stone fragments determined by plain abdominal radiography and ultrasound by 2 radiologists blinded to treatment at day 1, weeks 2, 4, 12, 24, and at 1 year. The primary endpoint is stone-free rate (SFR) at week 12. Results: A total of 140 patients were recruited into the study. Patients were comparable with respect to age, sex, race, and stone parameters at baseline. The overall SFR at week 12 was 72% (n = 49 of 68) in patients with SWL and 76% (n = 54 of 71) in SWL with simultaneous inversion at the end of study (P = .591). There was a trend for SFR to improve over time with >80% of patients being stone-free after 1 year in both groups. No significant adverse effects were noted in both groups of patients. Conclusion: Although not statistically significant, SWL with simultaneous inversion is a valuable adjunct in assisting the passage of lower pole renal stones with a SFR of 76%. In clinical practice, this also translates to a 1.28 times improvement in SFR with no or minimal additional costs. [ABSTRACT FROM AUTHOR]

: ObjectivesTo determine the prevalence of chronic prostatitis/chronic pelvic pain syndrome (National Institutes of Health Category III prostatitis) in Penang, Malaysia and estimate the proportion of cases ascertained by population survey that met consensus clinical criteria for “chronic prostatitis.”: MethodsOne percent of 20 to 50-year-old men in Penang, Malaysia were surveyed using the National Institutes of Health Chronic Prostatitis Symptom Index. A clinical evaluation that included lower urinary tract localization studies was recommended for symptomatic subjects who met the survey definition to identify bacterial prostatitis and other diagnoses that would exclude them from the consensus clinical definition for chronic prostatitis (Category III).: ResultsOf 3147 subjects surveyed, 275 (8.7%) met the survey criteria for chronic prostatitis. The prevalence of chronic prostatitis was 8.0% among Malays, 8.9% among non-Malays, and 16% among noncitizens (P = 0.025). The prevalence increased with age: 6.3% in 20 to 30-year-old men, 8.9% in 31 to 40-year-old men, and 12.6% in 41 to 50-year-old men (P <0.001). Of 87 subjects evaluated clinically, 65 (75%) met the consensus clinical criteria for chronic prostatitis.: ConclusionsChronic prostatitis represents an important, international healthcare problem. A thorough clinical evaluation is necessary to verify that chronic prostatitis is indeed responsible for a patient’s pelvic pain and lower urinary tract symptoms. [Copyright &y& Elsevier]

Purpose: Prostate cancer is a bimodal disease with aggressive and indolent forms. Current prostate-specific-antigen testing and digital rectal examination screening provide ambiguous results leading to both under-and over-treatment. Accurate, consistent diagnosis is crucial to risk-stratify patients and facilitate clinical decision making as to treatment versus active surveillance. Diagnosis is currently achieved by needle biopsy, a painful procedure. Thus, there is a clinical need for a minimally-invasive test to determine prostate cancer aggressiveness. A blood sample to predict Gleason score, which is known to reflect aggressiveness of the cancer, could serve as such a test. Materials and Methods: Blood mRNA was isolated from North American and Malaysian prostate cancer patients/controls. Microarray analysis was conducted utilizing the Affymetrix U133 plus 2·0 platform. Expression profiles from 255 patients/controls generated 85 candidate biomarkers. Following quantitative real-time PCR (qRT-PCR) analysis, ten disease-associated biomarkers remained for paired statistical analysis and normalization. Results: Microarray analysis was conducted to identify 85 genes differentially expressed between aggressive prostate cancer (Gleason score ≥8) and controls. Expression of these genes was qRT-PCR verified. Statistical analysis yielded a final seven-gene panel evaluated as six gene-ratio duplexes. This molecular signature predicted as aggressive (ie, Gleason score ≥8) 55% of G6 samples, 49% of G7(3+4), 79% of G7(4+3) and 83% of G8-10, while rejecting 98% of controls. Conclusion: In this study, we have developed a novel, blood-based biomarker panel which can be used as the basis of a simple blood test to identify men with aggressive prostate cancer and thereby reduce the overdiagnosis and overtreatment that currently results from diagnosis using PSA alone. We discuss possible clinical uses of the panel to identify men more likely to benefit from biopsy and immediate therapy versus those more suited to an “active surveillance” strategy.

Objective: To assess the impact of stress urinary incontinence (SUI) on individual components of quality of life (QoL) using both condition-specific and generic questionnaires, and to compare the results of the 2 instruments with a control group.Methods: Women with or without SUI aged ≥21 years old were recruited. Subjects completed the International Consultation of Incontinence-Urinary Incontinence Short Form (ICIQ-UI-SF), International Consultation of Incontinence-Lower Urinary Tract Symptoms Quality of Life (ICIQ-LUTSqol), and EQ-5D questionnaires.Results: A total of 120 women with SUI and 145 controls participated. The ICIQ-LUTSqol total score (mean ± standard deviation) was significantly higher in the SUI group (38.96 ± 10.28) compared with the control group (20.78 ± 2.73) (P <.001). When adjusted for significant confounders, the SUI group continued to have significantly poorer QoL compared with the control group (P <.001). The negative effect of SUI on "physical activities" and "jobs" were the 2 most frequently reported and burdensome components of the ICIQ-LUTSqol, with approximately 50% of women with SUI affected "moderately" or "a lot." When measured using the EQ-5D questionnaire, there were significantly higher percentages of patients with SUI who had problems with usual activities, pain or discomfort, and anxiety or depression (P <.05).Conclusion: Women suffering from SUI have significantly poorer QoL compared with continent women when measured using both condition-specific and generic QoL measures. Clinicians should pay closer attention to the impact of SUI on individual components of QoL, particularly limitations on physical activities and jobs, which were the 2 most impairing and frequently reported components of QoL. [ABSTRACT FROM AUTHOR]

Background: There is currently a lack of randomized, sham-controlled trials that are adequately powered, using validated outcomes, to allow for firm recommendations on the use of magnetic stimulation for stress urinary incontinence. We report a protocol of a multicenter, randomized, double-blind, sham-controlled parallel-group trial to evaluate the efficacy of magnetic stimulation for stress urinary incontinence.Methods/design: One hundred twenty subjects with stress urinary incontinence will be randomized in a 1:1 allocation to either active or sham magnetic stimulation using computer-generated, permuted blocks of variable sizes. Subjects will receive 2 sessions of magnetic stimulation per week for 8 weeks (16 sessions total). The primary outcome is the improvement in severity of involuntary urine loss based on the International Consultation on Incontinence Questionnaire for Urinary Incontinence Short Form at the end of treatment sessions compared with baseline. Secondary outcomes include cure, stress urinary incontinence-related symptoms (incontinence episode frequency, urine loss in 1-hour pad test, pelvic floor muscle strength) and health-related quality of life (Patient Global Impression of Improvement, International Consultation on Incontinence Questionnaire-Lower Urinary Tract Symptoms Quality of Life and EQ-5D). The safety of magnetic stimulation will also be assessed. Besides evaluation of clinical treatment effectiveness, cost-effectiveness analysis using patient-reported outcomes will be performed.Discussion: This trial is designed to provide pending outcome information on this non-invasive treatment option. We intend to acknowledge the existing flaws in previous clinical trials and determine conclusively whether magnetic stimulation is effective for stress urinary incontinence.Trial Registration: ClinicalTrials.gov Identifier: NCT01924728. Date of Registration: 14 August 2013. [ABSTRACT FROM AUTHOR]

Abstract: Background: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) afflicts 2%-10% of adult men. Available therapies offer little or no proven benefit. Because acupuncture represents an attractive “natural” therapy, we compared the efficacy of acupuncture to sham acupuncture for CP/CPPS. Methods: Participants met US National Institutes of Health (NIH) consensus criteria for CP/CPPS, were aged ≥20 years old, and had a total score ≥15 on the NIH Chronic Prostatitis Symptom Index (NIH-CPSI) and symptoms for at least 3 of the preceding 6 months. They were randomized 1:1 to acupuncture or sham acupuncture. Treatment consisted of twice-weekly 30-minute sessions for 10 weeks (20 sessions total) without needle stimulation, herbs, or adjuvants. The primary response criterion was a 6-point decrease from baseline to week 10 in NIH-CPSI total score (range 0-43). Results: Thirty-two (73%) of 44 participants responded in the acupuncture group compared with 21 (47%) of 45 sham group participants (relative risk 1.81, 95% confidence interval, 1.3-3.1, P = .02). Long-term responses 24 weeks after completing therapy without additional treatment occurred in 14 (32%) of 44 acupuncture group participants and in 6 (13%) of 45 sham group participants (relative risk 2.39, 95% confidence interval, 1.0-5.6, P = .04). Conclusions: After 10 weeks of treatment, acupuncture proved almost twice as likely as sham treatment to improve CP/CPPS symptoms. Participants receiving acupuncture were 2.4-fold more likely to experience long-term benefit than were participants receiving sham acupuncture. [Copyright &y& Elsevier]

Abstract: Background: Prostatitis describes a combination of infectious diseases (acute and chronic bacterial prostatitis), chronic pelvic pain syndrome, and asymptomatic inflammation. Materials and methods: We employed evidence-based methods to review the epidemiology of prostatitis syndromes. Results: The prevalence of prostatitis symptoms could be compared in five studies surveying 10617 men. Overall, 873 participants met various criteria for prostatitis, representing an overall rate of 8.2%, with prevalence ranging from 2.2 to 9.7%. A history of sexually transmitted diseases was associated with an increased risk for prostatitis symptoms. Men reporting a history of prostatitis symptoms had a substantially increased rate of benign prostatic hyperplasia, lower urinary tract symptoms and prostate cancer. In one study, the incidence of physician-diagnosed prostatitis was 4.9 cases per 1000 person-years. Two studies suggest that about one-third of men reporting prostatitis symptoms had resolution after 1 year. Patients with previous episodes and more severe symptoms are at higher risk for chronic pelvic pain. Discussion: The prevalence of prostatitis symptoms is high, comparable to rates of ischaemic heart disease and diabetes. Clinical evaluation appears necessary to verify that prostatitis is responsible for patients’ symptoms. Prostatitis symptoms may increase a man''s risk for benign prostate hypertrophy, lower urinary tract symptoms and prostate cancer. We need to define natural history and consequences of prostatitis, develop better algorithms for diagnosis and treatment, and develop strategies for prevention. [Copyright &y& Elsevier]