HealthNotes

Acupuncture may be helpful for chronic prostatitis according to one small, uncontrolled study.⁶ Seventeen patients with chronic prostatitis that was unresponsive to conventional therapy were treated with electroacupuncture (acupuncture with electrical stimulation). The effectiveness of electroacupuncture therapy was reported to be moderate in 70% and excellent in 30% of the patients treated.

Prostatic massage through the rectum was once a common treatment for CBP and NBP, and is still prescribed by some practitioners. Prostatic massage is thought to promote circulation and drainage of infected areas.⁷ While little scientific research has been done to evaluate the effectiveness of this treatment, some physicians and their patients have reported symptomatic improvement.⁸ Prostatic massage should be conducted only by a trained specialist. Prostatic massage should be avoided in ABP because it is painful and could spread the infection.⁹ Also avoid this therapy in the presence of prostatic calculi (stones), a condition common in elderly men in which small calcifications develop in the prostate.

Controlled studies indicate psychological factors, such as anxiety and depression, occur more frequently in men with NBP and PD.^{10, 11, 12} This may be because psychological factors contribute to the development of NBP and PD, or perhaps they occur as a result of prostatitis. Nonetheless, some practitioners believe psychotherapy may help reduce symptoms in these cases.¹³

Some researchers have reported that certain cases of chronic prostatitis are helped by biofeedback (using simple electronic devices to measure and report information about a person’s biological system) and other treatments aimed at reducing chronic pain.¹⁴ This suggests that some of the causes of PD, and possibly NBP, may be neuromuscular. In support of this idea, smooth muscle relaxing medications are reported to reduce symptoms in men with CBP, NBP, and PD, and to reduce the recurrence rate of CBP.¹⁵ However, no controlled research has explored the effectiveness of biofeedback or alternative neuromuscular therapies for prostatitis.

A sitz bath is the immersion of the pelvic region (up to the navel) in water. Sitz baths are reported to provide temporary relief of symptoms in men with chronic prostatitis, although no controlled research has evaluated these claims.^{16, 17} This therapy is not recommended in ABP, as it may worsen the infection.¹⁸ In chronic prostatitis, doctors of natural medicine recommend “contrast sitz baths,” a series of alternating hot and cold baths, requiring two tubs (or a bathtub and adequately sized basin), one for each temperature. The hot sitz bath is taken first with the water at a temperature of 105–115ºF for 3 minutes. This is immediately followed by the cold sitz bath at 55–85º F for 30 seconds. This process is repeated two more times, for a total of six baths (three hot and three cold) per treatment.¹⁹