Role of alpha-blockers in type III prostatitis: a systematic review of the literature.

PURPOSE We examined the evidence for the effectiveness of alpha-blockers for type III prostatitis. MATERIALS AND METHODS Studies were identified through a search of MEDLINE, EMBASE and The Cochrane Library as well as a manual search of bibliographies of identified articles and abstract books of recent major international urology conferences. Inclusion criteria included randomized, placebo controlled trials of treatment for type III prostatitis and use of the National Institutes of Health-Chronic Prostatitis Symptom Index outcome measure. RESULTS Six unique trials in a total of 386 patients met inclusion criteria. One study showed no difference between alpha-blockers and placebo in terms of total or domain National Institutes of Health-Chronic Prostatitis Symptom Index scores and another did not report the p value. All of the remaining 4 studies showed a statistically significant difference in the total score in favor of alpha-blockers, while only 2 showed improved quality of life. Individual treatment effects were statistically significant more often when treatment was administered for 3 months or longer. Despite a common tool for outcome assessment meta-analysis of the results in individual trials was not possible due to differences in the manner of interpreting outcomes and reporting data. CONCLUSIONS The current published literature is insufficient to conclude with certainty that alpha-blockers are effective for type III prostatitis. Future studies should incorporate uniformity in data collection and reporting with improved health related quality of life as the end point of therapy.