Acupuncture for benign prostatic hyperplasia: A systematic review and meta-analysis

I haven’t covered acupuncture and prostate health  too much on my blog, but I seem to be seeing it more in the clinic.   This review is positive.

his systematic review and meta-analysis evaluated the effects of acupuncture on benign prostatic hyperplasia (BPH) through analysis of eight randomized controlled trials (RCTs) involving 661 men. Short-term benefits (4-6 weeks) were noted, with significant improvements in urinary symptoms and maximum urinary flow rate (Qmax) compared to sham-acupuncture. However, medium-term follow-ups (12-18 weeks) did not show significant benefits. The review highlights acupuncture’s potential for managing moderate to severe BPH symptoms in the short term but calls for further research with more rigorous designs and longer follow-up periods to confirm clinical significance and durability of these effects.

What goes without saying?  or maybe not is what would happen if the patients simply came in for monthly acupuncture afer their initial 8 week treatment regimen?  Would the effects last longer?  Probably!

Zhang W, Ma L, Bauer BA, Liu Z, Lu Y. Acupuncture for benign prostatic hyperplasia: A systematic review and meta-analysis. PLoS One. 2017 Apr 4;12(4):e0174586. doi: 10.1371/journal.pone.0174586. PMID: 28376120; PMCID: PMC5380320.

Purpose
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).

Conclusion
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.