Rapid CommunicationsQuercetin in men with category III chronic prostatitis: a preliminary prospective, double-blind, placebo-controlled trial
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Material and methods
Patients with chronic pelvic pain syndrome (CPPS) for at least 6 months were evaluated by history, physical examination, and examination and culture of expressed prostatic secretions, urethral swab, and first voided and midstream urine. The postmassage urine was omitted because prostatic fluid was obtained from all patients. Thirty patients without positive bacterial cultures localizing to the prostatic fluid were enrolled in the study after giving written informed consent. This study was
Results
All 15 patients randomized to quercetin completed the study; 2 of 15 patients randomized to placebo did not because of worsening symptoms. The final symptom scores of these 2 patients were not included in the analysis, but their lack of improvement was included. As seen in Table I, the groups did not differ significantly in age, symptom duration, initial number of white blood cells in the prostatic fluid, or NIH symptom score.
At the completion of the study, the mean symptom score improved from
Comment
Patients with chronic prostatitis refractory to conventional therapies are a great challenge and frustration in urologic practice.2 For those who do not respond to antibiotic therapy but have negative prostatic fluid cultures, the etiology is unclear. A proportion of these patients probably have true persistent bacterial infections; indeed, a significant proportion of men with culture-negative CPPS have positive bacterial signal in their prostatic fluid by 16S ribosomal RNA molecular techniques.
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2022, Asian Journal of UrologyCitation Excerpt :The investigators found low- to very low-quality evidence that antibiotics, alpha-blockers, 5alpha-reductase inhibitors), anti-inflammatories, phytotherapy, traditional Chinese medications, and intraprostatic botulinum instillation may reduce prostatitis symptoms without a raised incidence of adverse events in the short-term, except for alpha-blockers, which may be correlated with a rise in mild adverse events [7,19]. Focusing on phytotherapeutics and medical devices, the most analysed products included in previous studies were calendula-curcuma suppositories [20], oral formulation of cranberry [21], quercetin [22], and pollen extract [18,23]. In clinical trials, these treatments showed some beneficial effects on clinical symptoms compared to placebo (NIH-CPSI score mean difference: −5.02; 95% confidence interval: −6.81 to −3.23), but the quality of evidence was low, due to unclear or high risk of bias in most domains in most studies, and imprecision (the confidence interval crosses the threshold for the minimal clinically important difference) [7].
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D. A. Shoskes and J. Rajfer own stock in companies that will benefit from sales of the supplements reported in this study.