Circumcision plus antibiotic, anti-inflammatory, and α-blocker therapy for the treatment for chronic prostatitis/chronic pelvic pain syndrome: a prospective, randomized, multicenter trial

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Abstract
The purpose of the study was to evaluate the efficacy of circumcision combined with antibiotic, anti-inflammatory, and α-blocker therapy for the treatment for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). Subjects assigned to the circumcision group were given antibiotic, anti-inflammatory, and α-blocker medications and scheduled for surgery the same period in each site by study clinicians. Subjects assigned to the control group were asked to only take the same medications and remain uncircumcised until the end of the 3-month study period. The primary outcome was a reduction of at least four points on the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI). A total of 774 eligible participants underwent randomization, and the ratio of men with a decrease of at least four points on the total NIH-CPSI score from baseline to 12 weeks was 84.6 % in the circumcision group and 68.5 % in the control group (P < 0.001). Of the 713 men who completed the trial, the median total NIH-CPSI score decreased significantly from 21.0 ± 7.0 to 12.0 ± 8.0 (P < 0.001) in the circumcision group, and in the control group, the change was from 21.0 ± 8.0 to 15.0 ± 7.0 (P < 0.001). Comparison of the changes in the total and three subdomain NIH-CPSI scores over time revealed significant differences between the circumcision and control groups (P < 0.001). Our findings show that circumcision plus antibiotic, anti-inflammatory, and α-blocker therapy for CP/CPPS patients resulted in improved NIH-CPSI scores compared with medication therapy only.

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