Men suffering from category III chronic prostatitis may benefit from N-acetylcysteine as an adjunct to alpha-blockers

Low Urin Tract Symptoms. 2022 May;14(3):199-207. doi: 10.1111/luts.12425. Epub 2022 Jan 23.

Abstract

Objective: We designed this study to investigate the potential use of N-acetylcysteine (NAC) as an adjunct to alpha-blockers in the treatment of category III chronic prostatitis (CP).

Methods: Sixty-three men with category III CP with a National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) total score of 15 or more were randomized to either the NAC treatment group or the placebo treatment group. Besides tamsulosin at a dose of 0.4 mg once daily, participants based on their allocation group received NAC or placebo at a dose of 600 mg twice daily for 12 weeks. The efficacy of the medications was assessed by measuring changes in the NIH-CPSI total score and its subscales, including pain, urinary symptoms, and quality of life.

Results: Based on the general linear model analysis of the data, over the 12-week treatment, NAC+tamsulosin was statistically superior to placebo+tamsulosin in reducing the total NIH-CPSI score, pain subscore, and quality-of-life subscore (P value <.001). Further, after 12 weeks, more patients in the NAC+tamsulosin group than in the placebo+tamsulosin group met the responder criterion, defined as a decrease of at least 6 points in the NIH-CPSI total score (65.6% vs 29.0%). A more favorable outcome was also noted in the NAC+tamsulosin group regarding the number of patients reporting moderate or marked improvement in symptoms (62.5% vs 25.80%). No significant difference was seen between the groups concerning changes in urinary symptoms.

Conclusions: Our study provided clinical evidence that men with category III CP might benefit from NAC treatment. Further studies are needed for the validation of these findings.

Keywords: N-acetylcysteine; chronic pelvic pain; chronic prostatitis; inflammation; oxidative stress.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Acetylcysteine / therapeutic use
  • Adrenergic alpha-Antagonists / therapeutic use
  • Chronic Disease
  • Humans
  • Male
  • Pelvic Pain / drug therapy
  • Prostatitis* / diagnosis
  • Prostatitis* / drug therapy
  • Quality of Life
  • Tamsulosin / therapeutic use

Substances

  • Adrenergic alpha-Antagonists
  • Tamsulosin
  • Acetylcysteine