Abstract
BACKGROUND: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) presents substantial therapeutic challenges, as existing drug therapies demonstrate limited efficacy and often cause adverse effects. These limitations highlight the need to explore non-pharmacological alternatives. PURPOSE: This network meta-analysis aimed to evaluate the comparative efficacy of eight acupuncture therapies versus usual treatment (UT) for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). RESULTS: From 67 RCTs (5961 patients), all acupuncture modalities outperformed conventional drugs in clinical efficacy (P<0.05), with long-needle acupuncture ranking highest (SUCRA 88.7%). Specific outcomes revealed: 1) symptom scores: thumb-tack needle (SUCRA 90.9%) and long-needle acupuncture (72.2%) showed the greatest NIH-CPSI reduction; 2) Pain: long-needle acupuncture (76.3%) and acupoint catgut embedding (69.3%) ranked top; 3) Urination: long-needle acupuncture (82.9%) and conventional acupuncture (47.9%) surpassed UT; 4) Quality of life: thumb-tack needle (72.3%), electroacupuncture (65.6%) and long-needle acupuncture (64.1%) were optimal. Long-needle acupuncture consistently demonstrated superior efficacy across both subjective symptoms and objective measures. CONCLUSION: Acupuncture therapies, especially long-needle acupuncture, are more effective than UT for CP/CPPS, providing comprehensive symptom relief, pain reduction, and functional improvement, with long-needle acupuncture emerging as the most robust intervention.