MALE DISORDERS RESEARCH © JCM Ltd

ACUPUNCTURE IMPROVES SPERM MOTILITY
The first prospective, randomised, single-blind, placebo-controlled study of the effect of acupuncture in infertile men with severe oligoasthenozoospermia has shown that acupuncture can improve sperm motility. The German study, involving 29 men compared TCM acupuncture with placebo acupuncture. A significantly higher percentage of motile sperm was found after real acupuncture. No effect of acupuncture on sperm concentration was observed. (A prospective randomized placebo-controlled study of the effect of acupuncture in infertile patients with severe oligoasthenozoospermia. Fertil Steril. 2009 Apr 24. [Epub ahead of print]).

ACUPUNCTURE RELIEVES PROSTATE PAIN
Electroacupuncture (EA) can relieve symptoms in men with chronic prostatitis/chronic pelvic pain syndrome and is particularly effective for pain relief. In the first randomised controlled trial of EA for this condition, Korean researchers randomised 39 men into three treatment groups: advice and exercise plus 12 sessions of EA (EA); advice and exercise plus 12 sessions of sham EA (SEA); and advice and exercise alone (A&E) for six weeks. A total of six acupuncture points (bilateral Ciliao BL-32, Zhongliao BL-33 and Huantiao GB-30) were used to stimulate the sacral nerve and release the piriformis muscle, using an electrical pulse generator. At six weeks, prostatitis symptom scores had decreased significantly in the EA group compared with SEA and A&E groups. The EA group showed significant decreases in pain-related symptoms compared with the SEA and A&E groups. All EA participants experienced at least a six-point decrease in prostatitis symptom scores, compared with 16.7% SEA participants and 25% of A&E participants. In addition, levels of proinflammatory prostaglandin E2 in urine samples decreased significantly in the EA group, while it increased in the other two groups. This suggests that EA might be beneficial in the treatment of this condition by reducing inflammation of the prostate. (Electroacupuncture relieves pain in men with chronic prostatitis/chronic pelvic pain syndrome: three-arm randomized trial. Urology. 2009 May;73(5):1036-41).

AURICULAR ACUPUNCTURE FOR VASOMOTOR SYMPTOMS IN PROSTATE CANCER
The role of auricular acupuncture (AA) in men receiving luteinising-hormone releasing hormone (LHRH) analogues for cancer of the prostate has been investigated by a research group in the UK. Vasomotor symptoms similar to those observed in postmenopausal women can affect the quality of life in such men. Sixty patients (median age 74 years) received weekly AA for 10 weeks. Ninety-five percent of patients reported a decrease in the severity of symptoms, from a mean symptom score of 5.0 to 2.1. The authors concluded that the symptomatic improvement observed with AA was comparable with that achieved with pharmacotherapy and that, based on cost analysis, AA represented a viable alternative. (Auricular acupuncture: a novel treatment for vasomotor symptoms associated with luteinizing-hormone releasing hormone agonist treatment for prostate cancer. BJU Int. 2008 Aug 14).

ACUPUNCTURE FOR PROSTATE CANCER HOT FLUSHES
Both electroacupuncture (EA) and traditional acupuncture (TA) can reduce the impact of hot flushes on men who have had castrational treatment for prostate cancer. Swedish researchers randomised 31 men with hot flushes due to prostate cancer treatment to EA (12 points, with four electro-stimulated) or TA (12 points) weekly for 12 weeks. Hot flushes per 24 hours decreased significantly, from a median of 7.6 at baseline in the EA group to 4.1 after 12 weeks, and from 5.7 in the TA group to 3.4. Distress caused by flushes decreased from 8.2 in the EA group to 3.3, and from 7.6 to 3.4 in the TA group after 12 weeks. The overall ‘hot flush score’ decreased in the two groups by 78% and 73%, respectively, in line with or better than medical regimens for these symptoms. The effect lasted up to nine months after treatment ended. (Two Modes of Acupuncture as a Treatment for Hot Flushes in Men with Prostate Cancer-A Prospective Multicenter Study with Long-Term Follow-Up. Eur Urol. 2008 Feb 14. [Epub ahead of print]).

ACUPUNCTURE BENEFITS PROSTATE PAIN
Acupuncture treatment is more than twice as likely as sham treatment to improve men’s symptoms of chronic prostatitis/chronic pelvic pain syndrome. Malaysian researchers randomised 89 patients to ten weeks of twice-weekly 30-minute true or sham acupuncture sessions. The patients were scored on the NIH Chronic Prostatitis Symptom Index (NIH-CPSI). Response to treatment was defined as a minimum six-point decrease from baseline to week ten in NIH-CPSI total score. 73% participants responded in the acupuncture group compared with 47% of sham group participants. This level of response was maintained 24 weeks after completing therapy by 32% of the acupuncture group and 13% of the sham group. Participants receiving acupuncture were thus 2.4-fold more likely to experience long-term benefit than were participants receiving sham acupuncture. (Acupuncture versus sham acupuncture for chronic prostatitis/chronic pelvic pain. Am J Med. 2008 Jan;121(1):79.e1-7).

ACUPUNCTURE FOR CHRONIC PROSTATITIS
A pilot study has assessed the use of body and auricular acupuncture in men suffering from chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). Ten men who were refractory to conventional therapies were given 30 minutes of body and auricular acupuncture twice weekly for six weeks. A standardised set of acupuncture points, based on traditional Chinese medicine principles, was used. The body points given at each visit included  Waiguan SJ-5, Zulinqi GB-41, Taichong LIV-3,  Hegu L.I.-4,  Diji SP-8 and  Sanyinjiao SP-6. The auricular acupuncture points needled at each visit (alternating ears with each treatment) included Shenmen, Kidney, Liver, Lung and Spleen. Decreases in total prostatitis symptom scores at three and six weeks from baseline were significant and remained so after an additional six weeks of follow-up. Changes in quality of life scores were also significant. (A pilot study on acupuncture for lower urinary tract symptoms related to chronic prostatitis/chronic pelvic pain. Chin Med. 2007 Feb 6;2:1).

ACUPUNCTURE IMPROVES SPERM QUALITY
A study of the effect of acupuncture on sperm quality in men suffering infertility of unknown cause, found that after twice weekly treatment for five weeks, there were fewer structural sperm defects (acrosome position and shape, nuclear shape, axonemal pattern and shape, and accessory fibres of sperm organelles) and an increase in the number of normal sperm ejaculated. Other sperm abnormalities such as immature or dead sperm were not affected. Acupuncture was given at Guanyuan REN-4, Shenshu BL-23, Ciliao BL-32 and Taixi KID-3 with Zusanli ST-36, Xuehai SP-10, Sanyinjiao SP-6, Guilai ST-29 and Baihui DU-20 as secondary points. Deqi was obtained at all needling sites and aimed to be transmitted from Shenshu BL-23 and Ciliao BL-32 to the sacral or perineal area and the anterior hypogastric region. (Fertility and Sterility, Volume 84, Issue 1 , July 2005, Pages 141-147). Meanwhile there is evidence that infertility may now be affecting more men than women. Intra-cytoplasmic sperm injection (ICSI), in which a single sperm is injected straight into an egg and is normally used in cases where the sperm is of too poor quality to permit conventional fertilisation has become the most commonly used technique in Europe and now outnumbers conventional IVF. (European Society of Human Reproduction and Embryology annual conference, Copenhagen, 2005). And in the Merseyside and Cheshire health districts in Britain, the number of men seeking treatment for infertility has risen by nearly 70% in the past four years with ICSI now accounting for 60% of the ICSI/IVF treatments carried out at the Liverpool Women’s Hospital.

ACUPUNCTURE & CHRONIC PELVIC PAIN IN MEN
This Japanese study treated ten men suffering from chronic pelvic pain syndrome (eight of whom had previously received pharmacological medicines without benefit) at a single acupuncture point, Zhongliao BL-33, with the needle retained for ten minutes whilst being rotated manually. Treatment was given weekly for five weeks. At the end of the treatment period, there was significant improvement in chronic prostatitis symptoms and quality of life scores, and intrapelvic venous congestion was significantly improved in four of the patients. (Int J Urol 2004; 11: 607-12).

ACUPUNCTURE & MALE INFERTILITY
In a small Brazilian study, 19 male patients with sperm abnormalities (sperm count, motility and morphology) were randomly assigned to receive true (treatment group) or sham (control group) acupuncture and moxibustion treatment. The treatment group were needled at Qichong ST-30, Taixi KID-3, Zusanli ST-36, Hegu L.I.-4, Sanyinjiao SP-6, Gongsun SP-4, Taichong LIV-3 and Neiguan P-6 (with deqi), and received moxibustion (until the skin was reddened) at Shenshu BL-23, Zhishi BL-52, Sanjiaoshu BL-22, Mingmen DU-4, Ciliao BL-32, Qihai REN-6, Guanyuan REN-4, Zhongji REN-3, Pishu BL-20, Weishu BL-21, Shimen REN-5, Taiyuan LU-9, Feishu BL-13, Gaohuangshu BL-43, Xinshu BL-15 and Zigong (M-CA-18). Treatment was given twice a week for 10 weeks. The control group received needling and moxibustion at non-points. At the end of treatment, patients in the treatment group showed a significant improvement in sperm morphology ( i.e. normally formed sperm). There was no significant difference between the groups in terms of seminal fluid volume, sperm count or motility. (Asian J Androl 2003 Dec; 5: 345-348).

ACUPUNCTURE & CHRONIC PROSTATITIS
Some sources suggest that up to 10% of men suffer from some of the symptoms of chronic prostatitis, more commonly referred to nowadays as chronic pelvic pain syndrome (CPPS). Whilst western medical treatment does not offer a lot of help for this condition, there have been reports and studies rom China over many years of its successful treatment by acupuncture. Now a western study has confirmed these findings. Twelve men with CPPS that was refractory to standard western treatment (antibiotics, alpha-blockers, anti-inflammatories), received treatment at 3 sets of acupuncture points (total 30 points) twice weekly for 6 weeks. Ten of them had a greater than 50% decrease symptoms at the end of the course of treatment, and in 8 of these there was sustained improvement at follow up (33 weeks). The authors conclude that acupuncture appears to be a safe, effective, and durable treatment in improving symptoms in, and the quality of life of, men with chronic prostatitis/chronic pelvic pain syndrome refractory to treatment. (Urology. 2003 Jun;61(6):1156-9).

ACUPUNCTURE & VASOMOTOR SYMPTOMS
A Swedish study has shown acupuncture to be effective in reducing vasomotor symptoms (hot flushes) in men following castration therapy for prostatic carcinoma. Patients received twice weekly acupuncture for 2 weeks, and weekly for 10 weeks. Flushes were reduced by 70% after 10 weeks and was 50% lower 3 months after the last treatment (Journal of Urology 1999; 161(3); 853-856).

ACUPUNCTURE AND IMPOTENCE
29 patients with psychogenic (non-organic) impotence were treated by doctors in the Urology and Anaesthesiology Departments of Ankara University, Turkey. All patients were needled at points Ciliao BL-32, Dadun LIV-1, Yinlian LIV-11, Neiguan P-6, Tiaokou ST-38, Qugu REN-2 and Baihui DU-20 for a total of ten treatments. Successful results (two satisfactory sexual activities in a week) were achieved in 20 (69%) patients (Eur Urol 1994;26:52-55).