Summary of findings 3.
Circumcision plus usual care compared to waiting list plus usual care for chronic prostatitis/chronic pelvic pain syndrome
| Circumcision plus usual care compared to waiting list plus usual care for chronic prostatitis/chronic pelvic pain syndrome | |||||
| Patient or population: participants with chronic prostatitis/chronic pelvic pain syndrome Setting: hospital (surgery), China Intervention: circumcision at 4 weeks (outcome was assessed after circumcision) Comparison: waiting list for circumcision at 3 months (outcome was assessed before circumcision) | |||||
| Outcomes | № of participants (studies) | Quality of the evidence (GRADE) | Relative effect (95% CI) | Anticipated absolute effects* (95% CI) | |
| Risk with waiting list for circumcision | Risk difference with early circumcision | ||||
| Prostatitis symptoms assessed with: NIH‐CPSI score Scale from: 0 to 43 follow‐up: 12 weeks | 713 (1 RCT) | ⊕⊕⊕⊝ Moderate1 | ‐ | The mean prostatitis symptoms was 15 | MD 3.00 lower (3.82 lower to 2.18 lower)2 |
| Adverse events3 | 713 (1 RCT) | ⊕⊕⊝⊝ Low1,4 | RR 1.23 (0.86 to 1.76) | Study population | |
| 130 per 1000 | 30 more per 1000 (18 fewer to 98 more) | ||||
| Sexual dysfunction ‐ not reported | ‐ | ‐ | ‐ | ‐ | ‐ |
| Quality of life ‐ not reported | ‐ | ‐ | ‐ | ‐ | ‐ |
| Depression and anxiety ‐ not reported | ‐ | ‐ | ‐ | ‐ | ‐ |
| *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; MD: mean difference; NIH‐CPSI: National Institutes of Health ‐ Chronic Prostatitis Symptom Index; RCT: randomised controlled trial; RR: risk ratio. | |||||
| GRADE Working Group grades of evidence High quality: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate quality: we are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low quality: our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect. Very low quality: we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect. | |||||
1Downgraded 1 level due to high risk of bias: study not blinded (high risk of performance and detection bias).
2Confidence intervals were constructed using transformations described in the Cochrane Handbook for Systematic Reviews of Interventions Section 7.7.3.5.
3All adverse events were minor.
4Downgraded 1 level due to imprecision issues: few events in each group and wide confidence interval.