Multiple treatments exist for CPPS, including drugs and physical therapy. 
the aim of this study is to compare the efficacy of medical management (Alfuzosin + Amitryptylin) versus yoga (yoga + placebo) for the treatment of CPPS.

It was a randomised crossover study (CTRI/2022/05/042706) with 20 patients in each group. Group 1 received Alfuzosin & Amitryptylin (AA) and group 2 received Yoga & Placebo (YP) for six weeks. After the end of six weeks, a washout period of one week was given and the crossover was done. The change in NIHCPSI scores was noted and compared using SPSS and R software.

The median age in group 1 was 30.50 (25.25-38.00) years and in group 2 was 31 (26.00-34.00) years. The median decrease in overall NHCPSI score in Group 1 after 6 weeks of AA was 10 (8.25-13.75) points (p<0.001) and after 6 weeks of YP was 6 (3.25-9.75) points (p<0.001). In Group B the median decrease in overall NHCPSI score after 6 weeks of YP was 9 (5.25-11.75) points (p<0.001) and after 6 weeks of AA was 7.5 (3-12.5) points (p<0.001). There were no carryover effects. The period analysis showed there is no difference between the reduction of NHCPSI score between the two groups. The Sequence analysis showed the Sequence of Medical managent followed by yoga to significantly better.

Both groups had similar efficacy in decreasing symptoms of the CPPS patient. In subset analysis, the urinary symptoms scores responded to medical management rather than yoga. other symptoms reduced in both the groups without any significant difference.

Yoga is not inferior to alfuzosin and amitriptyline for the treatment of CPPS. The initial symptoms can be managed by medical management (especially in patients with higher urinary symptoms scores) and after remission of the symptoms, the patient can continue yoga as the maintenance therapy.