Chronic Prostatitis/Chronic Pelvic Pain Syndrome: A Disease or Symptom? Current Perspectives on Diagnosis, Treatment, and Prognosis

Overview

Journal Am J Mens Health

Specialties Health Services
Public Health

Date 2020 Feb 2

PMID 32005088

Citations 26

Authors

Jianzhong Zhang

Chaozhao Liang

Xuejun Shang

Hongjun Li

Affiliations

Soon will be listed here.

Abstract

Definitive diagnosis and selection of effective treatment for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) are frustrations encountered frequently by urology care providers in their practice. Knowledge of etiology and pathophysiology is not sufficient and therapeutic guidelines have not yielded acceptable outcomes and prognoses for both patients and care providers. The authors present updated perspectives on CP/CPPS, including definition, diagnosis, treatment, and prognosis, based on literature review and clinical experience. A key point is to shift the diagnostic and therapeutic focus from a single entity of disease toward associated symptoms of CP/CPPS. An individualized multimodal treatment approach to cope with the course of the disorder is proposed. Communications and personal/family/community supports are emphasized as an important component in the therapeutic regime and rehabilitation of patients with CP/CPPS. The purpose is to improve comprehension on CP/CPPS and to help care providers and patients to achieve the goal of medical intervention-relieving associated symptoms of CP/CPPS and improving the quality of life.

Citing Articles

The characteristics of brain function alterations in patients with chronic prostatitis/chronic pelvic pain syndrome across varying symptom severities evaluated by NIH-CPSI.

Ge S, Xiang Y, Hua X, Wang Z, Hu Q, Guo Y Front Neurosci. 2025; 19:1511654.

PMID: 40078709 PMC: 11897570. DOI: 10.3389/fnins.2025.1511654.

Network pharmacology and animal experiments revealed the protective effects of Guilong prescription on chronic prostatitis and its possible mechanisms.

Peixuan Z, Zeqi S, Qiongyin F, Cai Z, Ting W J Tradit Chin Med. 2025; 45(1):89-99.

PMID: 39957162 PMC: 11764937. DOI: 10.19852/j.cnki.jtcm.20240423.002.

Effectiveness of Extended-Release Bupropion and Duloxetine on Pelvic Pain and Sexual Function among Patients with Chronic Prostatitis/Chronic Pelvic Pain.

Jaafari S, Molaeinezhad M, Tarrahi M, Moosaei M, Sahfiei K, Afshar H Adv Biomed Res. 2024; 13:98.

PMID: 39717243 PMC: 11665165. DOI: 10.4103/abr.abr_202_23.

Comparative study of trace metal concentration in the diagnosis of category III prostatitis.

Lin Z, Li M, Zhang M, Gong Y, Gan X, Liang W BMC Urol. 2024; 24(1):259.

PMID: 39604918 PMC: 11600811. DOI: 10.1186/s12894-024-01656-9.

Evaluation of efficacy and safety of low-intensity pulsed ultrasound in patients with concurrent erectile dysfunction and chronic prostatitis/chronic pelvic pain syndrome: a prospective, randomized controlled study.

Li Z, Li D, Zu X, Xiang B, Wang G, Tang Z BMC Urol. 2024; 24(1):232.

PMID: 39438979 PMC: 11495096. DOI: 10.1186/s12894-024-01630-5.

References

Nnoaham K, Kumbang J . Transcutaneous electrical nerve stimulation (TENS) for chronic pain. Cochrane Database Syst Rev. 2008; (3):CD003222. DOI: 10.1002/14651858.CD003222.pub2. View

Kessler T . Biomarkers in chronic pelvic pain syndrome: did we find the Holy Grail?. BJU Int. 2017; 120(1):1. DOI: 10.1111/bju.13922. View

Li H, Liu J, Guo G, Li P, Zhang M, Wang Z . [Investigation of chronic prostatitis and altered bowel habits]. Zhonghua Nan Ke Xue. 2002; 8(5):338-40. View

Krieger J, Lee S, Jeon J, Cheah P, Liong M, Riley D . Epidemiology of prostatitis. Int J Antimicrob Agents. 2008; 31 Suppl 1:S85-90. PMC: 2292121. DOI: 10.1016/j.ijantimicag.2007.08.028. View

Nickel J, Alexander R, Schaeffer A, Landis J, Knauss J, Propert K . Leukocytes and bacteria in men with chronic prostatitis/chronic pelvic pain syndrome compared to asymptomatic controls. J Urol. 2003; 170(3):818-22. DOI: 10.1097/01.ju.0000082252.49374.e9. View

Krieger J, Ross S, Deutsch L, Riley D . The NIH Consensus concept of chronic prostatitis/chronic pelvic pain syndrome compared with traditional concepts of nonbacterial prostatitis and prostatodynia. Curr Urol Rep. 2002; 3(4):301-6. DOI: 10.1007/s11934-002-0054-z. View

Nickel J, Freedland S, Castro-Santamaria R, Moreira D . Chronic Prostate Inflammation Predicts Symptom Progression in Patients with Chronic Prostatitis/Chronic Pelvic Pain. J Urol. 2017; 198(1):122-128. DOI: 10.1016/j.juro.2017.01.035. View

Lotti F, Corona G, Mancini M, Biagini C, Colpi G, Innocenti S . The association between varicocele, premature ejaculation and prostatitis symptoms: possible mechanisms. J Sex Med. 2009; 6(10):2878-87. DOI: 10.1111/j.1743-6109.2009.01417.x. View

Al Edwan G, Muheilan M, Atta O . Long term efficacy of extracorporeal shock wave therapy [ESWT] for treatment of refractory chronic abacterial prostatitis. Ann Med Surg (Lond). 2017; 14:12-17. PMC: 5237771. DOI: 10.1016/j.amsu.2016.12.051. View

10.

Koh J, Ko H, Wang S, Cho K, Kim J, Lee S . The impact of depression and somatic symptoms on treatment outcomes in patients with chronic prostatitis/chronic pelvic pain syndrome: a preliminary study in a naturalistic treatment setting. Int J Clin Pract. 2014; 68(4):478-85. DOI: 10.1111/ijcp.12340. View

11.

Doggweiler R, Whitmore K, Meijlink J, Drake M, Frawley H, Nordling J . A standard for terminology in chronic pelvic pain syndromes: A report from the chronic pelvic pain working group of the international continence society. Neurourol Urodyn. 2016; 36(4):984-1008. DOI: 10.1002/nau.23072. View

12.

Hu M, Wazir J, Ullah R, Wang W, Cui X, Tang M . Phytotherapy and physical therapy in the management of chronic prostatitis-chronic pelvic pain syndrome. Int Urol Nephrol. 2019; 51(7):1081-1088. DOI: 10.1007/s11255-019-02161-x. View

13.

Magistro G, Wagenlehner F, Grabe M, Weidner W, Stief C, Nickel J . Contemporary Management of Chronic Prostatitis/Chronic Pelvic Pain Syndrome. Eur Urol. 2015; 69(2):286-97. DOI: 10.1016/j.eururo.2015.08.061. View

14.

Thakkinstian A, Attia J, Anothaisintawee T, Nickel J . α-blockers, antibiotics and anti-inflammatories have a role in the management of chronic prostatitis/chronic pelvic pain syndrome. BJU Int. 2012; 110(7):1014-22. DOI: 10.1111/j.1464-410X.2012.11088.x. View

15.

Guan X, Zhao C, Ou Z, Wang L, Zeng F, Qi L . Use of the UPOINT phenotype system in treating Chinese patients with chronic prostatitis/chronic pelvic pain syndrome: a prospective study. Asian J Androl. 2014; 17(1):120-3. PMC: 4291855. DOI: 10.4103/1008-682X.138189. View

16.

Vicari E, La Vignera S, Castiglione R, Condorelli R, Vicari L, Calogero A . Chronic bacterial prostatitis and irritable bowel syndrome: effectiveness of treatment with rifaximin followed by the probiotic VSL#3. Asian J Androl. 2014; 16(5):735-9. PMC: 4215680. DOI: 10.4103/1008-682X.131064. View

17.

Nickel J . Clinical evaluation of the man with chronic prostatitis/chronic pelvic pain syndrome. Urology. 2003; 60(6 Suppl):20-2; discussion 22-3. DOI: 10.1016/s0090-4295(02)02298-7. View

18.

Koh J, Ko H, Wang S, Cho K, Kim J, Lee S . The association of personality trait on treatment outcomes in patients with chronic prostatitis/chronic pelvic pain syndrome: an exploratory study. J Psychosom Res. 2014; 76(2):127-33. DOI: 10.1016/j.jpsychores.2013.11.004. View

19.

Yuan P, Ma D, Zhang Y, Gao X, Liu Z, Li R . Efficacy of low-intensity extracorporeal shock wave therapy for the treatment of chronic prostatitis/chronic pelvic pain syndrome: A systematic review and meta-analysis. Neurourol Urodyn. 2019; 38(6):1457-1466. DOI: 10.1002/nau.24017. View

20.

Shoskes D . Treatment response to conventional and novel therapies in chronic prostatitis. Curr Urol Rep. 2003; 4(4):311-5. DOI: 10.1007/s11934-003-0091-2. View