Objective: Chronic abacterial prostatitis/pelvic pain syndrome (CP/CPPS) is characterized by pain, voiding and sexual dysfunction persisting fo r> 3 months. The symptoms tend to occur in relapses of varying length. To evaluate what causes a relapse and what precautions patients with CP/CPPS undertake to avoid a relapse and/or aggravation of symptoms, individual semi-structured interviews were performed.
Material and methods: Information was obtained from semi-structured in-depth interviews with 10 selected men with CP/CPPS (mean age 44 years; 30-62 years). The interviews were transcribed and analysed according to Girorgi's phenomenological method as modified by Malterud.
Results: CP/CPPS tended to start in connection with a specific event involving cold exposure, suggesting cold as an initiating stimulus for CP/CPPS. The informants also reported that cold exposure caused aggravation of symptoms and provoked their relapse. Sitting on cold objects, spending time in cold, damp or windy surroundings and walking on a cold floor were provocative and thus were avoided. The exposure did not have to be either prolonged or intense. Heat applied to the perineum, as well as spending time in a warmer climate, gave relief from symptoms.
Conclusions: It appears that cold is one of the factors that can trigger a process resulting in CP/CPPS. The fact that cold also causes aggravation of symptoms and can initiate a relapse was evident, as was the fact that symptoms could be relieved by heat. The connection between cold and symptom aggravation is well known among clinicians but has not previously been studied in a systematic way. The fact that cold, in a susceptible man, can initiate a process resulting in CP/CPSS has not been reported before. Studies aimed at elucidating the mechanisms behind this phenomenon are warranted. Reflex vasoconstriction in a susceptible individual is a possible cause.