New treatments for chronic prostatitis/chronic pelvic pain syndrome

Nat Rev Urol. 2010 Mar;7(3):127-35. doi: 10.1038/nrurol.2010.4. Epub 2010 Feb 9.

Abstract

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common condition among men of a wide age range, with detrimental effects on quality of life. The etiology, pathogenesis, and optimal treatment of CP/CPPS remain unknown, although progress has been made in these domains in recent years. A wide variety of pharmacologic and nonpharmacologic therapies have been studied in clinical trials, but most have shown limited efficacy in symptom alleviation. CP/CPPS is increasingly viewed as a condition that involves variable degrees of neuropathic pain. Medications such as gabapentin, pregabalin, memantine, and tricyclic antidepressants are often used in other neuropathic pain conditions and, therefore, are considered potential treatments for CP/CPPS. Few studies of these agents in patients with CP/CPPS have been reported, but future clinical trials should help to determine their utility and to characterize the pathogenetic mechanisms of pain in CP/CPPS. Combining treatment trials with biomarker, genomic, and imaging studies, in addition to epidemiologic and symptom-based assessments, will maximize the ability to probe disease etiology and pathogenesis, as well as identify effective treatment.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Amines / therapeutic use
  • Chronic Disease
  • Cognitive Behavioral Therapy / methods
  • Cyclohexanecarboxylic Acids / therapeutic use
  • Gabapentin
  • Humans
  • Male
  • Pelvic Pain / complications*
  • Pelvic Pain / diagnosis
  • Pelvic Pain / therapy*
  • Prostatitis / complications*
  • Prostatitis / diagnosis
  • Prostatitis / therapy*
  • Randomized Controlled Trials as Topic / methods
  • Randomized Controlled Trials as Topic / trends
  • Treatment Outcome
  • gamma-Aminobutyric Acid / therapeutic use

Substances

  • Amines
  • Cyclohexanecarboxylic Acids
  • gamma-Aminobutyric Acid
  • Gabapentin