Male CP/CPPS: where do we stand?

World J Urol. 2019 Jun;37(6):1015-1022. doi: 10.1007/s00345-019-02718-6. Epub 2019 Mar 12.


Introduction: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), commonly encountered in urologic practice, carries with it a stigma of poor understanding, ineffective treatment, and significant financial and quality of life burden.

Materials and methods: This clinically practical review is based on the authors' personal clinical experience in interpretation and application of currently available evidence.

Results: Significant progress has been made in terms of classification and evaluation of the disease, leading to encouraging improvements in treatment outcomes. The Chronic Prostatitis Symptom Index (CPSI) is a helpful tool in clinical evaluation and has proven invaluable for research purposes, while UPOINT has demonstrated the heterogeneity of the disease and provides physicians with a uniquely patient-centered approach to treatment. The importance of the microbiome in the evaluation of CP/CPPS patients has yet to be fully appreciated. While personalized, multi-modal therapy appears to be the key to treatment, the addition of pelvic floor physiotherapy (PFPT) with injection of trigger points, and psychosocial therapies to the multi-modal approach armamentarium are promising advances. Innovative interventional approaches are encouraging but require study.

Conclusions: While encouraging therapies have been added to personalized, multi-modal treatment strategies, newer innovative therapies appear promising for improved treatment of CP/CPPS patients.

Keywords: Chronic pelvic pain syndrome; Chronic prostatitis; Evaluation; Treatment.

Publication types

  • Review

MeSH terms

  • Humans
  • Male
  • Prostatitis* / diagnosis
  • Prostatitis* / therapy