Chronic prostatitis/chronic pelvic pain syndrome

CP/CPPS, also known as primary prostate pain syndrome, is characterized by persistent or recurrent pain in the prostate or perineal area for ≥ 3 of previous 6 months without evidence of UTI.

The pathophysiology of this syndrome is not fully understood, but it is believed to involve dysregulation of neurotransmitters and inflammation. Abnormalities in the regulation of neurotransmitter release and/or abnormal levels of extracellular neurotransmitter concentrations have been implicated in the neuronal foundations of pain disorders. Inflammation, either with the presence of white cells in the prostatic secretions or without, may also play a role.

The global prevalence of CP/CPPS is estimated at 2-10%, and is reported to constitute about 14% of male urological outpatients visits.

Risk factors for CP/CPPS include age, stress, and a history of prostate infections.

Clinically, patients with CP/CPPS typically present with pain in the pelvic area but may also include the perineum, rectum, prostate, penis, testicles, and abdomen. They may also experience urinary symptoms, such as urgency, frequency, hesitancy, and poor or interrupted flow. Pain during ejaculation is also a common symptom.

CP/CPPS can significantly impact the patient's QoL, leading to negative cognitive, behavioral, sexual, or emotional outcomes.