Update on minimally invasive therapy for chronic prostatitis/chronic pelvic pain syndrome.

Once primary treatment fails, the diverse causes and symptoms of chronic pelvic pain syndrome require clinicians to consider several secondary approaches. Multimodal therapy addresses unique symptoms and targets illness origin. However, once medical modalities fail, minimally invasive therapies should be considered, including transurethral needle ablation hyperthermia, cooled thermotherapy, electromagnetic chair, prostatic massage, and intraprostatic botulinum toxin A injection. Low evidence levels exist for all approaches, but we anticipate promising results of larger trials for cooled thermotherapy and look forward to the emergence of experimental techniques using botulinum toxin A.