R Christopher Doiron1, Daniel A Shoskes2, J Curtis Nickel3. 1. Department of Urology, Queen's University, Empire 4, Kingston General Hospital, 76 Stuart St, Kingston, ON, K7L 2V7, Canada. chris.doiron@queensu.ca. 2. Department of Urology, Glickman Urologic and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA. 3. Department of Urology, Queen's University, Empire 4, Kingston General Hospital, 76 Stuart St, Kingston, ON, K7L 2V7, Canada.
Abstract
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.
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/CPPSpatients 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/CPPSpatients.