A case‐control study of risk factors in men with chronic pelvic pain syndrome

Abstract

OBJECTIVETo compare the demographic, behavioural, clinical and medical history characteristics of men with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and asymptomatic controls, to identify characteristics that might be associated with this syndrome. PATIENTS AND METHODSSelf-administered epidemiological questionnaires were completed by 463 men with CP/CPPS and 121 asymptomatic agematched controls. We compared the prevalence of possible risk factors between men with CP/CPPS and controls, using generalized Mantel-Haenszel tests, and developed multivariate predictive models using logistic regression methods, adjusting for clustering by clinical centre within both methods. RESULTSCompared to controls, men with CP/CPPS reported a significantly greater lifetime prevalence of nonspecific urethritis (12% vs 4%, P = 0.008), cardiovascular disease (11% vs 2%, P = 0.004), neurological disease (41% vs 14%, P < 0.001), psychiatric conditions (29% vs 11%, P < 0.001), and haematopoietic, lymphatic or infectious disease (41% vs 20%, P < 0.001). CONCLUSION

Recent trend of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) management

“…Various complex causes (urinary tract infection, prostatic urinary tract counterflow [9], Cytokines [10], pelvic floor spasm [11], systemic nervous or endocrine cause [12] and neuropsychiatric cause [13]) affects CP/CPPS in terms of pathological physiology (Fig. 1).…”

Clinical phenotyping in chronic prostatitis/chronic pelvic pain syndrome and interstitial cystitis: a management strategy for urologic chronic pelvic pain syndromes

“…Patients with UCPPS have a high incidence of concomitant, but associated medical conditions that are often pain related or have features of autonomic dysfunction, as well as peripheral and central nervous system sensitization (neuropathic). 24 These include irritable bowel syndrome, fibromyalgia, Clinical phenotyping in CP/CPPS and IC DA Shoskes et al vulvodynia, chronic fatigue syndrome, migraine headaches and low back/leg pain. These patients are phenotyped into the neurological/systemic phenotype by good history taking supplemented by physical examination.…”

Proposed New Pathophysiology of Chronic Prostatitis/Chronic Pelvic Pain Syndrome

“…Men with CP/CPPS were 5 times more likely to self-report a history of nervous system disease, as compared to asymptomatic age-matched controls in the CPCRN Study [18].…”

“…However, studies that have looked for the presence of sexually transmitted organisms such as Chlamydia trachomatis, Trichomonas vaginalis, Ureaplasma urealyticum, or Mycoplasma hominis have failed to show persistent infection [17]. Although the presence of an active infection was not evident in men participating in the National Institutes of Health (NIH) cohort study, patients with CP/CPPS were found to have a significantly greater history of urethritis, as compared to age-matched controls [18]. In susceptible men, urethritis could serve as a source of inflammation that could cause chronic pelvic pain well after the resolution of infection.…”