Chronic Prostatitis/Chronic Pelvic Pain Syndrome and Male Bladder Pain Syndrome/Interstitial Cystitis: How Are They Related?

Abstract

To date, the heterogeneous pathophysiology of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and bladder pain syndrome/interstitial cystitis (BPS/IC) has not been fully elucidated. Thus, it is difficult to make a full comparison between CP/CPPS and male BPS/IC. Controversy and confusion surrounding the terminologies and classifications of CP/CPPS and BPS/IC complicates the issue. CP/CPPS and male BPS/IC are not mutually exclusive conditions, in that they have similarities in their pathogenesis and clinical presentation. Based on the working definitions of these terms, it would be correct to say that male BPS/IC is subsumed by CP/CPPS, and that male BPS/IC can be regarded as CP/CPPS with clear bladder-specific features. Although the term CP/CPPS may be inappropriate, especially since "CP" may be misleading, the perspective that CP/CPPS and male BPS/IC are male urological chronic pain syndromes could enhance the understanding of the relationship between the two. The European Association of Urology classification for chronic pelvic pain is systematic and corresponds well with our knowledge of chronic pain. Therefore, this classification might be the solution to the problems associated with the existing terminologies and taxonomy of CP/CPPS and BPS/IC. In the management of urological chronic pelvic pain in men, clinical phenotyping systems (the UPOINT or UPOINTs system) profile patients and indicate how tailored treatment could be achieved as individualized, multimodal therapeutic regimens. It would be prudent to include bladder-specific features, such as painful filling or painful urgency, in the criteria for the organ-specific domain of the UPOINT(s) system.