title: Chronic prostatitis/chronic pelvic pain syndrome: symptoms are aggravated by cold and become less distressing with age and time.
abstract: OBJECTIVE
  To evaluate how age and the duration of the condition influence the distress caused by the chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and to study how heat and cold influence the symptoms associated with CP/ CPPS as reported by patients afflicted with the condition.
  
  
  METHODS
  Forty-eight men (median age 50 years; age range 27-70 years) who had suffered from CP/CPPS for a duration ranging from 18 months to 40 years were included in the study. The evaluation included determination of the serum prostate-specific antigen level, the National Institutes of Health's Chronic Prostatitis Symptom Index (NIH-CPSI) and the International Prostate Symptom Score (IPSS).
  
  
  RESULTS
  The mean NIH-CPSI score was 23.0 +/- 4.8. The mean IPSS was 14.3 +/- 7.2. Dysuria was reported by 30 men (63%) and ejaculatory pain by 22 (48%). Men with dysuria had painful ejaculations more often (60%) than men without (22%) (p <0.01). There was a strong negative correlation between age and the NIH-CPSI quality of life (QOL) score (correlation coefficient 0.646; p < 0.001). Independent of age, the duration of the disease also correlated with the NIH-CPSI QOL score (correlation coefficient -0.48; p < 0.02). The total NIH-CPSI score did not correlate with either age or the duration of the disease. Nearly every other man stated that the disease had started in association with a specific event, which for 15 men (31%) included exposure to cold. Forty men (83%) reported that cold caused symptom aggravation and/or induced a relapse. Thirty men (63%) stated that taking a hot bath and 22 (46%) reported that spending time in a hot climate decreased the symptoms.
  
  
  CONCLUSIONS
  Age, as well as the duration of the condition, influenced the distress induced by CP/CPPS, suggesting an improved coping ability with time as well as age. The ambient temperature appears to play a role as cold was frequently reported as causing symptom aggravation and heat was often reported to be ameliorating. The mechanisms behind this association between CP/CPPS and temperature as well as the correlation between ejaculatory pain and dysuria require further study.
authors.affiliation: Research and Development Centre and the Department of Urology, Kärnsjukhuset, Skövde, Sweden. hans.hedelin@vgregion.se
authors.forename: Hans
authors.initials: H
authors.lastname: Hedelin
authors.forename: Karin
authors.initials: K
authors.lastname: Jonsson
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001494:Baths; D002908:Chronic Disease; D013790:Climatotherapy; D003080:Cold Temperature / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D053159:Dysuria / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D004542:Ejaculation / Q000502:physiology; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010147:Pain Measurement; D017699:Pelvic Pain / Q000209:etiology* / Q000503:physiopathology* / Q000628:therapy; D011467:Prostate / Q000098:blood supply; D011472:Prostatitis / Q000209:etiology* / Q000503:physiopathology* / Q000628:therapy; D011788:Quality of Life; D013997:Time Factors; D014661:Vasoconstriction / Q000502:physiology