title: Chronic prostatitis/chronic pelvic pain syndrome: a review of evaluation and therapy.
abstract: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), also known as NIH Category III Prostatitis is a highly prevalent syndrome with significant impact on quality of life. As a heterogeneous syndrome, there exists no 'one size fits all' therapy with level 1 evidence to guide therapy. This often leads to a nihilistic approach to patients and clinical outcomes are poor. In this review, we examine the evidence for CP/CPPS therapies and discuss our technique of clinical phenotyping combined with multimodal therapy.
  
  
  
  Review of Medline articles with terms 'non-bacterial prostatitis', 'abacterial prostatitis' and 'chronic pelvic pain syndrome'.
  
  
  
  Many individual therapies have been evaluated in the treatment of CP/CPPS; antibiotics, anti-inflammatory medications (including bioflavonoids), neuromodulators, alpha blockers, pelvic floor physical therapy and cognitive behavior therapy. Each of these has been found to have varying success in alleviating symptoms. UPOINT is a system of clinical phenotyping for CP/CPPS patients that has 6 defined domains, which guide multimodal therapy. It has been validated to correlate with symptom burden and therapy guided by UPOINT leads to significant symptom improvement in 75-84% of patients based on three independent studies.
  
  
  
  CP/CPPS is a heterogeneous condition and, much like with prostate cancer, optimal therapy can only be achieved by classifying patients into clinically meaningful phenotypic groups (much like TNM) and letting the phenotype drive therapy.
authors.affiliation: Columbia University Division of Urology, Mount Sinai Medical Center, Miami Beach, FL, USA.
authors.forename: A S
authors.initials: AS
authors.lastname: Polackwich
authors.affiliation: Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.
authors.forename: D A
authors.initials: DA
authors.lastname: Shoskes
mesh_terms: D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D002908:Chronic Disease; D003131:Combined Modality Therapy; D006801:Humans; D008297:Male; D017699:Pelvic Pain / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology / Q000628:therapy*; D010641:Phenotype; D026741:Physical Therapy Modalities; D011472:Prostatitis / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology / Q000628:therapy*; D011788:Quality of Life; D012720:Severity of Illness Index; D013315:Stress, Psychological; D013577:Syndrome
chemical_list: D000317:Adrenergic alpha-Antagonists; D018712:Analgesics, Non-Narcotic; D000893:Anti-Inflammatory Agents