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What is CP/CPPS?


The "prostatitis" diagnosis is assigned to 8% and 1% of patients by urologists and primary care physicians, respectively. There are an estimated 2 million outpatient visits for prostatitis per year in the US. There are more outpatient visits for prostatitis than for BPH or prostate cancer. Dr Nickel (2001) found a 9.7% prevalence of prostatitis-like symptoms in the community. The most conservative study puts the incidence at around 3%, which means at least 4.5 million men in the US and 90 million worldwide. In 2002 a lot of research emerged to show that IC and CPPS are one and the same, and Dr CL Parsons from UC San Diego has suggested both conditions should be renamed as Lower Urinary Dysfunctional Epithelium (LUDE).

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) has a wide range of symptoms, with some confusion at the moment due to possible overlap with other conditions. For instance, some men report frequent urination and others don't. Some report sexual dysfunction and erectile difficulties, others don't - they can have intercourse daily. In addition, men with sterile orchialgia, epididymitis and urethritis are usually excluded from chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), but recently some experts have said that these men also have CP/CPPS, which not only targets the prostate. Many men who are told they have prostatitis are misdiagnosed. Inflammation may be centred in the bladder. This condition is called Interstitial Cystitis, which features painful, frequent urination, although IC expert C. Lowell Parsons says only 15 % of men with IC have frequency and urgency.

Roughly speaking, when cultures are negative, chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) can be described as persistent relapsing pain or discomfort in any of the following areas:

Some of the functional symptoms are:

Other often reported symptoms are:

Many people believe that the disease is a generalized, whole-body disorder, not merely isolated to the lower genitourinary tract. This idea has been proved to be true in BPS/IC recently.

The condition is notorious for waxing and waning. The pain can recede for hours and even days, then return inexplicably with force. In addition, people experience remissions which can last months to years, then have another flare-up.

From the 2001 AUA Meeting comes the following definition:

The pain can be unrelenting and emotionally exhausting. It can damage and even destroy marriages, it can rob families of their fathers and husbands. Striking at the very core of a man's maleness, it is truly a terrible affliction. Men have committed suicide because of this disease.

"The quality of life for a patient with Chronic Prostatitis is similar to that experienced by patients with acute myocardial infarction, unstable angina or active Crohn disease". J. Curtis Nickel, MD, FRCSC, Canada.

"Some patients experience so much pain that the condition is handled much like a chronic pain syndrome that occurs secondary to cancer. Therapy may begin with judicious use of narcotics until the patient experiences some relief". Keith B. Armitage, MD et al.