Chronic pelvic pain syndrome: a non-prostatocentric perspective

Abstract

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common urological diagnosis affecting young and middle aged men. Symptoms of genital or pelvic pain associated with voiding or sexual dysfunction were historically attributed to an inflamed prostate gland. A review of urological and non-urological literature pertaining to CPPS was conducted in order to devise a plausible alternative description of this syndrome. Due to publisher's criteria, only select articles are included and cited for this purpose. Evidence of a bacterial etiology is non-existent, while evidence of prostatic inflammation is conflicting and non-specific. More plausible causes of prostatitis-like symptoms include musculoskeletal pain, pelvic floor muscular dysfunction, myofascial pain syndromes or functional somatic syndromes. Thorough evaluation and appropriate therapy for patients has been seriously hindered by decades of a prostatocentric approach to CP/CPPS. The following article introduces an alternative perspective.