Chronic Prostatitis (Chronic Pelvic Pain Syndrome)

  1. rion healyST5 Urology Register1,
  2. charlotte thorneLocum General Practitioner2,
  3. Aditya Manjunathconsultant urologist1
  1. 1Department of Urology, North Bristol NHS Trust, UK
  2. 2South West, UK
  1. Correspondence to R Healy rhealy1{at}

What you need to know

  • Chronic prostatitis, also known as chronic pelvic pain syndrome, is defined as pelvic pain accompanied by variable urinary symptoms and sexual dysfunction lasting at least three months.

  • Detect important differences such as urological and rectal cancers, bacterial infections, benign prostatic enlargement and neurological conditions

  • Empower patients by providing information about their condition and considering psychosocial and quality of life issues early on

A 64-year-old man presents with frequent perineal and testicular pain due to frequent urination. He had previously been treated with antibiotics for prostatitis which did not help. She is very concerned about what these symptoms may indicate and why they recur.

Chronic prostatitis is defined as pelvic pain with various associated urinary symptoms and sexual dysfunction that lasts for at least three months.1 This is a common condition that can affect the patient’s quality of life.2 The National Institutes of Health have defined four categories of prostatitis (Table 1).67 Type 3, chronic non-bacterial prostatitis, is the most common, and accounts for about 90% of all diagnoses.68 Chronic prostatitis is also known as chronic pelvic pain syndrome (CPPS) or primary prostate pain syndrome. Recently, bodies such as the European Association of Urology (EAU) have been trying to move away from the term chronic prostatitis, as CPPS should be considered distinct from acute and chronic bacterial prostatitis and is not associated with active infection.3 In this article, we refer to it as CPPS to avoid confusion with chronic bacterial prostatitis, which is much less common.

See this table:

Table 1

National Institutes of Health Prostatitis Classification 199567

According to literature reviews of population-based studies from North America, Finland, Singapore, Japan, and Malaysia, the incidence of CPPS is 2–10% in men.4 A large cross-sectional study shows that the risk increases with age,…

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