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Chronic prostatitis: current treatment options

Authors Pirola GM, Verdacchi T, Rosadi S, Annino F, De Angelis M

Received 12 February 2019

Accepted for publication 3 May 2019

Published 4 June 2019 Volume 2019:11 Pages 165—174

DOI https://doi.org/10.2147/RRU.S194679

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 2

Editor who approved publication: Dr Jan Colli


Giacomo Maria Pirola, Tiziano Verdacchi, Stefano Rosadi, Filippo Annino, Michele De Angelis

Department of Urology, Usl Toscana Sud Est, San Donato Hospital, Arezzo, Italy

Abstract: Male chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is represented by a heterogeneous group of symptoms that can cause an important impairment of daily quality of life for patients. Diagnosis of CP/CPPS is often not clear and treatment can be challenging, as it varies according to the different causative factors and derived symptoms. Differently from approaches used in the past, the diagnosis and subsequent treatment rely on separating this entity from chronic bacterial prostatitis and considering it as a multifactorial disease. Autoimmunity and inflammation, myofascial tenderness, neuroinflammation, and psychological causes have been clearly related to this disease, and therefore CPPS should not only be considered as related to benign prostatic enlargement. A multitude of different symptoms related to urinary, genital, rectal, and perineal areas can be attributed to this condition and therefore should be routinely investigated in patients, as well as possible differential diagnoses which can cause the same symptoms, such as pudendal nerve entrapment syndrome. The aim of this narrative review is to focus on CPPS after an infectious cause has been excluded.

Keywords: chronic prostatitis, chronic pelvic pain syndrome, pudendal neuralgia, physical therapy, pharmacological treatment


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