CP/CPPS - the disease and syndrome

Chronic nonbacterial prostatitis or chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a pelvic pain condition in men occurring from around 20 years of age. Inflammation can be detected in a fraction of patients, but is not a prerequisite for the diagnosis. Symptoms like pelvic pain, painful voiding and ejaculation, disturbed sexual functions are common, often resulting in a significant impact on quality of life. Professor J Curtis Nickel, Kingston, Ontario, Canada, reported at the EAU annual meeting 2008 in Milan that the annual cost of a prostatitis patient exceeds that of a patient with type 1 diabetes. He also stated that the quality of life of a man with prostatitis is similar to a patient with a heart attack or acute Crohn's disease.

Apart from starting with an antibiotic to exclude bacterial cause, there is no medical treatment obvious for the doctor to prescribe and, except for Japan, there is no drug with the indication CP/CPPS approved by the health authorities, neither in Europe or North America. NSAID and alpha-blockers are frequently tried, successfully in some cases, but there is an obvious need for more effective drugs that can alleviate symptoms of CP/CPPS.

With a reported prevalence of 2-16% (Current Clinical Urology Series, Chronic Prostatitis/Chronic Pelvic Pain Syndrome. Edited by Shoskes. Humana Press), CP/CPPS still constitutes a considerable white spot on the urology map and causes a lot of suffering by patients and frustrated doctors not having tools enough to alleviate the patient's symptoms.

Current research initiated by prof J Curtis Nickel focus on phenotyping the patients, as a tool that should contribute to the understanding of what drugs should be used on a particular patient.

The 2011 annual EAU Congress in Vienna provided a comprehensive overview of the CP/CPPS area with the latest developments presented by leading urologists. Cernelle was the sponsor of a symposium, "New developments in the understanding and management of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS)" and there was an ESU course on CP/CPPS. Visit the EAU Vienna website and listen to the podcasts.

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