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Introduction to chronic prostatitis and chronic pelvic pain syndrome (CP/CPPS)
Riccardo Bartoletti1, Nicola Mondaini, Carlo Pavone
1Department of Urology, University of Florence, S. Maria Annunziata Hospital, Italy. riccardo.bartoletti@unifi.it
Abstract:
Prostatitis is the most frequently diagnosed illness in men under 50, accounting for about 8% of all consultations with urologists. Estimates based on published studies suggest that the incidence of prostatitis in the population is somewhere between 4% and 11%. In 1995 the National Institutes of Health (NIH) classified prostatitis into 4 main categories: 1) acute bacterial; 2) chronic bacterial; 3) pelvic pain syndrome; 4) asymptomatic inflammatory. The aetiological agent most often involved is bacterial, particularly the category of Gram (-) bacteria, followed by Gram (+), chlamydiae and mycoplasmas; however many cases of prostatitis are caused by bacteria which are difficult to isolate or by aetiopathogenic mechanisms which are immunological, neurological, psychosomatic or anatomical in nature. An observational study was recently done on the Italian territory in order to estimate the incidence and risk factors of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). The disease incidence estimation was 13.8%. Cigarette smoking, high caloric diet with low consumption of fruit and vegetables, constipation, meteorism, slow digestion, sexual relationship with more than one partner and coitus interruptus were more likely in CP/CPPS patients than in controls (p < 0.001). CP/CPPS had a negative influence on sexual desire, erectile dysfunction and premature ejaculation (p < 0.001). The Meares Stamey test was positive in 13.3% of patients and 2.9% of controls.
Insights
Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) affects 13.8% of men, linked to lifestyle factors like smoking and diet. This condition negatively impacts sexual health, including desire and function.
Area of Science:
- Urology
- Public Health
- Epidemiology
Background:
- Prostatitis is a common condition affecting men under 50, with population incidence estimated between 4% and 11%.
- The National Institutes of Health (NIH) classifies prostatitis into four categories: acute bacterial, chronic bacterial, pelvic pain syndrome, and asymptomatic inflammatory.
- Bacterial infections, particularly Gram-negative bacteria, are common causes, but immunological, neurological, and psychosomatic factors also play a role.
Purpose of the Study:
- To estimate the incidence and identify risk factors for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) in Italy.
- To investigate the impact of CP/CPPS on sexual health outcomes.
Main Methods:
- An observational study was conducted on the Italian population.
- Data collected included lifestyle factors, sexual history, and Meares Stamey test results.
- Statistical analysis compared patients with CP/CPPS to a control group.
Main Results:
- The estimated incidence of CP/CPPS was 13.8%.
- Risk factors identified included cigarette smoking, high-calorie diets, low fruit/vegetable intake, constipation, meteorism, slow digestion, multiple sexual partners, and coitus interruptus (p < 0.001).
- CP/CPPS significantly correlated with reduced sexual desire, erectile dysfunction, and premature ejaculation (p < 0.001). The Meares Stamey test was positive in 13.3% of patients versus 2.9% of controls.
Conclusions:
- CP/CPPS is prevalent and associated with specific lifestyle and behavioral risk factors.
- The condition significantly impairs sexual function and desire.
- Further research into the multifactorial etiology and effective management strategies for CP/CPPS is warranted.
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