Classification and treatment of men with chronic prostatitis/chronic pelvic pain syndrome using the UPOINT system

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common condition; however, many of the traditional therapies used in clinical practice fail to show efficacy when subjected to large randomized placebo-controlled trials. This may be because CP/CPPS is a heterogeneous syndrome rather than a specific disease which would explain the failure of "one size fits all" therapy. In order to direct appropriate therapy, we have developed a six-point clinical phenotyping system to evaluate patients with chronic urologic pelvic pain. The clinical domains are urinary symptoms, psychosocial dysfunction, organ-specific findings, infection, neurologic/systemic, and tenderness of muscles, which produces the acronym UPOINT. Each domain is diagnosed clinically and is associated with specific therapies. This approach is simple and has proven effective in our hands for patients even after many years of failed therapies.