Chronic Prostatitis/Chronic Pelvic Pain Syndrome: The Past, Present, and Future

Summary

Our understanding of “chronic prostatitis” (CP) has evolved over the last century from being an infectious disease, a condition that was easy to comprehend and simple to treat with antimicrobials to an inflammatory condition that could be managed with anti-inflammatories. Until recently, most still believed that CP involved the prostate and that therapy was prostatocentric. However, our traditional biomedical model has failed most patients. Our understanding of the condition we now call chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) has further evolved to a concept of disease progression in susceptible individuals through a series of initiating events followed by neurological, endocrine, and immunological changes modified by cognitive mechanisms. This new understanding has promoted major shifts in diagnosis and treatment that should improve the management of patients diagnosed with CP/CPPS.