CHRONIC PROSTATITIS / CHRONIC PELVIC PAIN SYNDROME: CLINICAL PHENOTYPES AND THERAPEUTIC RESPONSE
Keywords:
chronic prostatitis; chronic pelvic pain syndrome; UPOINT; phenotypes; NIH-CPSI; male pelvic pain; multimodal therapyAbstract
DOI: https://doi.org/10.46296/yc.v10i18.0876
Abstract
Background: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a heterogeneous condition characterized by persistent or recurrent pelvic pain, usually for more than three months, in the absence of proven bacterial infection or another evident local disease explaining symptoms. It affects pain, urinary function, sexual health, psychosocial well-being and quality of life. Objective: To analyze the clinical phenotypes of CP/CPPS and their relationship with therapeutic response, emphasizing the UPOINT/UPOINTS model as a practical framework for individualized and multimodal care. Methods: A narrative review was conducted using international clinical guidelines, systematic reviews, phenotyping studies and relevant literature on diagnosis, outcome assessment and treatment of CP/CPPS. Discussion: Current evidence supports a phenotype-directed approach because no single monotherapy benefits all patients. The UPOINT/UPOINTS domains include urinary, psychosocial, organ-specific, infection, neurologic/systemic, tenderness of pelvic floor muscles and sexual dysfunction. Each domain suggests specific therapeutic strategies, such as alpha-blockers, culture-guided antibiotics, anti-inflammatory agents, phytotherapy, pain neuromodulators, pelvic floor physical therapy, psychological therapy and sexual dysfunction management. Conclusions: CP/CPPS should be understood as a biopsychosocial syndrome with variable clinical expression. Therapeutic response is optimized when treatment is tailored to the dominant phenotype, unnecessary repeated antibiotics are avoided and multidisciplinary care is implemented. NIH-CPSI is useful for monitoring symptom burden and response over time.
Keywords: chronic prostatitis; chronic pelvic pain syndrome; UPOINT; phenotypes; NIH-CPSI; male pelvic pain; multimodal therapy.
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