This Guideline covers the evaluation and treatment of men who present to a clinician with a complaint of chronic pelvic pain. This is Part II of a three-part series focusing on treatment of chronic prostatitis/ chronic pelvic pain syndrome (CP/CPPS). A challenge for clinicians treating these patients is the necessity to address symptoms and etiologies outside of the usual urologic evaluation. Consequently, recommended treatment utilizes a multimodal/multidisciplinary approach that is highlighted through discussion of referral to other specialists and allied health professionals while continuing to manage urologic symptoms. For discussion of patient evaluation and treatment of chronic scrotal content pain (CSCP), refer to Parts I and III of this series.
The systematic review that informs the Guideline statements was based on searches in Ovid MEDLINE (1946 to June 6, 2023), the Cochrane Central Register of Controlled Trials (through May 2023), and the Cochrane Database of Systematic Reviews (through May 2023). An updated search was conducted in June 2024.
The Chronic Pelvic Pain Panel developed evidence- and consensus-based statements to provide guidance for the treatment of patients with CP/CPPS, which may include lifestyle modification, behavioral therapy, pharmacologic and phytotherapeutic options, and procedural intervention.
We usually think of pain in response to tissue injury that resolves with healing. We now know that pain can also derive from neurologic origins. Effective treatment of CP/CPPS will require better understanding of what is causing persistence of the pain in addition to further testing of therapies under investigation to establish a role in patient care.
The Journal of urology. 2025 Apr 17 [Epub ahead of print]
H Henry Lai, Michel A Pontari, Charles E Argoff, Larissa Bresler, Benjamin N Breyer, Roger Chou, J Quentin Clemens, Elise Jb De, R Christopher Doiron, Dane Johnson, Erin Kirkby, Susan M MacDonald, Jill H Osborne, Sijo J Parekattil, Beth Shelly
Department of Urology, Washington University Medicine, St Louis, Missouri., Department of Urology, Fox Chase-Temple Urological Institute, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania., Department of Neurology, Albany Medical Health System, Albany, New York., Department of Urology, Northwestern University, Chicago, Illinois., Department of Urology, University of California San Francisco, San Francisco, California., Pacific Northwest Evidence-Based Practice Center, Oregon Health & Science University, Portland Oregon., Department of Urology, University of Michigan, Ann Arbor, Michigan., Department of Urology, Queen's University, Ontario, Canada., American Urological Association, Linthicum, Maryland., Department of Urology, Penn State Health, Hershey, Pennsylvania., Interstitial Cystitis Network, Healdsburg, California., Avant Concierge Urology, Winter Garden, Florida., Beth Shelly Physical Therapy, Moline, Illinois.