Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) 

Cross section of prostate gland.Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is ongoing pain in the area of the prostate gland. CP/CPPS is the most common of the 4 types of prostatitis which also include acute bacterial prostatitis, chronic bacterial prostatitis, and asymptomatic inflammatory prostatitis. The prostate gland is part of the male reproductive system. It sits just below the bladder and surrounds the urethra. The urethra is the tube that takes urine and semen out of the body. CP/CPPS is the most common form of pain of the gland. It is also known as nonbacterial prostatitis. Symptoms such as pain and trouble urinating may come and go.

What causes CP/CPPS?

The exact cause of CP/CPPS isn’t known. It may be caused by an infection that comes back again and again. It may be caused by inflammation of the gland. Muscle spasms in the pelvis may be a cause. Other causes of CP/CPPS may include:

  • Stress that tightens the pelvic muscles

  • Urine flowing back up into the prostate ducts

  • Not ejaculating often

In many cases, the cause isn’t clear.

What are the symptoms of CP/CPPS?

Some men don’t have symptoms. Or, they may have symptoms that come and go. The symptoms can include:

  • Pain in the genitals and pelvic area

  • Trouble urinating

  • Pain while urinating

  • Pain during or after ejaculation

How is CP/CPPS diagnosed?

Your healthcare provider will ask about your medical history and your symptoms. He or she may give you a physical exam, including a rectal exam. Your urine, blood, and semen may be tested for bacteria or certain chemicals. In some cases, you may have other tests. You may have an ultrasound or a transrectal ultrasound-guided biopsy. This is done to take tiny pieces of tissue to look at with a microscope. Or, you may have imaging tests such as a CT scan, MRI, or urodynamic studies that look at urine flow and other issues. These are done to look at your abdomen and pelvic areas.

How is CP/CPPS treated?

The goal of treatment is to help relieve symptoms. Treatments can include one or more of these:

  • Antibiotics

  • Anti-inflammatory or muscle-relaxing medicines

  • Alpha-blocker medicines, which relax the muscles in and around the gland

  • Sitz baths

  • Prostate massage

  • Dietary changes

  • Biofeedback

  • Surgery

  • Other medicines or herbal treatments