Summary
Definition
History and exam
Key diagnostic factors
- prostate pain
- duration of pain ≥3 months
- no other underlying pathology
- rectal pain
- perineal pain
- penile pain
- testicular pain
- inguinal pain
- prostate tenderness
- pelvic floor tenderness
- dysuria
- increased urinary frequency
- urinary urgency
- sexual dysfunction
- abdominal pain
- lower back pain
- abdominal tenderness
- poor urinary stream
- nocturia
Other diagnostic factors
- gluteal muscle tenderness
Risk factors
- hormonal imbalance
- genetics
- history of other pain syndromes
- childhood sexual abuse
- psychosocial factors
- history of previous urinary tract infection
- history of sexually transmitted infection
- immune dysfunction
- intra-prostatic urinary reflux
- irritable bowel syndrome
Diagnostic investigations
1st investigations to order
- clinical diagnosis
- dipstick urinalysis
- urine culture
- STI screen
Investigations to consider
- cystoscopy
- ultrasound imaging
- MRI
Treatment algorithm
all patients
Contributors
Authors
Daniel Engeler, MD
Chief Consultant Urologist and Chairman
Department of Urology
Kantonsspital St.Gallen
St Gallen
Switzerland
Disclosures
DE is the author of a number of references cited in this topic. DE declares that he has no other competing interests.
Brian Parsons, MBChB, FRCS, MD
Consultant Urologist
Royal Devon University Healthcare NHS Foundation Trust
Devon
UK
Disclosures
BP is the author of a number of references cited in this topic. BP declares that he has no other competing interests.
Acknowledgements
Dr Daniel Engeler and Dr Brian Parsons would like to gratefully acknowledge Dr Valentin Zumstein for his contribution to the initial drafts of this topic.
Divulgaciones
VZ declares that he has no competing interests.
Revisores por pares
Christopher Chapple, BSc, MBBS, MD, FRCS (Urol), FEBU, FCSHK (Hon)
Emeritus Consultant Urological Surgeon
Sheffield Teaching Hospitals NHS Foundation Trust
Sheffield
UK
Divulgaciones
CC acts or has acted as consultant/advisory board member for Coloplast, Ingenion, MUVON Therapeutics, Pierre Fabre, ProVerum, Takeda, Urovant Sciences; and as author for Astellas Pharma.
Amin Herati, MD
Assistant Professor of Urology
Department of Urology
Johns Hopkins Medicine
Lutherville
MD
Divulgaciones
AH is the author of a number of references cited in this topic. AH declares that he has no other competing interests.
Agradecimiento de los revisores por pares
Los temas de BMJ Best Practice se actualizan de forma continua de acuerdo con los desarrollos en la evidencia y en las guías. Los revisores por pares listados aquí han revisado el contenido al menos una vez durante la historia del tema.
Divulgaciones
Las afiliaciones y divulgaciones de los revisores por pares se refieren al momento de la revisión.
Referencias
Artículos principales
Engeler D, Baranowski AP, Borovicka J, et al; European Association of Urology. EAU guidelines on chronic pelvic pain. March 2022 [internet publication].Texto completo
Rees J, Abrahams M, Doble A, et al. Diagnosis and treatment of chronic bacterial prostatitis and chronic prostatitis/chronic pelvic pain syndrome: a consensus guideline. BJU Int. 2015 Oct;116(4):509-25.Texto completo Resumen
Franco JV, Turk T, Jung JH, et al. Non-pharmacological interventions for treating chronic prostatitis/chronic pelvic pain syndrome. Cochrane Database Syst Rev. 2018 May 12;(5):CD012551.Texto completo Resumen
Franco JVA, Turk T, Jung JH, et al. Pharmacological interventions for treating chronic prostatitis/chronic pelvic pain syndrome: a Cochrane systematic review. BJU Int. 2020 Apr;125(4):490-6. Resumen
Artículos de referencia
Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.

Diferenciales
- Interstitial cystitis/primary bladder pain syndrome
- Urinary tract infection
- Acute prostatitis
Más DiferencialesGuías de práctica clínica
- Chronic pelvic pain
- Diagnosis and treatment of chronic prostatitis and chronic pelvic pain syndrome: a new consensus guideline
Más Guías de práctica clínicaFolletos para el paciente
Prostatitis
Urinary tract infections in men
Más Folletos para el pacienteCalculadoras
NIH Chronic Prostatitis Symptom Index
Prostatism Symptom Score
Más CalculadorasInicie sesión o suscríbase para acceder a todo el BMJ Best Practice
El uso de este contenido está sujeto a nuestra cláusula de exención de responsabilidad