Abstract
Introduction: Chronic Prostatitis/Chronic Pelvic Pain Syndrome is a debilitating condition that is one of the most common reasons for visits to Urologists among male patients under the age of 50. Recently, a phenotypic method of classification and assessment of the disease has been introduced and validated. However, its use has not been studied in an Indian population so far.
Materials and Methods: Male patients with symptoms and signs suggestive of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) attending a single out-patient clinic at a tertiary-care hospital were prospectively evaluated using the NIH-CPSI score and UPOINT domains. Data from the evaluation was collated and analysed.
Results: A total of 30 patients who met the criteria for CP/CPPS were evaluated. Average age of the patients was 34.37 years. The positive domains were Urinary (27), Psychosocial (18), Organ-specific (13), Infection (8), Neurological/Systemic (5), Tenderness (4). Patients had an average IPSS score of (9.4). In the NIH-CPSI scores, the pain score average was (11.37), urinary scores were (6.03), and the Quality of Life domain scores were (7.2). The average NIH-CPSI score was 24.93.
Discussion: This study is probably the first time the NIH-CPSI score and UPOINT phenotype system has been studied in an Indian population. It was seen that the UPOINT domains were useful in classifying the disease and directing multimodal treatment.
Keywords: Prostatitis, NIH-CPSI Score, UPOINT Domains, Chronic Prostatitis.
References
- Krieger JN, Lee SW, Jeon J, Cheah PY, Liong ML, Riley DE.Epidemiology of prostatitis. Int J Antimicrob Agents. 2008; 31 Suppl 1: S85–90.
- Krieger JN, Nyberg L Jr, Nickel JC: NIH consensus definition and classification of prostatitis. 1999; 282(3): 236–7.
- Zhao Z, Zhang J, He J, Zeng G. Clinical Utility of the UPOINT Phenotype System in Chinese Males with Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS): A Prospective Study. PLoS One. 2013;8(1):e52044.
- Smith CP: Male chronic pelvic pain: An update. Indian J Urol. 2016; 32(1):34–9.
- Shoskes DA, Nickel JC, Dolinga R, Prots D. Clinical phenotyping of patients with chronic prostatitis/chronic pelvic pain syndrome and correlation with symptom severity. Urology. 2009; 73(3): 538–42.
- Polackwich AS, Shoskes DA: Chronic prostatitis/chronic pelvic pain syndrome: a review of evaluation and therapy. Prostate Cancer Prostatic Dis.2016; 19(2): 132–8.
- Nickel JC. Role of alpha1‑blockers in chronic prostatitis syndromes. BJU Int.2008;101 Suppl 3: 11–6.
- Shoskes DA, Nickel JC, Kattan MW. Phenotypically directed multimodal therapy for chronic prostatitis/chronic pelvic pain syndrome: a prospective study using UPOINT. Urology 2010; 75: 1249–53.
- Backonja M, Glanzman RL. Gabapentin dosing for neuropathic pain: evidence from randomized, placebo‑controlled clinical trials. Clin Ther2003; 25: 81–104.
- Nickel CJ and Shoskes DA: Phenotypic approach to the management of the chronic prostatitis/chronic pelvic pain syndrome. BJUI. 2010; 106: 1252-1263.
- McNaughton Collins M, Pontari MA, O’Leary MP, Calhoun EA, Santanna J, et al. Quality of life is impaired in men with chronic prostatitis: the Chronic Prostatitis Collaborative Research Network. J Gen Intern Med 2001; 16: 656–62.
- Nickel JC, Krieger JN, McNaughton‑Collins M, Anderson RU, Pontari M, et al.Alfuzosin and symptoms of chronic prostatitis‑chronic pelvic pain syndrome. N EnglJ Med 2008; 359: 2663–73.
- Mehik A, Alas P, Nickel JC, Sarpola A, Helström PJ. Alfuzosin treatment for chronic prostatitis/chronic pelvic pain syndrome: a prospective, randomized, double‑blind, placebo‑controlled, pilot study. Urology 2003; 62: 425–9.
- Calhoun EA, McNaughton Collins M, Pontari MA, O’Leary M, Leiby BE, et al. The economic impact of chronic prostatitis. Arch Intern Med 2004; 164: 1231–6.
- Pontari MA, Ruggieri MR. Mechanisms in prostatitis/chronic pelvic pain syndrome. J Urol2008; 179: S61–7.
- Arda E, Cakiroglu B, Tas T, Ekici S, Uyanik BS. Use of the UPOINT Classification in Turkish Chronic Pros-tatitis or Chronic Pelvic Pain Syndrome Patients. Urology. 2016; 97: 227-231.
- Guan X, Zhao C, Ou Z, Wang L, Zeng F, Qi L, et al. Use of the UPOINT phenotype system in treating Chinese patients with chronic prostatitis/chronic pelvic pain syndrome: a prospective study. Asian Journal of Andrology 2015; 17: 120–123.
Corresponding Author
Dr Omar Salim Akhtar
MBBS, MS (General Surgery), DNB (General Surgery), MRCS (Edin, UK), DNB (Urology)
Lecturer in Urology, Super Specialty Hospital, Government Medical College, Srinagar, J&K – 190010
DOI: https://dx.doi.org/10.18535/jmscr/v6i6.36
