Table 2.
Signs and symptoms reported by patients with CBP and CP/CPPS
|
Pain symptoms
9, 10, 11, 12, 13, 14
Pain or discomfort in one or multiple urogenital regions including the:
|
Retrospective data indicate that the most prevalent localisation for pain is the perineal region (63% of patients), followed by the testicular, pubic and penile areas 14.Tests for correlations between the NIH‐CPSI symptom domains suggest that urogenital pain has a greater impact on QoL than do urinary symptoms 14
IBS has been shown to be present in 22–31% of patients with CBP or CP/CPPS 13, 15 and can increase the severity of pain symptoms 13, 15, 16 |
| Pain on urination, or that increases with urination | |
| Pain during or after ejaculation | |
| Muscle tenderness or dysfunction in abdominal/pelvic regions | |
| Neuropathic pain | |
| Functional bowel symptoms (e.g. IBS) | |
| Urinary symptoms 9, 11, 17, 18, 19, 20 | Cohort studies report ≥1 LUTS symptom in 39–68% of patients 17, 18. There may also be an association with recurrent UTIs in a minority of patients 19, 21 |
| Voiding LUTS (weak stream, straining and hesitancy) | |
| Storage LUTS (urgency ± urge incontinence, increased urinary frequency, nocturia and dysuria) | |
| Urethral burning during, and independent of, micturition | |
| Haematospermia (blood in semen) | |
| Recurrent UTI (more applicable to CBP) | |
| Sexual dysfunction symptoms 17, 22, 23, 24, 25, 26, 27, 28, 29, 30 | Findings from cohort studies (n = 130–1 800) indicate that total or partial ED is reported by 15–55% of patients with CP/CPPS 22, 31, 32, 33, 34, while the prevalence of overall, self‐reported sexual dysfunction is higher at 46–92% 22, 23, 31, 34. Correlation studies of sexual dysfunction symptoms with NIH‐CPSI scores indicate that patients with CP/CPPS with sexual dysfunction have higher total and QoL scores, suggesting that sexual symptoms can contribute substantially to morbidity 28, 31, 32, 33, 35, 36. However, in one study the presence of ED was shown not to independently affect symptom severity or QoL in patients with CP/CPPS 37 |
| ED | |
| Ejaculatory dysfunction (premature, delayed or pain during, or after, ejaculation) | |
| Decreased libido | |
| Psychosocial symptoms 3, 18, 32, 33, 35, 36 | CBP and CP/CPPS can have a significant negative impact on QoL, potentially causing limitations to activity 38 and the QoL of patients with CBP or CP/CPPS has been shown to be as poor as that of patients with congestive heart failure or Crohn's disease 4. Negative behavioural consequences and psychosocial symptoms, such as depression and anxiety, can also have a significant impact 39, 40. Small (n < 250) case‐control studies indicate that depression, anxiety and panic disorder are significantly more common in men with chronic symptoms vs controls, using responses to the Patient Health Questionnaire (PHQ) 41 or other psychometric questionnaires (for example, the Perceived Stress Scale) 29, 42, 43. Furthermore, a small (n = 61) cohort study suggests patients with CP/CPPS can experience pain catastrophising (a negative cognitive‐affective response to anticipated or actual pain) and this was linked to more severe pain and QoL issues and the risk of developing chronic pain 44 |
| Anxiety or stress | |
| Depression | |
| Cognitive/behavioural consequences | |
| Decreased QoL |
ED, erectile dysfunction; IBS, irritable bowel syndrome; UTI, urinary tract infection.