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

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 reproductive system for people who are assigned male at birth. It sits just below the bladder and around 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.

Side view cross section of male pelvic organs.
With a healthy prostate, urine flows easily through the urethra.

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 people 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 peeing

  • Pain while peeing

  • Pain during or after ejaculation

How is CP/CPPS diagnosed?

Your healthcare provider will ask about your health history and your symptoms. They 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 belly (abdomen) and pelvic areas.

How is CP/CPPS treated?

The goal of treatment is to help ease symptoms. Treatments can include 1 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

  • Physical therapy for the pelvic floor muscles

  • Other medicines or herbal treatments

Online Medical Reviewer: Marc Greenstein MD
Online Medical Reviewer: Marianne Fraser MSN RN
Online Medical Reviewer: Raymond Kent Turley BSN MSN RN
Date Last Reviewed: 10/1/2021
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