CP/CPPS is a painful urologic condition that affects mainly young and middle-aged cisgender men and others assigned male at birth.

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is the most common urologic condition in cisgender men and others assigned male at birth (AMAB).

CP/CPPS is a type of prostatitis, an inflammation of the prostate, that’s also associated with other inflammatory symptoms. The pelvis, penis, scrotum and testes, rectum, perineum, and lower back can be affected.

What sets CP/CPPS apart from other types of prostatitis is that in this condition, symptoms last at least 3 months without infection or another identifiable explanation for the symptoms.

CP/CPPS symptoms last 3 months or longer and can fluctuate in severity from mild to severe.

If you have CP/CPPS, you may experience:

Experts don’t know exactly what causes CP/CPPS.

Some believe that CP/CPPS is triggered by a bacterial infection that causes tissue damage, while others suspect it’s caused by a microorganism but not bacteria.

There’s also research pointing to chronic inflammation and autoimmunity as possible causes. Some evidence suggests that pelvic floor dysfunction may be a cause rather than a sign of CP/CPPS.

Age is the biggest risk factor, as CP/CPPS tends to occur in young and middle-aged cisgender men and AMAB folks under 50 years of age.

Some other factors that may increase your risk of developing CP/CPPS are:

  • nerve damage in the lower urinary tract from surgery or trauma
  • a previous bladder infection
  • psychological stress

CP/CPPS can be hard to diagnose because the symptoms are similar to other conditions involving the urinary tract and prostate.

A healthcare professional will likely want to perform a combination of the following to help rule out other conditions that cause similar symptoms:

  • Verbal assessment: A clinician may ask about your personal and family medical history. They’ll want to know what your symptoms are and when they started, and they may ask about previous infections, surgery, or other trauma to the area.
  • Physical examination: A clinician will perform a physical examination, which may include checking for discharge from your urethra, swollen lymph nodes in the groin, and scrotal swelling or pain. They may also perform a digital rectal exam to see if your prostate is enlarged or tender to the touch.
  • Urinalysis: You may be asked to provide a urine sample that will be checked for bacteria to rule out bacterial prostatitis.
  • Blood tests: Blood tests may be used to check your blood for signs of infection and other prostate problems, such as prostate cancer.
  • Semen analysis: You may be asked to provide a sample of your semen. Semen analysis is used to check the quantity and quality of your semen and to look for blood and signs of infection.
  • Transrectal ultrasound: A transrectal ultrasound may be used to examine your prostate for abnormalities, such as tumors. The ultrasound is performed by inserting a pen-sized device, called a “transducer,” into your rectum.
  • Urodynamic tests: These can include different procedures, such as uroflowmetry, to check how well your bladder holds and releases urine.
  • Cystoscopy: A cystoscopy is performed under local anesthesia and involves inserting a thin tube called a “cystoscope” into the urethra to check for stones, narrowing, or blockage in your urinary tract.
  • Biopsy: A clinician may recommend a prostate biopsy because prostate cancer can cause many of the same symptoms as CP/CPPS. A prostate biopsy is an outpatient procedure performed by a urologist in a hospital. The urologist will use an ultrasound or another type of imaging to guide a biopsy needle into the prostate to collect a sample.

CP/CPPS can cause a wide range of symptoms that vary from person to person, so there’s no single treatment for it.

Treating the condition usually requires a combination of medical and home treatments to help reduce inflammation and manage your symptoms.

Medication

Although CP/CPPS isn’t a bacterial form of prostatitis, a clinician may prescribe a round of antibiotics initially while waiting for tests to rule out infection.

A clinician will likely recommend a combination of medications to help you manage your symptoms. Medications can include:

Counseling

Stress and other physiological conditions are thought to be one of the potential causes of CP/CPPS. Having the condition can also have a negative impact on mental health and lead to anxiety and depression.

Working with a mental health professional, such as a therapist, can help you cope with anxiety and depression and learn techniques to help manage stress.

At-home treatments

Here are things you can do at home to help relieve discomfort:

  • Use a heating pad or hot water bottle on your lower abdomen and back.
  • Soak in a warm bath or sitz bath.
  • Try relaxation exercises, such as deep breathing and visualization, which have been shown to help reduce anxiety and pain.
  • Do pelvic floor exercises, such as Kegel exercises, if you can tolerate them.
  • Empty your bladder often, as holding in urine has been shown to increase pain intensity in CP/CPPS.
  • Quit smoking — there’s some evidence that it may increase pain sensitivity.

Alternative therapies

The following alternative therapies may be worth considering alongside medical treatment for CP/CPPS:

  • Myofascial release has been found to improve pain intensity, sensitivity, and psychological symptoms associated with chronic pelvic pain.
  • Biofeedback, a mind-body therapy that helps you learn how to control physical processes including pain and anxiety, has benefits for some types of anorectal and pelvic pain, according to some research.
  • Acupuncture was shown to relieve pain and urinary symptoms, and improve the quality of life in people with CP/CPPS, according to a 2021 review of studies.

More research is needed to come up with targeted treatments for CP/CPPS.

Working with a healthcare professional can help you find a combination of medical, lifestyle, and alternative therapies to help you manage the condition.

Adrienne Santos-Longhurst is a Canada-based freelance writer and author who has written extensively on all things health and lifestyle for more than a decade. When she’s not holed-up in her writing shed researching an article or off interviewing health professionals, she can be found frolicking around her beach town with husband and dogs in tow or splashing about the lake trying to master the stand-up paddle board.