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Definitive diagnosis and selection of effective treatment for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) are frustrations encountered frequently by urology care providers in their practice. Knowledge of etiology and pathophysiology is not sufficient and therapeutic guidelines have not yielded acceptable outcomes and prognoses for bo...
Citations
... Актуальність. Одним із найпоширеніших запальних захворювань чоловічої статевої сфери є хронічний простатит (далі -ХП), який призводить до розвитку не лише еректильної дисфункції, але й безпліддя (Zhang, 2020;Yebes, 2023;Graziani, 2023). Тому пошук ефективних і безпечних лікарських засобів для лікування запальних захворювань органів чоловічої статевої сфери залишається актуальною проблемою сучасної фармації та фармакології. ...
... Найбільш перспективними для розроблення сучасних фітопростатопротекторів є лікарські рослини, які мають протизапальну, антисептичну, десенсибілізуючу, болезаспокійливу, імуномодулюючу дію та здатні позитивно впливати на гемостаз і мікроциркуляцію у тканинах ПЗ, усувати дизуричні прояви та нормалізувати обмін речовин (Нікітін, 2022; Карнаух, 2014). Одним із таких представників вітчизняної флори, що поширена на теренах північного Причорномор'я, є якірці сланкі (Tribulus terrestris L.), фітопрепарати з якої традиційно використовуються в лікуванні еректильної дисфункції, клімактеричного синдрому й атеросклерозу (Zhu, 2017). До складу ЛРС та фітозасобів на основі якірців сланких входять у значній кількості поліфенольні сполуки, фітостероли, стероїдні сапоніни, комплекс макро-та мікроелементів із потенційними протизапальними, антиоксидантними й антимікробними властивостями, що відкриває можливості їхнього позитивного впливу на перебіг ХП (Zhu, 2017). ...
... Одним із таких представників вітчизняної флори, що поширена на теренах північного Причорномор'я, є якірці сланкі (Tribulus terrestris L.), фітопрепарати з якої традиційно використовуються в лікуванні еректильної дисфункції, клімактеричного синдрому й атеросклерозу (Zhu, 2017). До складу ЛРС та фітозасобів на основі якірців сланких входять у значній кількості поліфенольні сполуки, фітостероли, стероїдні сапоніни, комплекс макро-та мікроелементів із потенційними протизапальними, антиоксидантними й антимікробними властивостями, що відкриває можливості їхнього позитивного впливу на перебіг ХП (Zhu, 2017). Водночас відомо, що фармакологічні властивості окремих фітозасобів на основі ЛРС якірців сланких можуть відрізнятись, а деякі види фармакологічної активності бути відсутніми, що значною мірою залежить від складу біологічно активно діючих речовин у сировині, місця походження ЛРС, технології екстракції (екстрагент, температура, тривалість екстракції), допоміжних речовин тощо (Zhu, 2017;Shahid, 2017;Ștefănescu, 2020). ...
Actuality. The search and creation of effective and safe prostatoprotective agents based on domestic medicinal plant raw materials remains an urgent task of modern phytopharmacology.
The purpose of the study was to evaluate the immunotropic properties of the ethanolic extract of Tribulus terrestris L. in the model of chronic turpentine prostatitis in rats.
Material and methods. Experiments were conducted on 96 sexually mature outbred white rats weighing 220–240 g, which were
kept in standard conditions of the vivarium of the Odesa National Medical University with free access to water and food. Chronic
turpentine prostatitis in rats was induced by a single rectal injection of 1,0 ml of a mixture of turpentine and 10% dimexide in a ratio
of 1 : 4. A thick extract of the threshed from the fruits of Tribulus terrestris L. was obtained by extraction with 50% ethanol in the ratio
of medicinal plant material : extractant (1 : 10). followed by its evaporation, condensation and standardization. The organoprotector
of animal origin Prostatylen was chosen as the comparison drug. Animals in 3 series of experiments were divided into the following
experimental groups of 8 individuals each: 1st group – intact; 2 – control pathology animals; 3rd group – animals that received a thick
extract of Tribulus terrestris L. anchovies (150 mg/kg, daily, intragastrically) within 20 days after phlogogen administration; Group
4 – animals that received prostatylen (200 μl/kg, daily, intraperitoneally) within 20 days after phlogogen administration. In order to
find out the participation of immune mechanisms in ensuring the therapeutic effect of the studied correction agents, in animals with
chronic prostatitis, their influence on the proliferative activity of peripheral blood lymphocytes, the functional activity of peripheral
blood neutrophil granulocytes in the spontaneous and induced NBT-test was studied, and the treatment background was evaluated
corresponding changes in the content of class A, M, G immunoglobulins, the level of circulating immune complexes, and the cytokine
profile in blood serum.
Research and results. It has been established that in the model of chronic “turpentine” prostatitis in rats, the ethanolic thick
extract of Tribulus terrestris L. shows an immunoprotective effect: it enhances the proliferative activity of peripheral blood lymphocytes
in the concanavalin-A test, restores the functional activity of peripheral blood neutrophil granulocytes in the NBT-test and promotes the
completion of phagocytosis corrects the content of immunoglobulins (Ig A, Ig M, Ig G) and restores the balance of pro-inflammatory
(TNF-α, IL-1β) and anti-inflammatory (IL-4, IL-10) cytokines, surpassing the comparative drug Prostatilen in terms of the expressiveness
of its immunocorrective effect.
Conclusion. Reasonable feasibility of further research aimed at creating a new phytoprostatoprotector with immunomodulating
properties based on the ethanolic thick extract of Tribilus terrestris L.
Key words: thick extract of Tribullus Terrestis L., prostatilen, humoral immunity, cytokine profile, immunoprotective action.
... population suffers from CP/CPPS-associated symptoms during their lifetime. 1 Despite the considerable advances in modern medicine, managing CP/CPPS remains challenging. 5 Treatment options consist of drug therapy, modifications of lifestyle, psychotherapy sessions, and acupuncture. ...
... Studies' suitability for inclusion was based on the full-text articles. Studies were included if they fulfilled all the inclusion criteria: (1) only randomized prospective studies were included. There were no restrictions on race, age, or treatment regimen. ...
Aims
Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) prevalence varies from 8.4% to 25% of the male population and is associated with diminished health‐related quality of life. Managing CP/CPPS remains challenging and there is not any common option to treat all patients effectively because of the complex disease nature. The currently available data for the extracorporeal shockwave therapy (eSWT) effect on pain relief and well‐being were analyzed in the present study.
Methods
We adhered to PRISMA 2022 guidelines for reporting the quantitative and qualitative data synthesis. A literature search was conducted in March 2023 using PubMed/Medline, Scopus, and Google Scholar. Randomized prospective studies of eSWT alone or eSWT plus conventional medicinal treatment were included. The risk of bias was estimated using the RoB 2.0. Primary outcomes were self‐reported scores, including the NIH‐CPSI questionnaire and VAS, at 1 month or 2, 3, and 6, months follow‐up.
Results
The CP/CPPS patients who receive eSWT have more pronounced pain relief and improvement of other subjective NIH‐CPSI scores compared with control groups that received placebo or medication therapy. The effect of eSWT seems to be long‐lasting and was confirmed in the 6‐month follow‐up ( p < 0.01).
Conclusions
Based on the meta‐analysis of accessible studies, we receive the equivalence eSWT applicability for the CP/CPPS treatment and can be offered to patients because of its noninvasiveness, high level of safety, and successful clinical results demonstrated in this analysis.
... Ключові слова: хронічний простатит, трібестан, простатилен, ендотелій протекторний ефект Пошук ефективних і безпечних природних фітозасобів для поліпшен ня репродуктивного здоров'я чолові ків залишається актуальним завдан ням сучасної фармацевтичної науки. Простатит є третім за значимістю захворюванням передміхурової зало зи (ПЗ) після раку та доброякісної гіперплазії й складає понад 20 % андрологічної патології [1,2]. Водно час хронічний простатит/синдром хронічного тазового болю (ХП/ СХТБ) -одне з найчастіших захворю вань у чоловіків, яке часто поєд нується з уретритом, везикулітом або аденомою ПЗ. ...
Порушення гемодинаміки та мікроциркуляції в тканинах передміхурової залози (ПЗ) внаслідок ендотеліальної дисфункції є одним з провідних патогенетичних механізмів розвитку хронічного простатиту. Тому лікувальна ефективність сучасних простатопротекторів значною мірою визначається їхньою здатністю коригувати подібні патологічні зміни в тканинах ПЗ за умов запалення. Мета дослідження – порівняльне вивчення впливу простатопротектора на основі лікарської рослинної сировини якірців сланких трібестану та комплексу регуляторних пептидів тваринного походження простатилену на стан ендотелію судин у щурів з хронічним простатитом (ХП). У досдідженні порівнювали вплив поширених простатопротекторів – трібестану та простатилену на стан ендотелію судин на моделі ХП у щурів. Модель ХП у щурів відтворювали одноразовим ректальним уведенням 1,0 мл суміші скипидару з 10 % димексидом у співвідношенні 1 : 4. Простатопротектори (трібестан і простатилен) застосовували одноразово щоденно протягом 30 діб після уведення тваринам флогогену. Показано, що за умов ХП у щурів розвивається ендотеліальна дисфункція: змінюється вміст S-нітрозотіолів (S-NO) й ендотеліну-1, співвідношення вазодилатаційно-вазоконстрикторного потенціалу, а також спостерігається дисбаланс маркерів ендотеліальної дисфункції – активності еNO-синтази та іNO-синтази. Дослідження показали, що трібестан в умовно-терапевтичній дозі 60 мг/кг за внутрішньошлунко- вого введення та простатилен у дозі 200 мкл/кг за внутрішньоочеревинного введення протягом 30 діб щурам з моделлю ХП з різною ефективністю стабілізують вміст S-NO й ендотеліну-1 у крові та коригують порушення функції ендотелію судин шляхом зменшення дисбалансу активності еNO-синтази й іNO-синтази. За умов експерименту трібестан характеризувався більш виразним ендотелій протекторним ефектом порівняно з простатиленом.
... Rather than being a single disease entity, this condition is characterized by a collection of associated symptoms. Patients with CP/CPPS experience persistent pain in the perineal and/or low abdominal region, often accompanied by lower urinary tract symptoms, sexual dysfunction, and psychological challenges [3]. ...
... Despite many efforts to elucidate the specific pathogenesis of the disease, CP/CPPS is not well understood and there is no universally successful treatment so far. Current existing treatments are mostly limited to pharmacologic therapies including antibiotics, antiinflammatory medicines, and α-blockers [2,3]. There are some alternative therapeutic strategies that have been studied, such as shockwave therapy, physiotherapy, and radiofrequency thermotherapy [4,5]. ...
Purpose:
The primary goal of this study is to evaluate the effect of the non-invasive radiofrequency hyperthermia (RFHT) device on chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) rat model and investigate the underlying mechanism.
Materials and methods:
In this study, Sprague-Dawley rats were randomly distributed into three groups: (1) normal control group, (2) CP/CPPS group, and (3) RFHT group. CP/CPPS rat models were induced by 17β-estradiol and dihydrotestosterone for 4 weeks and RFHT was administered for 5 weeks after model establishment. During RFHT administration, core body temperatures were continuously monitored with a rectal probe. After administering RFHT, we assessed pain index for all groups and collected prostate tissues for Western blot analysis, immunofluorescence, and immunohistochemistry. We also collected adjacent organs to the prostate including urinary bladder, testes, and rectum for safety assessment via H&E staining along with a terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labeling assay.
Results:
After administering RFHT, pain in rats was significantly alleviated compared to the CP/CPPS group. RFHT reduced high-mobility group box 1 (HMGB1) expression and improved inflammation by downregulating subsequent proinflammatory cytokines through inhibition of the toll-like receptor 4 (TLR4)-nuclear factor kappa B (NF-κB) pathway. In prostate-adjacent organs, no significant histological alteration or inflammatory infiltration was detected. The area of cell death also did not increase significantly after RFHT.
Conclusions:
In conclusion, RFHT demonstrated anti-inflammatory effects by inhibiting the HMGB1-TLR4-NF-κB pathway in CP/CPPS rat models. This suggests that RFHT could serve as a safe and promising therapeutic strategy for CP/CPPS.
... Chronic prostatitis/chronic pelvic pain syndrome (CP/ CPPS) is the most common genitourinary disorder in men under 50 years of age [1], and it has been reported that 35-50% of men in all age groups will be affected by symptoms suggesting prostatitis during their lifetime [2]. In addition, the prevalence of CP/CPPS is estimated to range from 8.4% to 25% on different continents [3]. Based on the classification system of prostatitis syndromes established by the National Institute of Health (NIH) in 1999, CP/CPPS can be divided into two subtypes: IIIA (inflammatory), and IIIB (Noninflammatory), accounting for about 90-95% of all prostatitis cases [4]. ...
... The manifestations of CP/CPPS were heterogeneous, mainly including urogenital pain, lower urinary tract symptoms (LUTS), psychological problems, and sexual dysfunction [5,6]. The disorder not only impairs the quality of life (QOL) of patients but often leads to severe psychosocial and economic burdens [3,6]. ...
Background
This study aimed to assess the methodological quality of the systematic reviews/meta-analyses (SRs/MAs) of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) using A Measurement Tool to Assess systematic Reviews (AMSTAR2) and to explore the potential influencing factors.
Methods
PubMed, EMBASE and Cochrane Library databases were searched for relevant studies. AMSTAR2 was used for evaluating the methodological quality of eligible SRs/MAs. Differences between methodological characteristics of SRs/MAs were compared using chi-square tests. The intra-class correlation coefficient (ICC) was used to assess reviewer agreement in the pre-experiment. Multivariate regression analysis was used to identify potential factors affecting methodological quality.
Results
A total of 45 SRs/MAs were included. After AMSTAR2 evaluation, only two (4.4%) of 45 SRs/MAs were moderate, three (6.7%) were rated as low quality, and the remainder 40 (88.9%) were rated as critically low quality. Among the 16 items of AMSTAR2, item 3 and item 10 had the poorest adherence. Item 4 received the most significant number of "Partial Yes" responses. Univariable analysis indicated that there were significant differences in methodological quality in SRs between different continents (P = 0.027) as well as between preregistered SRs and those that were not (P = 0.004). However, in multivariate analysis, there was no significant association between methodological quality and the following research characteristics: publication year, continent, whether reporting followed Preferred Reporting Items for Systematic Reviews (PRISMA), preregistration, funding support, randomized controlled trials (RCT) enrollment, whether SR was published in the Cochrane Database of Systematic Reviews (CDSR), and whether with meta-analysis. Additionally, subgroup analysis based on interventional SRs/MAs showed that continent was independently associated with the methodological quality of SRs/MAs of CP/CPPS via univariable and multivariate analysis.
Conclusions
Our study demonstrates that the methodological quality of SRs/MAs of CP/CPPS was generally poor. SRs/MAs of CP/CPPS should adopt the AMSTAR2 to enhance their methodological quality.
... Te symptoms of CP/CPPS usually last for 3-6 months or longer [5,6]. Current common clinical treatments include alphaadrenergic blockers, antibiotics, pain medication, specialist physiotherapy, phytotherapy, and antidepressants, but these options are often inefective due to the complexity of CP/CPPS symptoms [7]. Terefore, understanding the mechanisms involved in causing the complex clinical symptoms of CP/CPPS might help us fnd more efective therapeutic targets. ...
Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is one of the most common diseases of the male urological system while the etiology and treatment of CP/CPPS remain a thorny issue. Cumulative research suggested a potentially important role of glial cells in CP/CPPS. This narrative review retrospected literature and grasped the research process about glial cells and CP/CPPS. Three types of glial cells showed a crucial connection with general pain and psychosocial symptoms. Microglia might also be involved in lower urinary tract symptoms. Only microglia and astrocytes have been studied in the animal model of CP/CPPS. Activated microglia and reactive astrocytes were found to be involved in both pain and psychosocial symptoms of CP/CPPS. The possible mechanism might be to mediate the production of some inflammatory mediators and their interaction with neurons. Glial cells provide a new insight to understand the cause of complex symptoms of CP/CPPS and might become a novel target to develop new treatment options. However, the activation and action mechanism of glial cells in CP/CPPS needs to be further explored.
... The debates about the definition of Chronic Prostatitis (CP)/Chronic Pelvic Pain Syndrome (CPPS) have been ongoing for decades. 1 According to the most recent version of the National Institute of Health (NIH) consensus classification, the diagnosis of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) relies upon the detection of leukocytes in expressed prostatic secretions (EPS), urine post prostatic massage (VB3), or seminal fluid analysis. These criteria doubled as many patients into the category of CP/CPPS as compared to the previous classification system. 2 The inherent diversity of the illness gives rise to a significant amount of variation in establishing clinical diagnosis CP/CPPS. ...
... Therefore, the NIH determined that the scoring system should be based on three large domains (degree of pain, lower urinary tract symptoms, and quality of life) that may be filled out by patients in order to interpret symptom quality into quantitative illness severity. [1][2][3][4] Numerous etiologies and pathogenic mechanisms for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) have been proposed. The authors propose a potential involvement of immunological, neurological, endocrine, and psychological aspects. ...
Background: Extracorporeal Shockwave Therapy (ESWT) has been indicated to relieve local perineal symptoms caused by Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS). Current research has examined the efficacy of ESWT in CPPS patients. Different types of energy generators for ESWT lead to development of different clinical protocols for treatment of CP/CPPS. Therefore in this review, we aimed to compare the clinical protocol, efficacy and safety profile of all these different ESWT machines in CP/CPPS treatment.
Method s: A systematic literature search of 3 search engines (PubMed, Scielo, and Science Directs) was undertaken using the following keywords: Chronic Prostatitis, Chronic Pelvic Pain Syndrome, and Extracorporeal Shockwave Therapy. A systematic review was conducted in accordance with Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guidelines. This review included original studies that evaluated the efficacy and clinical protocol of Extracorporeal Shockwave Therapy and Chronic prostatitis or Chronic Pelvic Pain Syndrome that are fully written in English with full-text articles readily available. This article excluded letters to the editor, reviews, and editorials about prostatitis other than CPPS.
Results: The search strategy yielded 8 journals that meet the inclusion and exclusion criteria from all 3 search engines. These 8 studies included 3 different types of energy generators (Piezoelectric, Electropneumatic, and Electromagnetic) with different protocols applied. All 3 types of energy generators of ESWT can effectively decrease all domains of CPSI score within 12 months of follow-up (P-value 0,05). The limitations of this systematic review include the restricted variety of energy generators with the lack of openly registered protocols.
Conclusions: In Conclusion, ESWT provides significant improvement in clinical symptoms as compared to oral medications alone. These therapeutic effects are also observed in all different types of energy generators with different clinical protocols with similar safety profiles.
... Chronic nonbacterial prostatitis (CNP) is a common disorder in adult men and is classified as type III prostatitis (chronic prostatitis/chronic pelvic pain syndrome; CP/CPPS). 1 The main symptoms of CNP include pelvic pain or discomfort, frequency of urination, urgency, and dysuria, which have a considerable impact on the life and health of patients. 2 The prevalence rate ranges from 2.2% to 9.7% around the world and 4.5% in China. 3,4 Although the pathogenesis of CNP remains unclear, increasing evidence has shown that immune dysfunction and chronic inflammation play a significant role in CNP. 5 Toll-like receptors (TLRs) are important receptors of the innate immune system that initiates inflammatory cascades by recognizing structurally conserved molecules derived from microbes. ...
Objective:
To investigate the anti-inflammatory effect of electroacupuncture (EA) on chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), also known as chronic nonbacterial prostatitis (CNP), and explore its underlying mechanism.
Methods:
A CNP rat was established by surgical castration combined with 17-β estradiol injection in male Sprague-Dawley rats for thirty consecutive days. The CNP rats received EA treatment once a day for eight days. Chronic pelvic pain was evaluated by mechanical withdrawal threshold measurement. The histological change was assessed by hematoxylin-eosin staining. The inflammatory cytokines in prostates were determined by enzyme-linked immunosorbent assays. The expressions of toll-like receptor 4 (TLR4), myeloid differentiation factor 88 (MyD88), inhibitors of kappa-B alpha (IκBα), and nuclear factor-kappa B (NF-κB) were detected by Western blotting. The nuclear translocation of NF-κB and the location of TLR4 were observed with immunofluorescence staining.
Results:
The results showed that EA decreased the prostate index, upregulated the mechanical withdrawal threshold, restored the histomorphology of the prostate, reduced the inflammatory factor levels, inhibited NF-κB p65 nuclear translocation, and downregulated the expression levels of critical proteins involved in the TLR4/NF-κB signaling pathway in prostates.
Conclusions:
Our findings suggested that EA could relieve pelvic pain and attenuate prostatic inflammation in estradiol-induced CNP rats. The underlying mechanism may be related to the inhibition of the TLR4/NF-κB signaling pathway.
... 4 While inconsistent presentation makes it difficult to capture the full population of patients with this condition, global prevalence of CPPS is estimated to be 8% to 25%. 5 Potential causes of CPPS in men include nerve damage, bladder dysfunction, stress, anxiety, and depression. 2 The diagnostic workup of CPPS includes biothesiometry to evaluate genital sensitivity to vibration and to identify conditions that may contribute to the etiology of chronic pelvic pain in men, such as sacral plexus disorders, peripheral neuropathy, or pudendal nerve entrapment syndrome. 6,7 In many cases, however, the exact cause remains unknown. ...
Introduction
Chronic pelvic pain syndrome (CPPS) is a common urologic condition that can cause significant disability in affected individuals. Physiologic explanations of chronic pain are often incomplete; appropriate management of CPPS includes recognition of biological, psychological, and social elements, known as the biopsychosocial model.
Objective
The aim of this narrative review is to investigate treatments for men with CPPS, with a special focus on those utilizing the biopsychosocial model of care.
Methods
A comprehensive literature search was conducted on the electronic databases PubMed, Embase, and Cochrane Library, using relevant Medical Subject Heading terms and keywords related to CPPS treatments. The search was limited to studies published in English from inception to January 2023. Additionally, reference lists of selected studies were manually reviewed to find studies not identified by the initial search. Studies were included if they investigated pharmacologic or nonpharmacologic treatments for men with CPPS.
Results
A total of 30 studies met the inclusion criteria. Antibiotics, α-blockers, nonsteroidal anti-inflammatory drugs, gabapentinoids, antidepressants, and phosphodiesterase type 5 inhibitors were among the pharmacologic agents included in trials attempting to reduce symptoms of male CPPS. Studies that focused on treating CPPS without medication included interventions such as shockwave therapy, acupuncture, physical therapy, botulinum toxin, cryotherapy, electrotherapy, exercise, and cognitive behavioral therapy.
Conclusion
α-Blockers and nonsteroidal anti-inflammatory drugs have shown promising results in treating CPPS in men, while the effectiveness of antibiotics remains controversial. Antidepressants and phosphodiesterase type 5 inhibitors may also be useful in decreasing symptoms in patients with CPPS. Treatments such as pelvic floor muscle therapy, acupuncture, shockwave therapy, and cognitive behavioral therapy must be considered effective complements to medical management in men with CPPS. While these interventions demonstrate benefits as monotherapies, the individualization and combination of treatment modalities are likely to result in reduced pain and improved quality of life.
... pelvis, penis, prostate) and/or urinary difficulties (e.g. difficulty voiding, painful urination, an urgency to urinate) [2,3]. CP/CPPS is prevalent across countries, with epidemiological studies estimating global prevalence rates between 2.2 % and 12 % [4][5][6], comparable to other non-communicable diseases such as diabetes mellitus or ischaemic heart disease. ...
Objectives:
Chronic prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) is a complex condition which causes a significant burden on the diagnosed individuals. Assessment and management are perplexing, often resulting in unsatisfactory outcomes. Existing research has only focused on patients' perspectives of pain experiences, but scant evidence is available to understand the barriers that undermine effective pain management. Using an exploratory approach, this study examined these barriers from practitioners' perspectives.
Methods:
Twelve semi-structured interviews were conducted with practitioners across disciplines who have experience in chronic pelvic pain management in males. Practitioners expressed their views and experiences in supporting men with CP/CPPS and what barriers they perceived when providing treatment for patients. Data were analysed using reflexive thematic analysis supported by NVivo software.
Results:
Five broad and interrelated themes were identified: (1) Where to Start, (2) Insufficient Resources, (3) Prioritisation, (4) Training and Confident Practice and (5) Constraints in Help-Seeking.
Conclusions:
Practitioners value multimodal management using a biopsychosocial approach; however, practical challenges prevent practitioners from choosing and applying this approach in clinical practice. The findings also identified some unique challenges faced by men with CP/CPPS consistent with previous evidence from patient perspective. Refining terminology, developing specific resources, and increasing psychosocial treatment options are urgently needed.
