Clinical Phenotyping and Multimodal Treatment of Men With Chronic Prostatitis/Chronic Pelvic Pain Syndrome From the Middle East and North Africa: Determining Treatment Outcomes and Predictors of Clinical Improvement

Objective

To evaluate the effectiveness of UPOINT based multimodal treatment on patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), and determine factors that could be associated with clinical improvement.

Methods

A retrospective study was conducted in Doha, Qatar including patients with CP/CPPS from the Middle East and North Africa. The UPOINT phenotyping system was used to classify patients and guide their multimodal therapy. NIH-CPSI scores were computed initially and after 3 months of treatment, and predictors of clinical improvement were assessed.

Results

The total NIH-CPSI improved significantly with a mean reduction of 8.21 after 3 months of treatment (P < .001). 66.2% of patients had a clinical improvement demonstrated as a total NIH-CPSI score reduction by at least 6 points after 3 months of treatment. No significant association was found between clinical improvement, and extent of pain (ORa = 1.198, 95% CI 0.392-3.662, P = .751), initial total NIH-CPSI (ORa = 0.983, 95% CI 0.886-1.089, P = .738), number of positive UPOINT domains (ORa = 0.871, 95% CI 0.451-1.681, P = .681), and number of prescribed therapies (ORa = 1.118, 95% CI 0.699-1.789, P = .641).

Conclusion

UPOINT phenotyping and directed therapy is associated with an important improvement in the CP/CPPS. Therapeutic response does not appear to related to age or ethnicity. Clinical improvement is also not predicted by initial extent and severity of the disease, whether relating to NIH-CPSI or the number of positive UPOINT phenotypes, neither to the number of therapies involved in the multimodal treatment strategy.

Other Information

Published in: Urology
License: http://creativecommons.org/licenses/by/4.0/
See article on publisher's website: https://dx.doi.org/10.1016/j.urology.2022.04.028