Chronic prostatitis (CP) is the most common urologic diagnosis in men younger than 50 years and is also common in men over 50 years.1 In 1995, to improve the diagnosis and treatment of this disorder, the National Institutes of Health (NIH) Prostatitis Collaborative Network undertook to define and Enzalutamide molecular weight classify the various forms of CP.2,3 NIH Category III disease, or nonbacterial CP/chronic pelvic pain syndrome (CP/CPPS), accounts for Inhibitors,research,lifescience,medical at least 90% of all cases of prostatitis, and its symptoms can affect up to 10% of men of all ages in North America.4–6 CP/CPPS is a debilitating syndrome

that has a serious and significant effect on a patient’s quality of life (QoL), affecting both mental and physical health.3,7 Moreover, the medical costs of CP/CPPS are considerable and have been estimated to be Inhibitors,research,lifescience,medical higher than the costs associated with rheumatoid

arthritis, peripheral neuropathy, or lower back pain.8 The main symptom of CP/CPPS is urogenital pain or discomfort, particularly pain related to ejaculation, possibly attributable in part to painful smooth muscle contraction.3 CP/CPPS also can be characterized by urinary symptoms that are irritative (storage) and obstructive (voiding).9 Although CP/CPPS often is accompanied by prostate inflammation, the clinical relationship Inhibitors,research,lifescience,medical between inflammation and prostatitis pain remains unclear. The etiology of CP/CPPS is complex and has not been fully elucidated. It is thought to be triggered by a variety of events, including previous infection, trauma, voiding dysfunction, allergic reactions, and/or a neuromuscular dysregulation Inhibitors,research,lifescience,medical in the pelvic floor or perineum.10,11 Current Treatment Strategies and the Role of α1-Blockers Successful management of CP/CPPS is a challenge for the treating physician; men with this disorder not only experience chronic genitourinary pain, but also may have other urinary symptoms and sexual dysfunction. The Inhibitors,research,lifescience,medical etiology and pathogenesis of CP/CPPS are multifactorial,

and few therapies have shown significant efficacy in reducing CP/CPPS-specific symptoms in randomized, double-blind, ALOX15 placebo-controlled trials. The weakness of the evidence has resulted in a lack of treatment consensus among health care practitioners regarding the most beneficial therapeutic approach. The medical treatments most often prescribed for men with CP/CPPS include antibiotics, α1-adrenergic antagonists (α1-blockers), anti-inflammatory agents, pain medications (analgesics and/or neuromodulators), and various combinations of these agents. Treatments of CP/CPPS are generally designed to mitigate specific symptoms that are either reported by the patient or identified during urological examination, with the goal of improving overall QoL.