Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Primary care physician practices in the diagnosis, treatment and management of men with chronic prostatitis/chronic pelvic pain syndrome

Prostate Cancer and Prostatic Diseases volume 12, pages 288–295 (2009)Cite this article

Abstract

To describe practice patterns of primary care physicians (PCPs) for the diagnosis, treatment and management of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), we surveyed 556 PCPs in Boston, Chicago, and Los Angeles (RR=52%). Only 62% reported ever seeing a patient like the one described in the vignette. In all, 16% were ‘not at all’ familiar with CP/CPPS, and 48% were ‘not at all’ familiar with the National Institutes of Health classification scheme. PCPs reported practice patterns regarding CP/CPPS, which are not supported by evidence. Although studies suggest that CP/CPPS is common, many PCPs reported little or no familiarity, important knowledge deficits and limited experience in managing men with this syndrome.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1

Similar content being viewed by others

References

  1. Krieger JN, Nyberg Jr L, Nickel JC . NIH consensus definition and classification of prostatitis. JAMA 1999; 282: 236–237.

    Article  CAS  PubMed  Google Scholar 

  2. Roberts RO, Lieber MM, Bostwick DG, Jacobsen SJ . A review of clinical and pathological prostatitis syndromes. Urology 1997; 49: 809–821.

    Article  CAS  PubMed  Google Scholar 

  3. Bennett B, Richardson P, Gardner W . Histopathology and cytology of prostatitis. In: Lepor H, Lawson R (eds). Prostate Diseases. WB Saunders and Co.: Philadelphia, 1993, pp 399–413.

    Google Scholar 

  4. Nickel JC, Downey J, Hunter D, Clark J . Prevalence of prostatitis-like symptoms in a population based study using the National Institutes of Health chronic prostatitis symptom index. J Urol 2001; 165: 842–845.

    Article  CAS  PubMed  Google Scholar 

  5. Roberts RO, Jacobson DJ, Girman CJ, Rhodes T, Lieber MM, Jacobsen SJ . Prevalence of prostatitis-like symptoms in a community based cohort of older men. J Urol 2002; 168: 2467–2471.

    Article  PubMed  Google Scholar 

  6. Roberts RO, Lieber MM, Rhodes T, Girman CJ, Bostwick DG, Jacobsen SJ . Prevalence of a physician-assigned diagnosis of prostatitis: the Olmsted County Study of Urinary Symptoms and Health Status Among Men. Urology 1998; 51: 578–584.

    Article  CAS  PubMed  Google Scholar 

  7. Clemens JQ, Meenan RT, O’Keeffe Rosetti MC, Gao SY, Calhoun EA . Incidence and clinical characteristics of National Institutes of Health type III prostatitis in the community. J Urol 2005; 174: 2319–2322.

    Article  PubMed  Google Scholar 

  8. McNaughton Collins M, Pontari MA, O’Leary MP, Calhoun EA, Santanna J, Landis JR et al. Quality of life is impaired in men with chronic prostatitis: the Chronic Prostatitis Collaborative Research Network. J Gen Intern Med 2001; 16: 656–662.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Turner JA, Ciol MA, Von Korff M, Berger R . Health concerns of patients with nonbacterial prostatitis/pelvic pain. Arch Intern Med 2005; 165: 1054–1059.

    Article  PubMed  Google Scholar 

  10. Calhoun EA, McNaughton Collins M, Pontari MA, O’Leary M, Leiby BE, Landis RJ et al. The economic impact of chronic prostatitis. Arch Intern Med 2004; 164: 1231–1236.

    Article  PubMed  Google Scholar 

  11. McNaughton Collins M, Pontari M . Prostatitis. In: Litwin M, Saigal C (eds). Urologic Diseases in America. U.S. Government Publishing Office, NIH Publication No. 07-5512: Washington, DC, 2007, pp 9–41.

    Google Scholar 

  12. Krieger JN, Egan KJ, Ross SO, Jacobs R, Berger RE . Chronic pelvic pains represent the most prominent urogenital symptoms of ‘chronic prostatitis’. Urology 1996; 48: 715–721; discussion 721–722.

    Article  CAS  PubMed  Google Scholar 

  13. Litwin MS, McNaughton-Collins M, Fowler Jr FJ, Nickel JC, Calhoun EA, Pontari MA et al. The National Institutes of Health Chronic Prostatitis Symptom Index: development and validation of a new outcome measure. Chronic Prostatitis Collaborative Research Network. J Urol 1999; 162: 369–375.

    Article  CAS  PubMed  Google Scholar 

  14. de la Rosette JJ, Hubregtse MR, Karthaus HF, Debruyne FM . Results of a questionnaire among Dutch urologists and general practitioners concerning diagnostics and treatment of patients with prostatitis syndromes. Eur Urol 1992; 22: 14–19.

    Article  CAS  PubMed  Google Scholar 

  15. Moon TD . Questionnaire survey of urologists and primary care physicians’ diagnostic and treatment practices for prostatitis. Urology 1997; 50: 543–547.

    Article  CAS  PubMed  Google Scholar 

  16. Nickel JC, Nigro M, Valiquette L, Anderson P, Patrick A, Mahoney J et al. Diagnosis and treatment of prostatitis in Canada. Urology 1998; 52: 797–802.

    Article  CAS  PubMed  Google Scholar 

  17. SPSS. SPSS, Inc.: Chicago, Illinois.

  18. Collins MM, Barry MJ, Bin L, Roberts RG, Oesterling JE, Fowler FJ . Diagnosis and treatment of benign prostatic hyperplasia. Practice patterns of primary care physicians. J Gen Intern Med 1997; 12: 224–229.

    CAS  PubMed  PubMed Central  Google Scholar 

  19. Nadler RB, Collins MM, Propert KJ, Mikolajczyk SD, Knauss JS, Landis JR et al. Prostate-specific antigen test in diagnostic evaluation of chronic prostatitis/chronic pelvic pain syndrome. Urology 2006; 67: 337–342.

    Article  PubMed  Google Scholar 

  20. Schaeffer AJ . Clinical practice. Chronic prostatitis and the chronic pelvic pain syndrome. N Engl J Med 2006; 355: 1690–1698.

    Article  CAS  PubMed  Google Scholar 

  21. Alexander RB, Propert KJ, Schaeffer AJ, Landis JR, Nickel JC, O’Leary MP et al. Ciprofloxacin or tamsulosin in men with chronic prostatitis/chronic pelvic pain syndrome: a randomized, double-blind trial. Ann Intern Med 2004; 141: 581–589.

    Article  CAS  PubMed  Google Scholar 

  22. Weidner W . Treating chronic prostatitis: antibiotics no, alpha-blockers maybe. Ann Intern Med 2004; 141: 639–640.

    Article  PubMed  Google Scholar 

  23. Hu JC, Link CL, McNaughton-Collins M, Barry MJ, McKinlay JB . The association of abuse and symptoms suggestive of chronic prostatitis/chronic pelvic pain syndrome: results from the Boston Area Community Health survey. J Gen Intern Med 2007; 22: 1532–1537.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Collins MM, Stafford RS, O’Leary MP, Barry MJ . How common is prostatitis? A national survey of physician visits. J Urol 1998; 159: 1224–1228.

    Article  CAS  PubMed  Google Scholar 

  25. McNaughton Collins M, MacDonald R, Wilt TJ . Diagnosis and treatment of chronic abacterial prostatitis: a systematic review. Ann Intern Med 2000; 133: 367–381.

    Article  CAS  PubMed  Google Scholar 

  26. O’Rorke JE, Chen I, Genao I, Panda M, Cykert S . Physicians’ comfort in caring for patients with chronic nonmalignant pain. Am J Med Sci 2007; 333: 93–100.

    Article  PubMed  Google Scholar 

  27. Kellerman S, Herold J . Physician response to surveys. A review of the literature. Am J Prev Med 2001; 20: 61–67.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

The authors thank all the participating primary care physicians for making this study possible. This research was funded by Grants (U01 DK65187, DK 65277, and DK 65257) from the National Institutes of Health, which had no other role in the design or conduct of the study, or preparation of the manuscript.

Author information

Authors and Affiliations

  1. Division of Health Policy and Administration, University of Illinois at Chicago School of Public Health, Chicago, IL, USA

    E A Calhoun & T Markossian

  2. Department of Urology, University of Michigan Medical Center, Ann Arbor, MI, USA

    J Q Clemens

  3. Department of Urology, David Geffen School of Medicine and Department of Health Services, School of Public Health, University of California, Los Angeles, CA, USA

    M S Litwin

  4. General Internal Medicine Division, Department of Medicine, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA

    E Walker-Corkery & M McNaughton-Collins

  5. National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA

    J W Kusek

Authors
  1. E A Calhoun
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J Q Clemens
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M S Litwin
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. E Walker-Corkery
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. T Markossian
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. J W Kusek
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. M McNaughton-Collins
    View author publications

    You can also search for this author in PubMed Google Scholar

Consortia

the Chronic Prostatitis Collaborative Research Network

Corresponding author

Correspondence to M McNaughton-Collins.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Calhoun, E., Clemens, J., Litwin, M. et al. Primary care physician practices in the diagnosis, treatment and management of men with chronic prostatitis/chronic pelvic pain syndrome. Prostate Cancer Prostatic Dis 12, 288–295 (2009). https://doi.org/10.1038/pcan.2009.9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/pcan.2009.9

Keywords

This article is cited by

Search

Advanced search

Quick links