Epidemiology of Chronic Prostatitis/Chronic Pelvic Pain

尽管成年男性患有慢性前列腺炎/慢性盆腔疼痛综合征(CP/CPPS)的负担很高， 对其病因、症状恶化或治疗后的自然病史知之甚少。虽然有广泛的 已经提出了假说，但很少有人对其进行详细的研究或使用严谨的 流行病学设计/方法。此外，很少有研究描述治疗后的自然病程。 CP/CPPS。 目的1.采用多点、事件病例对照的方法，确定慢性阻塞性肺疾病/慢性阻塞性肺疾病发展的危险因素 研究设计(200例事件病例，400例对照)。调查的风险因素包括早年和晚年。 生物、行为和其他因素集中在四个中心主题：1)营养、酒精摄入量和 吸烟；2)体重病史；影响骨盆区域的职业和娱乐活动；3)性行为 和其他泌尿生殖系统暴露；以及4)伴随的医疗条件(如纤维肌痛)，家族史 疾病、虐待和压力。与以前的研究不同，我们将提高我们得出因果关系的能力 推论通过a)将CP/CPPS事件与精心选择的没有CP/CPPS的对照进行比较 减少时间和选择偏差的可能性；b)临床评估病例和对照，以排除 非CPPS条件并减少错误分类诊断的影响；以及c)执行 流行病学/生物统计学调查，以探索替代的、非因果解释的可能性。 目的2.确定CP/CPPS症状恶化的危险因素并描述治疗后的自然情况 400例主要流行CP/CPPS的多点前瞻性纵向研究 病人。我们将比较每个患者最近就诊时症状恶化时的接触情况与 同一患者最近在就诊时几乎没有症状时的暴露，以避免选择偏见和 大大减少对比访问之间的差异。我们将使用此设计来调查相同的四个 目标1中的风险因素主题，并描述CP/CPPS治疗后的自然病史。据我们所知， 这项研究将是第一批CP/CPPS症状恶化危险因素的流行病学研究之一。 总而言之，这些研究解决了在CP/CPPS研究领域取得进展的一个关键障碍，方法是 使用适当和复杂的流行病学方法调查当前的重要假设。

Despite the high burden of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) among adult men, very little is known about its etiology, symptom exacerbation or treated natural history. While a wide range of hypotheses have been proposed, few have been investigated in any great detail or using rigorous epidemiologic designs/methods. Additionally, few studies have described the treated natural history of CP/CPPS. Aim 1. To determine risk factors for the development of CP/CPPS using a multi-site, incident case-control study design (200 incident cases, 400 controls). Risk factors investigated will include early- and later-in-life biologic, behavioral and other factors focused around four central themes: 1) nutrients, alcohol intake and smoking; 2) weight history, and occupational and recreational activities impacting the pelvic area; 3) sexual and other urogenital exposures; and 4) concomitant medical conditions (e.g., fibromyalgia), family history of disease, abuse and stress. In contrast to previous studies, we will enhance our ability to draw causal inferences by a) comparing incident cases of CP/CPPS to carefully-selected controls without CP/CPPS to reduce the possiblity of temporal and selection biases; b) clinically evaluating cases and controls to rule out non-CPPS conditions and reduce the impact of misclassified diagnoses; and c) performing epidemiologic/biostatistical investigations to explore the possiblity of alternative, non-causal explanations. Aim 2. To determine risk factors for CP/CPPS symptom exacerbation and describe the treated natural history of CP/CPPS using a multi-site prospective, longitudinal study of 400 mainly prevalent CP/CPPS patients. We will compare each patient's recent exposures at visits when he has exacerbated symptoms to the same patient's recent exposures at visits when he has few or no symptoms to avoid selection bias and greatly minimize differences between comparison visits. We will use this design to investigate the same four themes of risk factors as in aim 1 and to describe the treated natural history of CP/CPPS. To our knowledge, this study will be the one of the first epidemiologic studies of risk factors of CP/CPPS symptom exacerbation. Together, these studies address a critical barrier to progress in the field of CP/CPPS research by investigating current, important hypotheses using appropriate and sophisticated epidemiologic methods.