Epidemiology of Chronic Prostatitis/Chronic Pelvic Pain

尽管成年男性慢性前列腺炎/慢性盆腔疼痛综合征（CP/CPPS）的负担很高， 人们对其病因、症状加重或治疗自然史知之甚少。虽然范围广泛， 假设已经提出，很少有研究在任何更详细或使用严格的 流行病学设计/方法。此外，很少有研究描述了治疗的自然史 CP/CPPS。 目标1.使用多中心、事件病例对照确定CP/CPPS发展的风险因素 研究设计（200例事件病例，400例对照）。研究的风险因素包括生命早期和晚期 生物、行为和其他因素围绕四个中心主题：1）营养、酒精摄入和 吸烟; 2）体重史，以及影响骨盆区域的职业和娱乐活动; 3）性 和其他泌尿生殖系统暴露;和4）伴随的医学状况（例如，纤维肌痛），家族史 疾病虐待和压力与以往的研究相比，我们将提高我们的能力， a）将CP/CPPS的事件病例与精心选择的无CP/CPPS的对照病例进行比较， 减少时间和选择偏倚的可能性; 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。 目标2.确定CP/CPPS症状加重的风险因素，并描述治疗后的自然 使用400例主要流行CP/CPPS的多中心前瞻性纵向研究， 患者我们将比较每位患者在症状加重时的访视时的近期暴露情况， 同一患者最近在访视时的暴露，此时他几乎没有症状或没有症状，以避免选择偏倚， 最大限度地减少比较访问之间的差异。我们将使用这个设计来调查同样的四个 目的1中的风险因素主题，并描述CP/CPPS的治疗自然史。据我们所知， 本研究将是CP/CPPS症状加重危险因素的首次流行病学研究之一。 总之，这些研究解决了CP/CPPS研究领域进展的关键障碍， 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.