Symptoms and signs

CPPS is a slow disease evolving usually over many years. The patient commonly begins feeling weak with influenza like symptoms(fatigue/malaise) and having occasional discomfort with diffuse urinary problems like dribbling and penile "insensitivity" (paresthesia) that progresses in the worst case to severely debilitating pain and urgency. Progress can be sudden and rapid (within a few weeks), and an assumed triggering event is sometimes mentioned. Help is usually sought when pain and/or urinary and sexual problems begin to interfere with everyday life or there is a sudden obvious increase in symptoms. Sudden onset of urgency seems btw to be an important cause to seek medical advice. Stabilization and even permanent remission may occur after many years.

The common denominators for prostatitis/CPPS are symptoms emanating especially from the pelvis, groin and uro-genital apparatus.(1) The disease has a distinct periodicity / cyclicity with recurring flares (exacerbations) and improvements (remissions). Anecdotal evidence and studies also indicate that winter and spring see more flares and pain (discomfort, pressure-like sensations), while symptoms tend to vane or disappear during the summer (cold seems to worsen problems, while sun and heat ameliorates them).

Many patients indicate that flares are triggered by cold (freezing in general, just the feet, sitting on cold surfaces and swims in cold water). Also bicycling and vibrations from motorcycles and similar have been mentioned as problematical. Symptoms that may indicate a myofascial/tension disorder.

A small study noted that: "The informants also reported that cold exposure caused aggravation of symptoms and provoked their relapse. Sitting on cold objects, spending time in cold, damp or windy surroundings and walking on a cold floor were provocative and thus were avoided."(2)

A detailed review of symptom frequency can be found in "Symptoms correlated with prostatitis".(3) "A summary report on the impact of Prostatitis and Benign Prostatic Hyperplasia on men's lives and those of their families"(4) is also available.

In my next posts I will discuss symptom clusters and suggest clusters in CPPS (I have grouped symptoms, documented and anecdotal--I will also add INDICATIVE after the symptoms/signs that are most likely indicative of CPPS).

Andra bloggar om CPPS, kroniskt bäckenbottensmärtsyndrom, kronisk abakteriell prostatit, NIHIIIb
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(1) Moon TD et al., Urinary symptomatology in younger men, J Urol 50:700-703, 1997
(2) Hedelin H, Jonsson K. Chronic abacterial prostatitis and cold exposure. Scand J Urol Nephrol. 2007 May 9;1-6 [Epub ahead of print].
(3) Guercini F, Pajoncini C, Bini V, Porena M. Symptoms correlated with prostatitis. International Continence Society 2002:237.
(4) Bernardes J, Cameron E, Dunn P.“A summary report on the impact of Prostatitis and Benign Prostatic Hyperplasia on men's lives and those of their families” (“http://uk.groups.yahoo.com/group/bps-assoc/files/ Kings Fund Full Report (pdf)”)