LAUSR

This article by the group of Dr. Whitmore described concisely and thoroughly the current status of the diagnosis and management of chronic pelvic pain (CPP) or CPP syndrome (CPPS), particularly focusing on gynecological aspects of this often difficult-to-treat disease condition. Because CPPS is a larger umbrella of painful disorders encompassing different pelvic organs or structures including uterus, external genital organs (female or male), bladder, colon and pelvic floor muscles, there are significantly overlapping symptoms in CPPS patients, in whom multiple domains are involved in the emergence of overall symptoms. In this IJU special issue of the 2018 International Consultation on Interstitial Cystitis Japan (ICICJ) meeting, Dr. Ueda’s group showed that the involvement of multiple domains is also the case in men with CPPS, in which a number of patients who were symptomatically diagnosed to have chronic prostatitis showed a co-morbidity of cystoscopically-confirmed interstitial cystitis. Recent studies using animal models also revealed that pelvic organ cross-sensitization among bladder, colon, uterus or prostate greatly contributes to pelvic pain and bladder hypersensitivity, suggesting that multiple pelvic organs interact each other to exhibit the final symptomatic profile of CPPS. Thus, multidisciplinary approaches should be taken to explore the contribution of each domain of different pelvic organs or structures to the overall CPP symptoms including those of sexual dysfunction, as well described in this review, which could hopefully lead to the individualized treatment for better therapeutic outcomes in patients with CPPS.