It is nearly a decade since the National Institutes of Health (NIH) sponsored international consensus conference on chronic prostatitis led to the development of a productive multicentre collaboration in North America (Chronic Prostatitis Collaborative Research Network) and stimulated research initiatives around the world.¹ A modified classification for prostatitis was proposed, with a new name and clinical definition for the largest category, chronic pelvic pain syndrome (CPPS), to replace chronic non-bacterial prostatitis and prostatodynia.² Subsequently, development of a validated Chronic Prostatitis Symptom Index (NIH-CPSI) provided an outcome measure for treatment trials that is now almost universally adopted and allows comparison between studies.³ Although not intended to be a diagnostic instrument, and therefore requiring caution in its use as a means of detecting the condition, numerous studies using the same instrument have suggested a high population prevalence of CPPS.⁴

Significant advances have been made in our understanding of the prevalence and impact of this condition, its natural history, and to some extent, the pathogenesis, although the aetiology remains a mystery and advances in therapy have been disappointing. Nearly 10 years on, the time has come for greater clarity in our diagnostic labelling and a frank acceptance of the limitations of historical diagnostic approaches. The time …