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For many men, time, rather than current treatments, may have the greatest influence on symptoms
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 …