Clinical Phenotyping and Multimodal Treatment of Men With Chronic Prostatitis/Chronic Pelvic Pain Syndrome From the Middle East and North Africa: Determining Treatment Outcomes and Predictors of Clinical Improvement

Abstract

To evaluate the effectiveness of UPOINT based multimodal treatment on patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), and determine factors that could be associated with clinical improvement. A retrospective study was conducted in Doha, Qatar including patients with CP/CPPS from the Middle East and North Africa. The UPOINT phenotyping system was used to classify patients and guide their multimodal therapy. NIH-CPSI scores were computed initially and after 3 months of treatment, and predictors of clinical improvement were assessed. The total NIH-CPSI improved significantly with a mean reduction of 8.21 after 3 months of treatment (P < .001). 66.2% of patients had a clinical improvement demonstrated as a total NIH-CPSI score reduction by at least 6 points after 3 months of treatment. No significant association was found between clinical improvement, and extent of pain (ORa=1.198, 95% CI 0.392-3.662, P=.751), initial total NIH-CPSI (ORa=0.983, 95% CI 0.886-1.089, P=.738), number of positive UPOINT domains (ORa=0.871, 95% CI 0.451-1.681, P=.681), and number of prescribed therapies (ORa=1.118, 95% CI 0.699-1.789, P=.641). UPOINT phenotyping and directed therapy is associated with an important improvement in the CP/CPPS. Therapeutic response does not appear to related to age or ethnicity. Clinical improvement is also not predicted by initial extent and severity of the disease, whether relating to NIH-CPSI or the number of positive UPOINT phenotypes, neither to the number of therapies involved in the multimodal treatment strategy.