Tests for Chronic Pelvic Pain Syndrome (CPPS)
Tests for chronic pelvic pain syndrome (CPPS) involve considering the patient’s symptoms and whole body’s health. This non-bacterial category of prostatitis is the most common, affecting 90 to 95% of prostatitis patients, but it is the most difficult category of prostatitis to diagnose and treat because many of its causes originate outside of the prostate itself. In fact, it is estimated that 50% of CPPS cases are due to tension in the pelvic floor muscles and can even be caused by stress and emotional health problems. The chronic prostatitis causes that involve tension include pelvic floor disorders, neuromuscular tension, and chronic tension disorders. Inflammation from other places in the body usually accompanies chronic tension in the pelvic floor and is a major contributor to CPPS.
Two of the most effective and comprehensive ways of testing for chronic pelvic pain syndrome are NPAT and UPOINT. Both of these methods are holistic in that they look at the patient’s symptoms and recommend a personalized multimodal treatment program that is tailored to the patient’s needs.
The NPAT Program for CPPS recognizes that chronic pelvic pain is grounded in a man’s lifestyle, diet, nutrition, and other factors that originate outside the prostate and may contribute to chronic tension. NPAT stands for:
- Natural treatments (ALCAT, elimination diets, and wheat-free diets),
- Phytotherapy (pollen and quercetin together with probiotics),
- Alternative Treatments (acupuncture, prostate massage, pelvic rehabilitation and therapy), and
- Total body (exercise, chronic stress management, lifestyle)
This holistic, naturopathic treatment program individually analyzes each patient’s symptoms to form a complete treatment program that incorporates natural and alternative remedies for prostatitis.
The NPAT Program was developed by the leading naturopathic urologist Dr. Geo Espinosa, N.D. The NPAT Program specifically focuses on pelvic tension because many chronic prostatitis cases generally stem from problems that take place outside of the prostate and elsewhere in the body. The NPAT Program looks at a patient’s mental health, stress level, diet, possible allergies, and other aspects of health to diagnose and treat CPPS sufferers.
The UPOINT System is a new system that doctors can use to make more effective treatment decisions for patients with CPPS. It stands for the following domains: Urinary, Psychosocial, Organ specific, Infection, Neurologic/systemic, and Tenderness. It was developed by a urologist to help doctors and patients customize their treatment program for CPPS. A patient is classified as “yes” or “no” for each of the six domains in UPOINT. Once the doctor can see the problem areas and where the symptoms lie, he or she can provide treatments that have proven to effective for those problems. This helps patients avoid unnecessary and ineffective treatment.
In addition to giving the National Institutes of Health Chronic Prostatitis Symptoms Index (NIH-CPSI), a doctor may also run the following tests for chronic pelvic pelvic pain syndrome to rule out the specific domains when using the UPOINT system:
Urinary: Post-void residual measured by ultrasound
Psychosocial: Ask about clinical depression and the patient’s feeling of helplessness and hopelessness, also called catastrophizing
Organ Specific: Test for pain improvement after emptying of the bladder and prostate tenderness (through massaging and feeling the prostate for tenderness)
Infection: Urine culture, culture for mycoplasma and ureaplasma, culture of expressed prostatic secretions, or culture of urine after post-prostate massage
Neurologic/Systemic: Ask about pain outside of pelvic region and presence of other pain syndromes
Tenderness: Palpation of abdominal and pelvic skeletal muscles via rectum to check for spasm and trigger points
Both NPAT and UPOINT can help when performing tests for chronic pelvic pain syndrome because these methods assist the doctor in narrowing down the symptoms and their causes. This allows your health care provider to work with you to develop an individualized treatment program with multiple treatments that have been proven to work for your specific symptoms. These methods also help you avoid unnecessary and potentially harmful treatments that do not work for CPPS, such as antibiotics. Research shows that employing multimodal treatment program that includes both natural and alternative treatments for prostatitis is the best course of therapy that will get you on the path to recovery and pain relief.