Grant: CIHR Fellowship

Chronic prostatitis/chronic pelvic pain syndrome is the leading genitourinary condition in men. It is characterized by pain experienced in the perineum, genitalia, bladder or prostate for more than 3 months. This condition affects up to one out of every 6 men worldwide with a major impact on quality of life. Unfortunately, the underlying causes of this chronic pain condition are misunderstood and there is limited evidence of effective treatments. It is increasingly recognized that chronic pelvic pain can be caused by a range of mechanisms and these often do not involve the bladder and prostate tissues, which have been the primary targets of interventions. Investigating other mechanisms that involve alterations in muscles and function of the brain and spinal cord may be key to improve management. It is notable that the underlying causes will vary between individuals, which makes it complex to identify the best treatment. This requires an approach that identifies subgroups of patients having similar clinical presentation and mechanisms and use this information to personalize interventions. Tailoring interventions in this manner has not been attempted or tested for chronic pelvic pain. We will use innovative methods to undertake a detailed assessment of potential mechanisms of chronic pelvic pain in men, moving beyond its previous hypothesized causes. We will then use this knowledge to identify subgroups of patients to match interventions tailored to address each subgroup's characteristics. We will undertake a feasibility study to prepare this model of care in a full-scale clinical trial. This project has great potential to offer new insights into chronic pelvic pain in men and to provide a new foundation for future clinical studies that can ultimately improve clinical management. Our proposed approach represents a major departure from the common current approach to manage chronic pelvic pain and is likely to contribute to significant improvements in patient outcomes.