Chemokine Mechanisms in Chronic Pelvic Pain

Chronic pelvic pain is the hallmark of patients with chronic pelvic pain syndrome (CPPS), a non-bacterial category of prostatitis that is a significant source of morbidity in American men. The cause of CPPS is unknown and there is a lack of convenient biomarkers for diagnosis of this syndrome. This project will examine the expression of biomarkers in expressed prostatic fluid from adult men with and without a diagnosis of CPPS. Thus our specific aim is to validate the use of the chemokines MCP-1 and MIP-1alpha and mast cell tryptase as biomarkers for CPPS in humans and correlate their levels with CPPS symptoms.

Inclusion criteria

• CP/CPPS group inclusion criteria

Patients are eligible for the study if they meet the following criteria:

• Participant has signed and dated the appropriate Informed Consent document.
• Agreed to participate in Study procedures.
• Participant is at least 18 years of age.
• Participant reports a response of at least 1 on the pain, pressure or discomfort scale (SYM-Q, Question #1).
• Participant reports pain or discomfort in any of the 8 domains of the Male Genitourinary Pain Index (MGUPI) (items 1a, 1b, 1c, 1d, 2a, 2b, 2c, 2d).
• These CP/CPPS symptoms been present for the majority of the time during any 3 months in the previous 6 months.

Exclusion criteria

• Participant has an on-going symptomatic urethral stricture.
• Participant has an on-going neurological disease or disorder affecting the bladder or bowel fistula.

Participant has a history of cystitis caused by tuberculosis, radiation therapy or Cytoxan/cyclophosphamide therapy.

• Participant has augmentation cystoplasty or cystectomy.
• Participant has a history of cancer (with the exception of skin cancer).
• Participant has current major psychiatric disorder or other psychiatric or medical issues that would interfere with study participation (e.g. dementia, psychosis, upcoming major surgery, etc).
• Participant diagnosed with unilateral orchialgia, without pelvic symptoms.
• Participant has a history of transurethral microwave thermotherapy (TUMT), transurethral needle ablation (TUNA), balloon dilation, prostate cryo-surgery, or laser procedure.

Control group exclusion criteria In addition to the exclusion criteria listed above additional criteria for control subjects are as follows.

• In the past year, symptoms of discomfort or pain in the pelvic region for extended periods of time.
• Volunteers who have had a urinary tract infection with a urine culture value of >100,000 CFU/ml within the past three months.
• Volunteers treated with intravesical chemotherapy or BCG.
• Volunteers who have had any of the following sexually transmitted diseases (STDs) - gonorrhea, chlamydia, mycoplasma or trichomonas.
• Volunteers with inflammatory bowel disease (such as Crohn's disease or ulcerative colitis, but not irritable bowel syndrome)