Do we know what causes chronic pelvic pain?
In general, there are more white blood cells on average in a patient's prostatic fluid, but it's not a clear-cut point. I think one of the more interesting observations is that cytokines, which help control inflammation and can actually attract white blood cells to organs, are found in greater amounts in the prostatic fluid of some men with this condition. That suggests that maybe the prostate is a component of the syndrome.
These cytokines are similar to ones that would draw white blood cells to the joints and cause arthritis. So there may be logical explanations of why some men to have these pelvic pain symptoms.
How do you diagnose chronic pelvic pain syndrome?
The diagnosis is self-made. There is a questionnaire we use to quantify the symptoms. By definition, a syndrome is not a disease. It's not like a tissue diagnosis or a blood test.
Is there any way to treat it?
There's no effective therapy at this point. In the controlled studies that we've done, most notably the one where we gave patients an antimicrobial or an alpha blocker [antibiotics like Cipro or high blood pressure medications like Cardura], the patients did not show any improvement. Now, the negative aspect of the study was that we chose men for the study who had already been exposed to those drugs, and they had pretty severe symptoms. So, it's possible that those drugs may benefit some men who have the earlier onset of the condition.
