This proposal describes an integrated, multidisciplinary and collaborative approach to studying chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), a common yet poorly understood condition, in a spectrum of men from diverse racial, ethnic, socioeconomic, and geographic backgrounds. The goals of the project are to better understand the causes, natural history, and health status impact of this condition and to provide effective treatment for suffering patients. Our proposal is based on the assumptions that: 1) development of validated instruments to measure symptom frequency and severity, as well as measure the importance of symptoms from the patient's perspective, will provide insight into the diagnosis, treatment, and outcomes of this condition, while facilitating collaborative research; 2) design of a multicenter data base study to compile background and clinical data on a large population of patients with CP/CPPS will provide information on the natural history of this heterogeneous condition; 3) ongoing research on the pathophysiology of CP/CPPS will bring treatments to the forefront that need to be tested in clinical trials, and; 4) there is a large reservoir of patients with this condition in primary care, and study of them will advance our understanding of this condition. These assumptions lead to the following 4 specific aims: 1a) to develop a reliable, valid, and responsive instrument to measure symptoms in men with CP/CPPS; 1b) to develop and test a set of questions (index) to assess the impact of CP/CPPS on patients' daily function and quality of life; 1c) using the instruments that we develop, to assess the effect of alternative approaches to treatment on patients in a clinical trial, while concurrently testing the responsiveness of the instruments and performing sub-group analyses to determine whether there are distinct sub-populations of patients under the umbrella term, CP/CPPS; 2) to design a centralized, longitudinal, observational data base study of a large group of patients from multiple centers with symptomatology consistent with CP/CPPS to identify common patient characteristics and determine the natural history and epidemiology of CP/CPPS; 3) to design and execute a clinical trial in concert with other clinical centers of different treatments for CP/CPPS; 4) to describe how primary care physicians currently diagnose and manage patients with this condition in comparison with urologists, as well as utilize an ongoing, prospective, national study to provide population-based data from the CP/CPPS instruments we develop. Our research team will monitor new developments in the field of prostatitis, keeping up with changes in practice patterns through national database updates.
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