Association of Diet and Lifestyle With Chronic Prostatitis/Chronic Pelvic Pain Syndrome and Pain Severity

A Case-Control Study

X Chen; C Hu; Y Peng; J Lu; NQ Yang; L Chen; GQ Zhang; LK Tang; JC Dai


Prostate Cancer Prostatic Dis. 2016;19(1):92-99. 

In This Article

Abstract and Introduction


Background: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common problem with unclear etiology. Some diet and lifestyle factors were thought to correlate with CP/CPPS, but studies comprehensively investigate this correlation are rarely available. The current study was conducted to determine the potential lifestyle-related risk factors of CP/CPPS and its pain severity in Chinese population.

Methods: Participants were recruited from seven hospitals in Shanghai from July 2012 to August 2013. Demographics, medical history, diet and lifestyle information, and CP/CPPS symptoms were obtained from each participant using a questionnaire. Univariate and multivariate logistic regression analyses were used to identify potential lifestyle-related risk factors for CP/CPPS and its pain severity.

Results: A total of 784 men with CP/CPPS and 785 controls were enrolled in this study. Multivariate regression model indicated that age, nightshift work, stress, smoking status, alcohol consumption, less water intake, imbalanced diet, frequent sexual activity, delaying ejaculation and holding urine were identified as potential risk factors for CP/CPPS, whereas sedentary lifestyle, caffeinated drinks and less water intake were associated with severe pain in CP/CPPS patients.

Conclusions: Several diet and lifestyle factors associated with CP/CPPS and pain severity were determined in this study. These modifiable conditions are potential targets for treatment of CP/CPPS. However, further studies are necessary to determine their role in the pathogenesis of CP/CPPS.


Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common urological problem worldwide. According to National Institutes of Health (NIH) consensus, CP/CPPS is characterized by chronic pelvic pain symptoms without identifiable etiology and classified as type-III prostatitits.[1] A widely used questionnaire called the NIH-chronic prostatitis symptom index (NIH-CPSI) was developed for the diagnosis and assessment of CP/CPPS.[2] The prevalence of CP/CPPS ranges from 2.2 to 9.7% globally.[3] In a cross-sectional study conducted by Liang et al.,[4] the prevalence of prostatitis-like symptoms diagnosed through NIH-CPSI was 8.4% in China. Moreover, a substantial impairment in the quality of life and significant economic burden were observed in patients with CP/CPPS.[5,6] However, the etiology of CP/CPPS remains poorly understood.

Previous studies identified a wide range of potential risk factors correlated with CP/CPPS.[7,8] Conflicting results exist in these studies because of the different populations and study designs used. Among these potential risk factors, diet and lifestyle factors such as sexual habit and physical activity are variable and modifiable in different regions and populations. However, rarely had any study that comprehensively reported the lifestyle factors associated with CP/CPPS in Chinese population. Hence, we conducted a case–control study to investigate the association of diet and lifestyle factors with CP/CPPS and its pain severity among patients in Shanghai, China.