Clinical Application Of UPOINT(S) Phenotype Classification System In The CP/CPPS

Objective: Evaluate the clinical application of UPOINT phenotype classification system in Chinese patients with CP/CPPS. Compare the incidence of male sexual dysfunction between CP/CPPS patients and general population.And access the viability of bring the factor of sexual dysfunction into UPOINT system.Methods: Use UPOINT phenotype classification system to classify 225 patients which diagnosed of CP/CPPS in outpatient of he Second Affiliated Hospital of Soochow University from October 2014 to October 2015, according to the positive expression of each factors to the corresponding treatment(urinary: alpha blocker or antimuscarinic,psychosocial: Cognitive-behavioral, Anxiolytics or antidepressants, organ specific: sabal fruit extract; infection: antibiotic;neurologic/systemic: Neuromodulation treatment,amitriptyline or pregabalin, tenderness: pelvic floor physical therapy,Muscle relaxant)respectively. The questionnaire of National Institutes of Health Chronic Prostatitis Symptom Index(NIH-CPSI) and the International Prostate Symptom Score(IPSS) were used to estimate the severity of the patients with CP/CPPS and the changes of scores before and after treatment. On the other hand, the distribution and the severity of sexual dysfunction of 120 healthy men randomly selected from general population and patients with CP/CPPS were assessed by the questionnaire IIEF-5 and CIPE.Results:The percentage of patients positive for each domain was 76.44%, 32.44%,45.78%, 21.78%, 30.66%, 65.33% for the Urinary, Psychosocial, Organ-specific, Infection,Neurological/systemic and tenderness,respectively.There were no correlations between the number of positive domains and symptom duration and patients age, but the correlations of UPOINT domains with NIH-CPSI(r=0.426,p<0.05) and IPSS( r=0.241,p<0.05)was increased significantly.After incorporate the sexual dysfunction factors and the UPOINTsystem, this relationship between system and questionnaire still exists, and the correlation with Qo L( quality of life) and IPSS increased obviously.Use UPOINT phenotype classification system to classify patients in cohort and with corresponding treatment,the NIH- CPSI scores and IPSS scores reduced(7.00±3.39) and(4.55±3.51) respectively after treatment. The difference bewteen the pretherapy and post-treatment was significant.Among the 120 healthy men,the incidence of Erectile dysfunction(ED)and Premature ejaculation(PE) were 6.67% and 14.16% severally, and the incidence of ED and PE in patients with CP/CPPS were 16.00% and 20.00%,with a apparent statistical difference between each other.Conclusions:According to this classification system for patients with individualized treatment in patients with CP/CPPS,the scores of NIH- CPSI, IPSS both decreased significantly,We found that UPOINT phenotype classification system for CP/CPPS patients in China is suitable.And CP/CPPS could increase the incidence of sexual dysfunction significantly.In addition,the results we work out from figures support to merge sexual dysfunction factors into the UPOINT system.