CAUSES, DIAGNOSIS, AND NATURAL HISTORY Bacteria from Chronic Prostatitis Patients Produce Pelvic Pain in Mice Clinically Isolated Gram-Positive Prostate Bacteria Induce Chronic Pelvic Pain

Although somewhat fewer than last year, the studies of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) were certainly intriguing at this year’s American Urological Association (AUA) meeting. There was a renewed interest in the role of bacteria in the condition, although the story may be much more complicated than pointing to one disease-causing bacterium. One study showed that certain strains of common bacteria may cause symptoms—but probably only in those with a genetic predisposition to CP/CPPS. Bacteria may not be the only microbes to investigate either, implied one study of interstitial cystitis/bladder pain syndrome (IC/BPS) and overactive bladder, which showed a very different fungal mix in patients with these conditions compared with healthy persons. On the other hand, another study suggested that a condition known as small-fiber polyneuropathy might be responsible for pelvic pain symptoms, especially in patients who have other chronic pain problems in addition. Another hint about a cause of symptoms came from the IC/BPS studies: It’s long been known that certain foods and beverages can ramp up pain in IC/BPS and in CP/CPPS. But the common factor may not be acid or spice; it may be histamine. Most of the common troublesome foods and beverages for pelvic pain patients are indeed high in histamine, including alcohol, chocolate, mature cheeses, pickled foods, beans, and nuts. This finding may spur more studies looking at the role of mast cells in chronic pelvic pain, but it may also point to histamine-producing bacteria in the urogenital tract, which this study found.