Identification of novel susceptibility factors related to CP/CPPS‐like symptoms: Evidence from a multicenter case‐control study

Abstract Background We aimed to systematically identify novel susceptible factors related to the occurrence and development of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS)‐like symptoms that were not limited to lifestyles or dietary habits in Chinese population. Methods We recruited participants from three centers (Shanghai [northeast], Hefei [east], and Lanzhou [northwest]) from August 2020 to June 2021. Demographics, lifestyles, dietary habits, past medical history, and national institutes of health‐chronic prostatitis symptom index (NIH‐CPSI) were collected from the individuals via optimized questionnaires. Logistic regression analysis and multivariate adjustment models were used to calculate the odds ratio (OR) and 95% confidence interval (95% CI) to assess the association between these variables and CP/CPPS‐like symptoms. Results A total of 1851 participants were enrolled in this study (764 cases and 1087 controls). Age distributions differed between groups (median, range: 32, 18–74 vs. 29, 18–70, p < 0.001). After adjustment, physicochemical occupational hazards were identified significantly related to CP/CPPS‐like symptom occurrence and development (OR occurrence : 1.389, 95% CI: 1.031–1.870, p < 0.001; OR development : 2.222, 95% CI: 1.464–3.372, p < 0.001); besides, greater than or equal to four ejaculations per week significantly increased the likelihood of CP/CPPS‐like symptoms compared with one ejaculation per week (OR occurrence : 3.051, 95% CI: 1.598–5.827, p = 0.001). For these patients, who were easily felt gastrointestinal discomfort caused by spicy food intake, they had a higher incidence to affect with CP/CPPS‐like symptoms (OR occurrence : 2.258, 95% CI: 1.858–2.745, p < 0.001). In addition, history of drug allergy and genitourinary infections were identified as independent susceptible factors for the occurrence of CP/CPPS‐like symptoms (OR occurrence : 1.689, 95% CI: 1.007–2.834, p = 0.047; OR occurrence : 3.442, 95% CI: 2.202–5.382, p < 0.001, respectively), while the history of rheumatic immune diseases was found tightly associated with the development of CP/CPPS‐like symptoms (OR development : 2.002, 95% CI: 1.008–4.058, p = 0.048). Conclusion Infection/inflammatory/immune‐related disorders, novel dietary habits, and lifestyles associated with the susceptibility of CP/CPPS‐like symptoms' occurrence and development are identified. Altering these irregular conditions serves as potential strategies for the treatment of patients with CP/CPPS‐like symptoms.