The role of life style and diet modifications on treatment of chronic pelvic pain syndrome

INTERVENTION: 1) Nimesulide 100 mg bidaily for one week 2) Serenoa Repens (Saw Palmetto) one 320 mg tablet each day for three months. Saw palmetto is an extract of the fruit of Serenoa Repens: it is a phytotherapic agent commonly used worldwide for prostatic conditions. Its effectiveness for prostatitis was already showed in many clinical trials. 3) Intervention: modification of lifestyle and diet for three months. patients belonging the interventional arm are strongly recommended to strictly follow some lifestyle rules and dietary recommendations giving them a list prepared by Dr. Luigi Gallo, (MD specialist un urologist) including the following: Modifications of diet: avoidance of alcohol beverages, sodas, spicy foods, pepper, chilli, coffee, artificial sweeteners, tea. Modifications of lifestyle: 1) Walking and practicing relaxing sport activities (swimming, jogging, free exercises). 2) regular sexual activity: a)avoidance of sexual abstinence for more than 4 days b)Do not try to delay ejaculation in both masturbation and intercourse c)Do not practice interrupted coitus as contraceptive method. d)Do not have two ejacultations during the same day 3) Avoidance of sitting position for long time 4) Avoidance of sports that can be traumatic for the prostate (bicycling, motorcycling, horse riding etc.) 5) Avoidance of wearing tight underpants or trousers At second consultation (at the end of 3 months) patients assigned to this group will be invited to refill a questionnaire assessing the grade of acceptance to lifestyle modifications. Only the patients who will correctly follow lifestyle recommendations will be considered for outcome measurements, the others will be excluded. CONDITION: Chronic pelvic pain syndrome chronic prostatitis PRIMARY OUTCOME: The change in the mean total NIH‐CPSI scores of the two groups from baseline to after three months of treatment. SECONDARY OUTCOME: The change in mean NIH‐ CPSI subdomains (pain, micturition, QoL) of the two groups pre‐ and aftertreatment. INCLUSION CRITERIA: 1) patients coming to our center with a diagnosis of Category IIIa or IIIb CPPS (with or without presence of leukocytes) 2) age between 20 and 50 years 3) a score of > 1 in pain domain of NIH‐CPSI 4) duration of symptoms for more than 3 months 5) presence at clinical history of at least one lifestyle or diet risk factors.