A Urologist’s Nightmare: Evaluation and Management of CP/CPPS Patient

Posted by Christopher P. Smith, MD, MBA, MSS | Jan 2024

Christopher P. Smith, MD, MBA, MSS, presented “A Urologist’s Nightmare: Evaluation and Management of CP/CPPS Patient” at the 27th Annual Innovations in Urologic Practice conference on September 22nd, 2023.

How to cite: Smith, Christopher P. “A Urologist’s Nightmare: Evaluation and Management of CP/CPPS Patient.” September 2023. Accessed May 2024. https://grandroundsinurology.com/a-urologists-nightmare-evaluation-and-management-of-cp-cpps-patient/

A Urologist’s Nightmare: Evaluation and Management of CP/CPPS Patient – Summary

Christopher P. Smith, MD, MBA, MSS, discusses the diagnosis and management of chronic prostatitis and pelvic pain syndrome (CP/CPPS). He begins by presenting an algorithm for diagnosis, noting that CP/CPPS is non-specific and often a diagnosis of exclusion with unclear causes.

Dr. Smith presents the UPONT classification system for CP/CPPS as a tool to categorize and diagnose CP/CPPS based on the individual patient’s symptoms. He notes that most CP/CPPS patients have symptoms of at least two domains of the UPONT classification system.

Dr. Smith discusses the role of patient history, labs, and imagining in CP/CPPS diagnosis. He presents tools which can be used by both patient and physician to find a more specific diagnosis.

Dr. Smith concludes by addressing symptom relief and management of CP/CPPS. He reviews the benefits and drawbacks of interventions ranging from dietary and behavioral changes to low-intensity shockwave therapy.

About The 27th Annual Innovations in Urologic Practice:

Presented by co-chairs Mohit Khera, MD, MBA, MPH, and Michael Coburn, MD, FACS, the Innovations in Urologic Practice conference provides a detailed review and commentary on multiple genitourinary and urologic diseases. Among the featured oncological topics are bladder cancer and immunotherapies, as well as upper tract cancer management, prostate cancer, including state-of-the-art imaging, focal therapy, and MRI. Experts also discuss new tools and techniques for nephrectomy and treating advanced renal cell carcinoma. In terms of general urological approaches, the conference also includes pelvic reconstruction and trauma; men’s health topics like male infertility, andrology, and sexual dysfunction; OAB and voiding dysfunctions; and ways to diagnose and treat infections in the urology patient.

For further educational activities from this conference, visit our collection page.

About The Author

Christopher P. Smith, MD, MBA, MSS

Christopher P. Smith, MD, MBA, MSS, is an associate professor and board-certified urologist specializing in male and female urinary incontinence and voiding dysfunction. Dr. Smith is also a Colonel in the United States Army Reserve Corps and has been deployed three times in support of Operation Enduring Freedom (OEF). Dr. Smith attended Northwestern University Medical School in Chicago and completed his residency training in urology at Baylor College of Medicine. He completed his fellowship training under a National Institutes of Health (NIH) K12 Scholarship in Neurology and Female Urology at the University of Pittsburgh School of Medicine in Pennsylvania. He earned his MBA at the Katz School of Business, University of Pittsburgh, and his Master of Strategic Studies from the U.S. Army War College in Carlisle, Pennsylvania. Dr. Smith has published numerous articles in scientific journals, including over 70 peer-reviewed papers and many invited articles to other publications. An active academician and speaker, he has presented many papers at scientific meetings and has served as guest lecturer across the country. Dr. Smith is an international expert on the basic and clinical aspects of botulinum toxin use within urology. He has used botulinum toxin clinically for over a decade. Dr. Smith is a principal investigator on several clinical trials examining the effects of botulinum toxin to treat patients with overactive bladder and benign prostatic hyperplasia (BPH). In 2012, Dr. Smith was awarded a Department of Defense grant to compare the efficacies of onabotulinumtoxinA vs. oxybutynin in spinal-cord injury patients with neurogenic detrusor overactivity and a VA Merit Grant to compare the efficacy of onabotulinumtoxinA vs. tamsulosin in men with BPH and lower urinary tract symptoms. Dr. Smith was awarded the Paul Zimskind Award in 2006 by the Society for Urodynamics and Female Urology for continuing excellence and leadership in the field of voiding dysfunction. He was awarded a three-year Career Development Award by the Department of Veterans Affairs to study the role of spinal purinergic pathways in the development of bladder overactivity. In addition, he has been honored with the Astellas Rising Star in Urology Award by the American Urological Association Foundation for three years to support his career development research. Dr. Smith received 2nd prize in the prestigious Jack Lapides Essay Contest for a research paper in 2008 investigating the effects of botulinum toxin A in spinal cord injured bladders, as well as the Apple Award from the American Spinal Injury Association. He has also been listed in Castle Connolly’s America’s Top Doctors.

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