Is Lumbar Disk Herniation a Potential Risk Factor for Chronic Prostatitis/Chronic Pelvic Pain Syndrome? Insights From a Misdiagnosed Case.

Abstract

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a complex condition characterized by heterogeneous symptoms and unclear pathogenesis, often posing diagnostic and therapeutic challenges. Lumbar disk herniation (LDH) may compress the dural sac and irritate the cauda equina, producing subclinical symptoms that overlap with those of CP/CPPS and increasing the likelihood of misdiagnosis. We report the case of a 61-year-old man with an 8-year history of CP/CPPS unresponsive to standard treatments, including phytotherapy, anti-inflammatory agents, and physical therapy. Further evaluation revealed lower-limb weakness and low-back pain; lumbar CT identified disk herniation with dural sac compression. Treatment was revised to include traditional Chinese medicine (Mai Xue Kang capsules and a modified Chaihu-Guizhi-Ganjiang Decoction) along with lifestyle modifications, resulting in significant symptom relief and no recurrence at 6-week follow-up. A review of the literature supports the potential for LDH to mimic CP/CPPS symptoms, highlighting a diagnostic blind spot. This case emphasizes the importance of considering spinal etiologies in refractory CP/CPPS and advocates for a broadened diagnostic framework to enable more personalized treatment strategies.