{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T11:48:01Z","timestamp":1791805681134,"version":"4.3.4"},"reference-count":22,"publisher":"Wiley","issue":"15","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Prostate"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>To evaluate and compare the efficacy of a simplified diagnostic and individualized comprehensive treatment strategy based on the \u201cprostate\u2013pelvic syndrome (PPS)\u201d theory versus the traditional National Institutes of Health (NIH) conventional classification\u2010based protocol for type III prostatitis in men under 40 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this prospective randomized controlled trial, 222 patients (18\u201339 years) with type III prostatitis were randomly assigned to individualized comprehensive therapy guided by simplified PPS\u2010based diagnosis (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009112) or traditional NIH conventional classification\u2010based therapy (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009110) for 6 weeks. Randomization was performed using a computer\u2010generated sequence with allocation concealment via sealed opaque envelopes. The primary endpoint was the change in the NIH\u2010chronic prostatitis symptom Index (NIH\u2010CPSI) total score and the response rate (\u2265\u20096\u2010point decrease). Secondary endpoints included changes in prostate volume (PV), NIH\u2010CPSI subdomain scores, and the proportion of patients with sexual dysfunction (SD). Univariate and multivariate analyses identified factors influencing treatment response.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 212 patients completed follow\u2010up (108 PPS and 104 NIH). Baseline characteristics were comparable between groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u20090.05). After treatment, the median decrease in NIH\u2010CPSI total score was significantly greater in the PPS group than in the NIH group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003), and the response rate was higher (79.6% versus 61.5%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004). The intergroup difference was primarily driven by the quality\u2010of\u2010life domain (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003), while pain and voiding domain changes did not differ significantly between groups. Multivariate analysis identified PPS\u2010based treatment [odds ratio (OR)\u2009=\u20092.227, 95% onfidence intervals (CI): 1.143\u20134.337] and baseline factors, including SD (OR\u2009=\u20090.334, 95% CI: 0.165\u20130.673), sedentariness (OR\u2009=\u20093.554, 95% CI: 1.652\u20137.642), and PV\u2009\u2265\u200920\u2009mL (OR\u2009=\u20094.850, 95% CI: 1.870\u201312.575), as independent predictors of response.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In men under 40 years with type III prostatitis, individualized comprehensive therapy guided by simplified PPS\u2010based diagnosis was associated with greater symptom improvement\u2014particularly in quality of life\u2014compared with the traditional NIH conventional classification\u2010based protocol. The findings suggest that a comprehensive, symptom\u2010directed treatment strategy may outperform a more restricted classification\u2010based regimen, though the contribution of the simplified diagnostic pathway\u2014eliminating lower urinary tract pathogen localization and invasive expressed prostatic secretion testing\u2014per se requires further study.<\/jats:p>\n                    <jats:p>\n                      <jats:bold>Trial Registration:<\/jats:bold>\n                      MR\u201034\u201024\u2010035332;\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/www.medicalresearch.org.cn\">https:\/\/www.medicalresearch.org.cn<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pros.70236","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T12:39:12Z","timestamp":1788179952000},"page":"1525-1534","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy of a Simplified Diagnostic\u2013Therapeutic Strategy Based on the Prostate\u2013Pelvic Syndrome Theory Versus NIH Conventional Classification\u2011Based Protocol for Type III Prostatitis: A Randomized Controlled Trial"],"prefix":"10.1002","volume":"86","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7138-7909","authenticated-orcid":false,"given":"Xiaoma","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Urology, The First Affiliated Hospital of Anhui Medical University; Anhui Province Key Laboratory of Urological and Andrological Diseases Research and Medical Transformation Anhui Medical University Hefei China"},{"name":"Department of Urology Anhui Public Health Clinical Center Hefei China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1966-5478","authenticated-orcid":false,"given":"Li","family":"Xiao","sequence":"additional","affiliation":[{"name":"Department of Health Management Center Anhui Public Health Clinical Center Hefei China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Urology Anhui Public Health Clinical Center Hefei China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Urology Anhui Public Health Clinical Center Hefei China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Urology Anhui Public Health Clinical Center Hefei China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3931-2469","authenticated-orcid":false,"given":"Hexi","family":"Du","sequence":"additional","affiliation":[{"name":"Department of Urology, The First Affiliated Hospital of Anhui Medical University; Anhui Province Key Laboratory of Urological and Andrological Diseases Research and Medical Transformation Anhui Medical University Hefei China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,31]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40266-021-00890-2"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.5489\/cuaj.7607"},{"issue":"2","key":"e_1_2_12_4_1","first-page":"369","article-title":"The National Institutes of Health Chronic Prostatitis Symptom Index: Development and Validation of a New Outcome Measure","volume":"162","author":"Litwin M. 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