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Clinical Research

Effectiveness of diet, sexual habits and lifestyle modifications on treatment of chronic pelvic pain syndrome




The potential benefits of a therapeutic regimen for chronic pelvic pain syndrome (CPPS) based on the adherence to some specific rules concerning diet, sexual habits and lifestyle have never been investigated.


A review of literature was executed to prepare a vademecum of 13 rules relating to diet, sexual habits and lifestyle that patients had to adhere to in order to treat CPPS. Patients affected by CPPS were enrolled and assigned to two equal groups that were both treated with 100 mg of nimesulide for 1 week. Group two patients were instructed to adhere to the vademecum rules, whereas patients in Group one received instructions to make no changes in their lifestyles. The NIH-Chronic Prostatitis Symptom Index was administered at baseline and after 3 months. The main outcome measure was the change in the mean total NIH-Chronic Prostatitis Symptom Index scores between the two groups from baseline to after treatment. Statistical methods for two-group comparisons were used.


Overall,100 patients were recruited. Thirty-nine out of fifty patients (78%) belonging to Group two adhered to the vademecum rules. In Group one, the total NIH-Chronic Prostatitis Symptom Index score was 21.9 at baseline and 17.6 post-treatment, whereas in Group two these scores were 22.1 and 8.1, respectively (P<0.0001).


We detected 13 potentially eliminable risk factors for CPPS on the basis of which we prepared a vademecum of 13 rules to treat this disease that were well tolerated and highly effective in significantly reducing all types of symptoms caused by CPPS.

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Correspondence to L Gallo.

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Appendix 1

Appendix 1 Diet, sexual habits and lifestyle rules


  • Avoid consumption of all kinds of alcohol beverages

  • Avoid consumption of spicy foods, pepper, chilli and coffee

  • Follow a correct diet assuming each day 50% carbohidrates, 30% fats and 20% proteins

  • Increase your intake of fruits, vegetables and foods rich of natural fibers (dark bred, vegetables, spinaches)

Sexual activity

  • Avoid having two ejaculations during the same day

  • Avoid period of sexual abstinence longer than 4 days

  • Do not try to delay ejaculation in both intercourse and masturbation

  • Do not practice interrupted coitus as contraceptive method (ejaculate outside of partner’s vagina)

Lifestyle and perineal traumatism

  • Walk and practice relaxing sport activities (swimming, jogging, free exercises).

  • Avoid sedentary activities and sitting position for long time. Use a donut-shaped cushion if seated for longtime

  • Avoid sports that can be traumatic for your prostate (bicycling, motorcycling, horse riding etc.)

  • Avoid to wear tight underpants or trousers

  • Take frequent hot baths or bidets during which relax and release pelvic muscles

Appendix 2

Appendix 2 Questionnaire to detect risk factors

Dear patient, in order to investigate the potential causes of your problem is very important that you refill this questionnaire in the most sincere and honest way:


During the previous three months:

Did you drink alcohol beverages (wine, beer, spirits)? YES □ NO □

Did you drink more than one cup of coffee each day? YES □ NO □

Did you consume pepper, hot chilli and/or spicy foods? YES □ NO □

Did you have an excessive diet: high intake of carbohydrates (bread, pizza, rice and pasta) and/or high intake of fats (fried food, cakes, cured meats, cheese, milk) YES □ NO □

Did you have symptoms of bowel dysfunction (meteorism, irregular rectal function, abdominal constipation and/or frequent episodes of diarrhea, abdominal swelling after dinner, slow digestion)? YES □ NO □

Sexual habits

During the previous three months:

Did you try to delay ejaculation during intercourse and/or at masturbation? YES □ NO □

Did you have periods of sexual abstinence (absence of ejaculations) longer than four days? YES □ NO □

Did you have two ejaculations on the same day? YES □ NO □

Did you use coitus interruptus as anticoncepcional method (coming out of your partner’s vagina)? YES □ NO □


During the previous three months:

Did you have a sedentary life? YES □ NO □

Perineal traumatism

During the previous three months:

Did you have frequently a sitting position (for example driving car or sitting in front of a computer for long time)? YES □ NO □

Did you practice sports or activities that created pelvic traumatic stimulations (bycycling, motorcycling, horse-riding)? YES □ NO □

Did you wear constrictive clothing (underpants, trousers etc)? YES □ NO □

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Gallo, L. Effectiveness of diet, sexual habits and lifestyle modifications on treatment of chronic pelvic pain syndrome. Prostate Cancer Prostatic Dis 17, 238–245 (2014).

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