Chronic prostatitis (CP) is a common and frequent disease in adult males, mostly seen in 20-50 years old, about 50% of men have had symptoms of prostatitis at one point in their lives, with a worldwide prevalence of 2% to 9.7%. The most common of these is chronic non-bacterial prostatitis/chronic pelvic pain syndrome (CPPS), which accounts for about 90% to 95% of clinical cases. CP is often difficult to cure completely and is prone to recurrence. Compared to patients with chronic heart failure, diabetes, and Crohn’s disease, CP has a greater impact on patients’ quality of life. However, there are no specific diagnostic indicators and treatment criteria for CP, which has caused great problems in clinical practice. Past research on CP has always looked at the prostate as the root cause of the disease, but has not been able to identify the exact cause of CP. The National Institute of Diabetes, Digestive and Kidney Diseases (NIDDK) of the National Institutes of Health is conducting a collaborative study called MAPP, which attempts to link CP to interstitial cystitis (IC) and related clinical syndromes such as IC, based on a number of factors, including individual genetics, lifestyle, and surroundings, based on the specificity of each patient’s disease onset and outcome. ) and related clinical syndromes, such as irritable bowel syndrome, fibromyalgia syndrome, and chronic fatigue syndrome, to consider the diagnosis and treatment of these diseases as a whole. The study is divided into six parts: etiology study, urinary tract phenotype study, non-urinary tract phenotype study, neurobiological study, disease index study, and pain pathway study, which are divided into four collaborative groups. The etiology study, urinary tract and non-urinary tract phenotypes study is conducted by Prof. Daniel JC’s collaborative group. As part of the MAPP collaborative study, Prof. Daniel proposed the UPOINT treatment system for CP. In this paper, we present a systematic review of the background, specific contents, applied research and relative shortcomings of the UPOINT system. In 1999, the NIH classified CP into Class II, chronic bacterial prostatitis, Class IIIA, chronic inflammatory prostatitis (non-bacterial), and Class IIIB, chronic non-inflammatory prostatitis; the symptoms of CP were classified as pain, LUTS and impact on quality of life, and the CPSI score was used to determine the severity of the disease. This classification system and the CPSI questionnaire have played a great role in scientific research and clinical practice, but it is undeniable that the classification system has certain defects, especially for category III prostatitis, which accounts for about 80% or more of the total number of prostatitis, but is simply distinguished as IIIA and IIIB by the leukocyte count of EPS only, which lacks the necessary correlation with the patient’s symptoms, and therefore lacks exact clinical treatment guidance for clinical treatment. In addition to leukocytes, biological indicators such as lecithin vesicles, zinc, and urinary flow rate also lack specificity for the diagnosis of CP and cannot effectively guide treatment. The most recent studies have abandoned the prostate centric theory and considered CP as a “heterogeneous” disease, exploring the pathogenesis of CP from multiple etiological pathways, including infection (history of urinary tract infection/undetectable bacteria/nano-bacteria), autoimmune disorders, neurological abnormalities, endocrine abnormalities (HPA axis disorders), and endocrine disorders. abnormalities (HPA axis dysregulation, adrenocorticotropic hormone abnormalities), mucosal functional impairment (abnormal mucosal immune function, increased mucosal sensitivity to potassium ions), local anatomical alterations (urinary reflux/bladder neck obstruction), pelvic muscles, genetic polymorphisms, zinc and other micronutrient deficiencies, altered intraprostatic tissue pressure, psychiatric factors, etc. In addition to the lack of specific biological indicators for diagnosis and the numerous etiologies, the results of randomized controalled trials (RCTs) of CP are also contradictory. There are “3A” clinical drugs for CP, namely antibiotics such as levofloxacin, alpha-blockers such as tamsulosin, anti-inflammatory drugs such as rofecoxib, 5-alpha reductase inhibitors such as finasteride, and pentamidine. sodium polysulfide. The efficacy of the above RCTs on CP was negative with CPSI as the primary criterion. When GRA (global response assessment), CPSI subscores and MPQ (McGill Pain Questinnaire) were used as the second criterion, it showed that these drugs had some efficacy. Moreover, the above drugs such as levofloxacin and tamsulosin were found to have positive results in some non-strictly required clinical trials, which shows that CP patients have different responsiveness to the same drug. In addition, Shoskes DA et al. as well as NickelJC et al. found that combination therapy for CP, was more effective than single drug therapy for CP. In conclusion, there is no one model drug for the treatment of CP, and each patient has different responses to different drugs because of their own etiology. Therefore, the treatment for CP needs to be typed, that is, according to each individual patient’s etiology, physical condition, disease regression and so on to give the corresponding treatment, this treatment includes medication, but also includes some physical therapy such as acupuncture and massage, as well as the improvement of the patient’s lifestyle habits, mental health regulation and so on. 2, specific content UPOINT system is a new diagnosis and treatment system based on the above problems in CP diagnosis and drug treatment, combined with the current CP clinical practice. Specifically, UPOINT summarizes CP into 6 basic “clinical phenotypes”: U is urinary, P is psychosocial, O is organic-specific, I is infection, N is The so-called “clinical phenotype” is the heterogeneous characteristics of CP, which consists of different etiological mechanisms, disease characteristics, clinical syndromes and disease transformation patterns, as well as the corresponding diagnosis and treatment. Each phenotype of UPOINT has its own specific clinical criteria and corresponding treatment methods. The UPOINT system is defined by a series of clinical parameters and is associated with a large number of evidence-based treatments. According to Shoskes, Liu, Longfei, et al. indicated that U refers to patients who exhibit irritative or obstructive voiding symptoms and/or nocturia; P refers to psychological problems associated with symptom severity, including depression, anxiety, stress, and poor coping (e.g., catastrophic thinking, lack of family social support, etc.); O refers to prostate tenderness on rectal examination and clear evidence of prostate inflammation (confirmed by EPS or VB3 I refers to definite lower urinary tract infection, including recurrent urinary tract infection, prostate-specific specimens (EPS or VB3) with culture of uropathogenic bacteria; N refers to conditions of unknown etiology that may be related to the central nervous system, including irritable bowel syndrome, fibromyalgia, chronic fatigue syndrome, and migraine; T refers to definite painful spasms in the perineum, pelvic floor, or acute muscle spasms in the perineum and acute myofascial painful trigger points during pelvic floor examination. In a retrospective study, Shoskes et al. found that the probability of each individual phenotype of the UPOINT diagnosis and treatment system was different in CP, specifically O was found in 61% of patients, T in 53%, U in 52%, N in 37%, P in 34%, and I in 16%. I was 16%. Moreover, only 22% of the patients showed only one phenotype alone, while the remaining 78% had a complex phenotype. Although age did not affect the number of phenotypes at 45 years, the number of phenotypes tended to increase with the duration of the disease, especially in CP patients with a disease duration >2 years, and was positively correlated with CPSI. Wagenlehner et al [39] found that in a total of 1219 European patients, most of them had a combination of phenotypes. Among 937 Italian CP patients, 908 patients (96.91%) had O, 638 patients (68.09%) had T, 537 patients (57.31%) had U, 423 patients (45.14%) had N, 323 patients (34.47%) had P, and 68 patients (7.26%) had I. Of the 290 German CP patients, 260 had U (89.66%), 120 had T (41.38%), 112 had O (38.62%), 98 had P (33.79%), 79 had N (27.24%), and 53 had I (18.28%).Hedelin HH found in a retrospective study of 50 CP patients that the patients had a complex phenotype, with U accounting for 52%, O and N for 45.14%, P for 323, and I for 7.26%. Shoskes et al. used the UPOINT system in a study of CP patients and found that O accounted for 70%, T for 64%, U for 59%, N for 39%, P for 37%, and I for 16%. 4, the shortcomings of the UPOINT diagnosis and treatment system The UPOINT system does not fully summarize all clinical manifestations of CP. For example, because erectile dysfunction (ED) is present in 40% to 70% of CP patients, German scholar Magri V included ED in the system and called it “UPOINTS”. According to Magri et al, the UPOINT system has a good correlation in Italian CP patients, while in German patients, UPOINTS (S for sexual dysfuntion) is superior to the UPOINT system. However, through their analysis, Mary et al. pointed out that although CP patients can present with ED, the inclusion of ED in UPOINT, i.e. “UPOINTS”, does not increase the accuracy of this diagnostic system, but rather makes it less correlated with CPSI. Therefore, Mary et al. concluded that the UOPINT system has a strong correlation with CP and can be used clinically. In addition, Shoskes and colleagues are also developing and testing a special questionnaire for this system in order to provide better guidance for the treatment of CP. Although UPOINT has been used clinically, it is limited to retrospective studies and there is a lack of prospective studies with large samples. Moreover, the system is still in version 1 and has been in use for a relatively short time, and the diagnostic criteria for each phenotype are not fully detailed. In addition, UPOINT mainly stratifies CP patients and classifies them according to different clinical manifestations into corresponding etiological mechanisms and therapeutic measures. However, the etiological mechanisms indicated by UPOINT are not the “underlying mechanisms” of CP, and according to Brandon et al, the system is based on symptomatology in general, which may inevitably attribute symptoms of different etiologies to the same phenotype or classify symptoms of the same etiology into different phenotypes. . This is one of the reasons why Brandon et al. proposed an alternative diagnosis and treatment system “DABBERC”. The proposed UPOINT system provides a feasible way for individualized treatment of CP. We expect the MAPPD Collaborative Group to develop a reasonable questionnaire for the UPOINT diagnosis and treatment system so that patients with CP can be treated in a standardized and reasonable manner.