Several types of monotherapy have been introduced and researched for CP/CPPS. These treatment methods include alpha blockers, antibiotics, hormone therapy, anti-inflammatory treatment, plant therapy, anticonvulsant and non-pharmacological treatment. It was reported that these treatment methods are effective for treatment of CP/CPPS but there are other reports that such methods are not effective. In addition, research cases were limited and therapeutic methods that were available were not backed up by adequate research.

Alpha blockers have been researched as monotherapy and its therapeutic effect on CP/CPPS symptoms were reported in several theses. Nickel et al. reported in their research that Silodosin was effective for improvement of symptom and quality of life of in patients with CP/CPPS[14]. And it was further reported that terazosin[15] and alfuzosin[16] that are alpha blockers are also effective. However, according to a multicenter research performed at two places, their results presented the opposite. According to research done by Alexander et al., the NIH-CPSI score for 6-weeks of tamsulosin treatment did not show any improvement and in another large scaled research done on alfuzosin, it was reported that the advantage of alpha blocker was not represented and the symptom was not improved[17].

Antibiotics have been used for bacterial prostatitis almost essentially even in the case when culture tests were negative [18]. And there is also research reporting symptom improvement. In tetracycline research, symptom improvement was represented when comparing with the control group by using such an agent for 12 weeks. However, a survey on quality of life was not sufficient[19]. In a randomized controlled research, levofloxacin was used for 6 weeks and it was compared with placebo[20]. In total score of the NIH-CPSI, improved score between two groups was represented but its difference was not shown. In NIDDK-sponsored research, it was announced that ciprofloxacin was not superior to placebo[21]. In Meta-analysis for use of antibiotics[22], there was a research study that presented results that it may be clearly, individually effective, but not statistically and clinically. It is considered that CP/CPPS was caused by bacteria and that it may not be cultured in some patients or uncultured due to anti-inflammatory cytokine blocked antibiotics[23]. This result suggests that antibiotics treatment should not be recommended as first line therapy and this case is applicable particularly to a patient who fails antibiotic treatment previously.

Anti-inflammatory medicine has also been widely used for several symptoms of CP/CPPS and various drugs particularly including rofecoxib [24], pentosanpolysulfate [25], zafirlukast (a leukotriene antagonist) [26],prednisone [27], and tanezumab[28] have been researched. In case of administering Rofecoxib and celecoxib in high concentrations, symptom improvement was represented. Symptom improvement was evident in pentosanpolysulfate when its concentration was high but its CPSI score did not show clear improvement compared with control group. Zafirlukast and prednisone were not effective for symptom improvement and tanezumab also did not show any advantage. Anti-inflammatory treatment also did not show significant symptom improvement as monotherapy and it is not recommended as monotherapy as well. In plant treatment, quercetin was effective because antioxidant and material with anti-inflammatory function were contained in it[29]. In randomized, double-blind, placebo-controlled trials, the NIH-CPSI after quercetin treatment was lowered compared with control group and its side effect was also almost nil. Therefore, quercetin was somewhat effective as monotherapy.

In neuromodulatory treatment, pregabalin showed improvement in total score of NIH-CPSI and pain score but it was not significant statistically.

In hormone treatment, there is research using mepartricin that lowers estrogen levels[34] and research that uses finasteride[30]. Mepartricin research showed improvement in total NIH-CPSI score but its number was limited and the finasteride research showed symptom improvement compared with control group but it was not significant statistically. As such, hormone therapy was also not promising as monotherapy.

Regarding physical therapy, there is research showing results using Myofascial trigger point release. Research was performed on patients with CP/CPPS but the results were not significant statistically and its sample size was limited [31]. Each had merit/demerit as monotherapy and through active research, its efficacy was not demonstrated. Moreover, it was hard to treat patients with CP/CPPS by monotherapy and this treatment is unable to be applied clinically yet in the field where active research was not performed.

Since a few research reporting that monotherapy was not effective were presented, a study was done on the efficacy of several treatments performed simultaneously, showing that it was more effective than monotherapy. Nickel et al. reported that when treating with alpha blocker, antibiotics or pain killing anti-inflammatory drug at the same time, the clinical score was more improved than control group and in other studies, it reported that when treating with alpha blocker, antibiotics and pain killing anti-inflammatory drug at the same time, it was more effective than monotherapy[32].

CP/CPPS was understood and developed by the NIH classification. Monotherapy was not effective for diversified syndromes of CP/CPPS. Therefore, it was insisted that the cause of several symptoms of CP/CPPS should be entirely clarified and that it be properly treated at the same time.

In 2009, Nickel and Shoskes reported that CP/CPPS should be approached and treated based on its phenotype[33]. And Volkan et al. reported that complex treatment was as safe as monotherapy[34] and Nickel et al. explained the concept of UPOINT in detail in his CP/CPPS review thesis[35].

It was learned that in order to properly and directly treat CP/CPPS, it is required to diagnose six kinds of clinical phenotype systems in the patients. Clinical six areas include urinary symptoms, psychosocial dysfunction, organspecific findings, infection, neurologic/systemic, and tenderness of muscles and it was named as UPOINT [7].

Approach to UPOINT was encouraged by research results showing that medicine (alpha blockers, anti-inflammatory drug) being used as existing monotherapy was not effective for CP/CPPS treatment. However, clinical research on UPOINT was limited and its mechanistic treatment principle was not clarified. Moreover, a study on or inter-domain showing symptoms by patient was not performed. Furthermore, because long-term evaluation for the treatment was not performed, there are many tasks to be done in further research and its efficacy should be also verified [50].