Chronic Prostatitis/Chronic Pelvic Pain Syndrome: Research Progress and Precision Diagnosis‐Therapy Under the Integrated Neuro–Immune–Metabolic–Microbiota Axis Framework

ABSTRACT Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common disease with a highly heterogeneous clinical presentation that severely affects quality of life, and its traditional diagnostic‐therapeutic model faces substantial challenges. This narrative review systematically summarizes some of the recent important advancements in CP/CPPS, highlighting the evolution from a prostate‐centered view toward a multidimensional syndrome involving local and systemic processes. We focus on five core axes: clinical heterogeneity, local prostatic inflammation, systemic activation of pain pathways, immune metabolic reprogramming, and the gut–prostate axis. On the basis of multi‐omics evidence, including Mendelian randomization, we propose a hypothesis‐generating neuro–immune–metabolic–microbiota framework to organize potential interactions among these dimensions. For diagnosis, we discuss biomarkers, multiparametric magnetic resonance imaging, and symptom‐based stratification models that go beyond traditional approaches. For treatment, we summarize new directions aimed at axis rebalancing, including neuromodulation, novel interventions targeting immune metabolic pathways, microbiota‐targeted therapy, and phenotype‐guided multimodal integrated treatment. Future research must develop precision diagnostic tools that combine multi‐dimensional information, and validate interventions targeting specific axis hub nodes in prospective clinical trials, in order to move CP/CPPS management from empirical treatment toward individualized precision medicine.