Male chronic pelvic pain is a relatively rare and commonly misunderstood condition, but it can drastically affect the quality of life for men who suffer from it. The nature and severity of symptoms vary significantly from person to person. The causes and symptoms of male chronic pelvic pain have not yet been thoroughly researched, and many doctors remain in disagreement about the right way to go about diagnosing or treating the condition.
Male chronic pelvic pain ranges in severity from mild to excruciating. It is typically diagnosed as either chronic prostatitis (CP), chronic pelvic pain syndrome (CPPS), or chronic nonbacterial prostatitis, and occurs when male patients experience significant pelvic pain lasting more than six months with no known infection or other disease as a cause.
The most common symptoms of male pelvic pain are dull, aching pain and pressure in the pelvis, groin, lower back, testicles or penis, pain or difficulty urinating or visible blood in urine, sexual difficulties including erectile dysfunction and premature, painful or bloody ejaculation, and constant feelings of exhaustion, heaviness or general malaise.
The exact causes of pelvic pain in many male patients remain unknown, but documented cases have helped establish recurring patterns in some of the common causes. These include bladder and kidney disorders like urinary tract infections, kidney stones and interstitial cystitis, bacterial infections or inflammations of male reproductive organs like epididymitis and prostatitis, STDs, nerve disorders caused by pinched nerves or accumulated scar tissue, hernias, intestinal problems like haemorrhoids or anal fissures, pelvic muscle damage and complications from previous surgeries.
Diagnosing pelvic pain can be a long and complicated process, because correctly pinpointing the cause is crucial to treatment. Urine and blood tests are usually performed first to screen for infections and chemical or hormonal imbalances, and a penile culture may be analysed for STDs. X-rays, CAT scans and ultrasounds of the pelvis, lower abdomen and testicles are performed to look for any immediate physical causes such as spinal problems, cysts, excess fluids, damaged or pinched blood vessels, hernias, inflammation and swelling of the testes or epididymis or testicular torsions.
According to the Center for Chronic Pelvic Pain, two of the most important diagnostic tools for chronic pelvic pain patients are electromyography (EMG) and nerve conduction studies (NCS), which test nerve and muscle function by inserting very small needles into affected areas.
Treatments for male pelvic pain vary substantially from patient to patient because the causes and symptoms are so unpredictable and widespread. A wide range of drugs including broad-spectrum antibiotics like ciprofloxacin and painkillers like non-steroidal anti-inflammatory drugs (NSAID) and opiates may be prescribed, along with muscle relaxants, antidepressants and anticonvulsants like pregabalin and gabapentin. Surgery is sometimes necessary in extreme cases, especially those suspected to be caused by tumours, hernias or major lesions.
Newer research also shows the effectiveness of certain physiotherapy methods to alleviate some or all male chronic pelvic pain symptoms. According the Stanford University Department of Urology, one of the most promising physical therapies is "The Wise-Anderson Protocol," which uses breathing exercises and relaxation techniques to relieve tension, pressure and spasms in pelvic floor muscles.
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