How common is chronic pelvic pain syndrome?
Between 30% and 50% of men (average age 40 years) may experience the afflicting symptoms of chronic bacterial prostatitis, chronic prostatitis, or chronic pelvic pain syndrome.
If I have Chronic Pelvic Pain Syndrome what should I feel?
· Perineum (the area between the back passage and the scrotum) pain
· Genitalia (testicles and penile tip pain being prevalent complaint) pain
· Lower back and abdomen (especially suprapubic area) pain
CPPS is associated with issues with emptying the bladder (burning and stinging of the urine, difficulty in starting to urinate, weak stream, straining, urgency and frequency, and waking at night to empty the bladder), and ejaculatory issues.
When a man suffers from chronic pain syndrome, it hurts his life as it leads to stress, anxiety, and depression. Activities of daily living can be challenging.
When men with chronic pelvic pain syndrome see their private urologist or NHS consultant, they have been carrying this weight for a long time, and despite trying many treatment alternatives, they feel that it never comes to a resolution. Nothing works. They are typically desperate.
Understanding Chronic Pelvic Pain Syndrome is crucial. It is essential to understand that the path is not straight, and flare-ups are common. The aim is to regain a quality of life on which further steps can be built.
The original precipitating factor, whether infective or inflammatory, is the priming of the pain nervous system that supplies the prostate and surrounding pelvic area. Even when the initial infective or inflammatory cause settles down, the nervous system is sensitised, and pain persists.
What treatment will the doctor give me for CPPS?
Long-term treatment with antibiotics and anti-inflammatory medicines is commonly ineffective. There is always a high expectation with every new medication or treatment that is tried. This is human nature. An adequate consultation adjusts perspectives. This is achieved by your NHS urologist or private urologist explaining the nature of the disease, that investigations rarely find anything significant, yet they are a must to be done to exclude any treatable condition and a multi-level plan is agreed between the patient and the caring doctor. There is no single treatment sure effect; the problem must be addressed from different angles. Management involves pharmacological, lifestyle and alternative approaches. Not every man will benefit from the same protocol, so this has to be tailored accordingly. Flare-ups are common, and they lead to a negative whirlpool effect. If one is always aware that this can happen and has a backup plan during the setback, typically, men find they do better.
Treatment of chronic pelvic pain syndrome includes a combination
Alpha-blockers like tamsulosin (work by decreasing the intraprostatic pressure and helping empty the bladder better; results are).
Daily Phosphodiesterase inhibitors (PDE5i) – Cialis 5mg on a long-term basis (PDE5i increases the availability of nitric oxide, which induces smooth muscle relaxation; men start feeling an improvement after one week)
Anti-inflammatory Agents like non-steroidal (ibuprofen) or natural anti-inflammatory like Quercetin and/or omega supplements (response was not durable and was limited to the duration of therapy).
Pain-modifying medications such as gabapentin, pregabalin, memantine, and tricyclic antidepressants can be considered potential treatments for chronic pelvic pain syndrome.
Prostatic Massage (historically, this was common practice, but there is limited evidence regarding its efficacy).
Pelvic Floor Physical Therapy with biofeedback (these are only for elected patients and allow both patients and physiotherapists to monitor the pelvic floor muscles leading to their re-education).
Hot baths and hot water bottles (relax the musculature, providing relief, even though)
Lifestyle Changes: weight loss, exercise, relaxation techniques and change in diet
Acupuncture (anti-inflammatory effect and its effects are sustained).
Shockwave treatment (20-minute sessions, either 1 or 2 sessions per week. The beneficial effect of the shock-wave treatment is usually felt 4 weeks from the start of the treatment).
