Chronic Pelvic Pain Syndrome/ Chronic Prostatitis (CPPS/CP)
What is Chronic Pelvic Pain Syndrome?
Chronic Pelvic Pain Syndrome/Chronic Prostatitis (CPPS/CP) is a common condition in men that can have a variety of pain presentations. Symptoms of CPPS/CP may include discomfort in the area between the rectum, testicles, or penile pain and pain with urination or ejaculation. The syndrome is complex and may be representative of many contributing factors. The National Institute of Health (NIH) published a classification system for CPPS and CP.
The NIH-Chronic Prostatitis Symptom Index classifies patients with CPPS/CP into 4 groups:
- Acute Bacterial Prostatitis
- Chronic Bacterial Prostatitis
- Chronic Nonbacterial Prostatitis
- Asymptomatic Inflammatory Prostatitis
Of these four classifications, the chronic nonbacterial prostatitis group is also commonly known as CPPS.
What is the prevalence of CPPS/CP?
A report from Mount Sinai Hospital in Toronto estimates the prevalence of chronic pelvic region pain to range from 5-15% in men, and an article published in the Journal of the American Medical Association estimates approximately 9% prevalence of prostatitis in the community with about 90-95% of that being CPPS/CP (Anothaisintawee et al., 2011).
What can we do about it?
In light of the complex nature of CPPS, management is highly dependant on the root cause of the condition. A multi-faceted approach to treatment is normally helpful for men with nonbacterial prostatitis/CPPS. A team approach to treatment is usually most beneficial as the treatment may be focused on a combination of many conditions that may include pelvic myofascial trigger points, pudendal neuralgia, stress/anxiety, central sensitization, and even autoimmune diseases such as Irritable Bowel Syndrome (Liao et al., 2016) just to name a few. It is clear that a tailored plan must be made for each person, there are no protocols or recipes that encompass any one person’s experience with CPPS. It is important to seek out a trusted team of experienced healthcare professionals to manage CPPS that may include a medical doctor, physiotherapist, naturopath, massage therapist, and psychologist.
References
Anothaisintawee T, Attia J. Nickel, JC, Thammakraisorn S, Numthavaj P, McEvoy M, Thakkinstian A. (2011). Management of Chronic Prostatitis/ Chronic Pelvic Pain Syndrome: A Systematic Review and Network Meta-analysis. JAMA. 2011;305(1):78-86
Giuseppe M, Wagenlehner F.M.E., Grabe M, Weidner W, Stief C.G., Nickel C.J. (2016).Contemporary Management of Chronic Prostatitis/Chronic Pelvic Pain Syndrome. European Journal of Urology. 69: 286-297
Liao, C. et al. Chronic Prostatitis/Chronic Pelvic Pain Syndrome is associated with Irritable Bowel Syndrome: A Population-based Study. Sci. Rep. 6, 26939; doi: 10.1038/srep26939 (2016).
Mount Sinai Hospital Wasser Pain Management Center. Chronic Pelvic Region Pain. (unknown date). www.mountsinai.on.ca/care/pain_management/conditions/chronic-pelvic-region-pain.
For Chronic Pelvic Pain Syndrome/Chronic Prostatitis;
Downtown Vancouver Physiotherapy Clinic
Electra Health – 970 Burrard Street, Vancouver BC
Open 7 days a week from 8 am to 8 pm
604-685-4325 (HEAL)
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