Chronic pelvic pain syndrome, previously known as chronic prostatitis, is a condition that mainly manifests as pelvic pain, but other symptoms can accompany this condition as well. The causes of chronic pelvic pain syndrome (CPPS) are not well understood. This problem has traditionally been treated with antibiotics, although bacteria are rarely involved. It can persist over time and be present intermittently. This syndrome usually occurs in younger men, under 50 years old, especially between 35 to 50 years old.

The main symptoms

Besides the pain, which can vary from day to day and is often present for more than three months, the main symptoms include constant or intermittent discomfort in the muscles of the pelvic floor, prostate, testes, penis, rectum, perineum area, lower abdomen, groin, coccyx or lower back.

Some men experience sexual problems such as painful or premature ejaculation or erectile dysfunction. Urinary problems such as increased frequency of urination, urinary urgency, pain when urinating or a weak urine stream may also be present.

Causes

We do not know what causes chronic pelvic pain syndrome (CPPS). Sometimes symptoms get better with medicines that modify nerve signals. Because of this, some people think it is a kind of neuropathic pain. Like vulvodynia (pain in the vulva) in women, it is often made worse by tension in the pelvic floor muscles. In fact, this may be why pressure on the prostate is so painful during the exam—because the exam involves pressure over some of the pelvic floor muscles.

Treatment of chronic pelvic pain syndrome can be long and difficult

In terms of treatment, the multi-drug approach combined with lifestyle changes is preferred. They may include:

• The use of antibiotics to fight infection caused by bacteria, if there is the presence of bacteria;
• Medications to relax the muscles near the prostate, thereby reducing pressure on the urethra and allowing urine to flow more easily;
• Analgesics and painkillers for pain;
• Relaxation exercises for the pelvic floor muscles;
• Anxiolytics or antidepressants;
• Not to mention the benefits of hot water bottles or hot baths (sitz baths) to relieve pain and discomfort.

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Prostate massages?

Prostate massage, formerly used by the doctor to decongest it, is nowadays only used to obtain and analyze seminal fluid when the urine analysis does not isolate the germ responsible for the infection.

Prevention

It seems that fighting stress, through relaxation, meditation or any other therapy improves this syndrome. It is also advisable to limit foods that irritate the bladder such as caffeine, alcohol or spices. Intensive cycling is not recommended either.

Can I have sex if I have this condition?

Apart from the pain that can be bothersome and the erection that is sometimes momentarily failing, this condition does not prevent sexual intercourse. In some cases, the erection is painful, but an ejaculation can provide relief. If the bacteria involved can be sexually transmitted, intercourse must be protected.

Take the time to visit each of our pages on this website, as well as our YouTube channel, in order to get familiar with the disease with our expert lectures, our section on available resources, the support that is offered to you.

Do you have any questions or concerns? Above all, do not hesitate. Contact us at 1 855 899-2873 to discuss with a nurse specializing in uro-oncology. It’s simple and free, like all our services.

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Sources and References
American Urological Association-Prostatitis (Infection of the Prostate)
Association québécoise de la douleur chronique (AQDC)
Prostate Cancer – Understand the disease and its treatments; Fred Saad, MD, FRCSC and Michael McCormack, MD, FRCSC, 4^th et 5^th editions

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