Chronic Pelvic Pain Syndrome

What is Chronic Pelvic Pain Syndrome?

Chronic pelvic pain syndrome (CPPS) is chronic pelvic pain that has been present for at least three of the preceding six months. It is a debilitating condition that is infamous for the pain and impaired quality of life it causes. Patients who present with CPPS are often frustrated by the persistent and severe nature of this pain. CPPS can be difficult to deal with. However, the physicians at the Men’s Health Institute will work with you to improve pain control and your quality of life.

What Causes Chronic Pelvic Pain Syndrome?

CPPS is not always the result of a single factor but rather a combo of multiple factors acting simultaneously.

Pelvic floor dysfunction

The pelvic floor is a group of muscles that form a basket to support your pelvic organs—the bladder, prostate, and bowels in men. Contracting and relaxing these muscles allows you to control your bowel movements and urination, as well as assist in sexual activity.

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However, when your pelvic floor muscles stop working the way they should, a condition called pelvic floor dysfunction ensues. This condition causes your pelvic muscles to tighten or weaken. When the muscles tighten or spasm, you will have difficulty peeing or passing stool along with chronic pelvic pain. When they weaken, you may experience trouble controlling your urine and stool.

Research shows that men with CPPS are more likely to have abnormal pelvic floor muscles than those without pain.

Stress

Some men are more prone to stress and have a harder time relaxing than others. Thus, under stressful situations, these men unknowingly tense their pelvic muscles, leading to trigger points and sore, painful muscles. These clenched pelvic muscles further perpetuate stress, driving a never-ending vicious cycle of pain and stress.

Hormone Imbalance

Sometimes, CPPS may be the result of hormonal imbalances, particularly an imbalance in the stress hormone and the network that regulates its release.

Trapped Nerve

CPPS can also stem from compression of a nerve known as the pudendal nerve. In men, this nerve supplies the skin of your scrotum, the perineum (the skin of the area behind the scrotum), and your penis. Just like the median nerve in your wrist can get compressed, the pudendal nerve can also get pinched as it courses through your pelvis. Sitting pain that gets better after standing or sitting on a toilet seat indicates CPPS due to a trapped nerve.

Prostatitis

Prostatitis is an inflammation of your prostate gland. We often use the terms “chronic prostatitis” and CPPS interchangeably.

That said, despite the use of the term prostatitis, we are not exactly sure as to what degree the prostate could be the source of symptoms in CPPS. Moreover, unlike bacterial prostatitis, CPPS is not caused by any identifiable bug and hence may not always respond to antibiotics.

Neural Cross-talk

Research shows that there’s a two-way crosstalk between your bladder and bowels. This means that the two systems communicate with each other. If something irritates your bowels, it can also sensitize the nerves feeding your pelvic organs and vice versa.

Bladder Pain

Sometimes, the source of CPPS could be a painful bladder syndrome, also called interstitial cystitis. This condition affects the lining of your bladder, causing chronic pelvic and bladder pain. It also causes you to urinate more often and with smaller amounts of urine than usual.

Autoimmunity

At times, your own immune system may go haywire and start attacking your prostate, leading to chronic pelvic pain.

How is Chronic Pelvic Pain Syndrome Treated?

We use a multi-disciplinary approach to treat CPPS. Some of the commonly used therapies for CPPS include:

Pelvic Floor Therapy

Pelvic floor therapy focuses on methods to release overly tense pelvic floor muscles. It entails pelvic floor physical therapy and trigger point injections. This protocol helps loosen the tightened pelvic floor muscles. 

Medications

Depending on the cause of CPPS, we offer various medications, such as:

  • antibiotics to treat any underlying infection
  • painkillers to help relieve pain and inflammation
  • medications to relax your prostate and the bladder neck muscle, to improve urinary flow and minimize urinary obstruction
  • hormone supplements

Sitz Bath

Sitz baths may provide some relief from acute episodes of CPPS.

Dietary changes

While none of the food products cause actual physical damage to your prostate, it’s best to avoid excessive use of certain substances that may irritate your gland. These include:

  • tobacco (cigarette smoking)
  • alcohol
  • tea
  • soda
  • caffeine (coffee)
  • spicy foods

Have a question or want to schedule an appointment?

Board-certified, fellowship-trained urologists staff Tower Men’s Health. We will pair you with one of our many experiencd physicians to help address any concerns you may have and help you on your journey towards improved quality of life. Feel free to reach out to the physicians at Tower Men’s Health at 310-854-9898.