Chronic pelvic pain

Condition

It's more than just physical discomfort. It's pain perceived in the pelvis, affecting both men and women, and it can echo through all aspects of life. This condition often comes packed with a suite of negative cognitive, behavioral, sexual, and emotional consequences, further complicating the lives of those affected. Pelvic pain is not a standalone condition. It's often intertwined with symptoms suggestive of lower urinary tract, sexual, bowel, pelvic floor, or gynaecological dysfunction. The potential sources of this pain are manifold, ranging from the prostate, bladder, scrotum, penis to gynaecological origins. The impact of chronic pelvic pain on quality of life is profound, with as many as 15% of men and women suffering from symptoms indicative of pelvic pain syndrome. It's not a fringe issue, but a widespread concern that demands our attention.

Treatment

Addressing chronic pelvic pain requires a meticulous diagnostic evaluation. The key to effective management doesn't just lie in treating the symptoms, but in identifying and addressing the root cause. A prime example of this approach is the treatment of interstitial cystitis, a condition often associated with chronic pelvic pain. In the face of chronic pelvic pain, we are not just treating a condition - we are committed to unraveling its complexities, understanding its origins, and providing a comprehensive treatment strategy to restore comfort and improve quality of life.

F.A.Q.s

What is chronic pelvic pain?

Chronic pelvic pain syndrome is chronic or persistent pain related to the pelvic area and it can be either primary when no underlying pathology or infection is identified or secondary when an identifiable cause is present.It was previously known with many different name such as chronic prostatitis, prostatodynia,interstitial cystitis etc but those terms have been abandoned as they are misleading and imprecise.

From which organs can chronic pelvic pain come from?

Any pelvic organ or structure can be the source like prostate,bladder,testis and epididymis,penis,urethra,female external genitalia,bowel or pelvic floor muscles.

What types of pain can a patient with chronic pelvic perceive?

Pelvic pain varies. It may affect a small area around your pelvis or the whole area.

Types of pelvic pain include:

a sharp, stabbing or burning pain that happens suddenly
a pain that comes on slowly but does not go away
a dull or heavy ache, or feeling of pressure
a twisted or knotted feeling
a cramping or throbbing pain, which may come and go
pain only when you’re doing something, like exercising, having sex, or peeing

Is chronic pelvic pain dangerous?

The prognosis of chronic pelvic pain secondary to other conditions depends on the underlying pathology.Primary pelvic pain (when no underlying cause is present) does not pose any risk for the patient’s life but both conditions severely affect quality of life and they are related with emotional distress,anxiety,stress and depression which can further aggravate symptoms and lead to further frustration.

How common is chronic pelvic pain?

The incidence of chronic pelvic pain can be as high as 15% but unfortunately it is underdiagnosed as many patients do not seek medical advice with the perception that it is not curable.

Which are the most common sources of primary pelvic pain syndrome?

The most common organs involved in this condition are the prostate,bladder,pelvic floor muscles,bowel and pain related to sexual intercourse in females.

How is primary chronic pelvic pain diagnosed?

This condition is diagnosed based on the patient’s symptoms and medical history along with negative investigations for any underlying conditions.Typically those patients have negative results from CT,MRI or ultrasound scans,negative investigations for infectious diseases,and no findings in colonoscopy or cystoscopy.

It is not rare for those patients to have multiple repeated investigations from many doctors with the hope that “something” that explains their symptoms will be found.This should be avoided as it increases the patient’s insecurity about diagnosis and leads to further emotional distress.

Is there any cure for primary chronic pelvic pain syndrome?

The answer largely depends on the organ responsible for the symptoms, the available treatment methods and the motivation from the patient.Sometimes treatments do not work right from the beginning and this can cause significant disappointment for the patient.

Different methods have been used alone or in combination with good results.Some of those include:

Physiotherapy
Pain medications
Intravesical instillations
Acupuncture
Antidepressants
Shockwave therapy

The exact treatment plan will be made by your doctor and it will depend on your symptoms.It is of paramount importance to understand that multiple specialties may need to be involved in managing this condition like Gynaecologists,Pain specialists,Physiotherapist,Psychologists etc.