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Prostatitis / Pudendal Nerve Entrapment / Chronic Pelvic Pain Syndrome

Prostatitis and Pudendal Nerve Entrapment are some examples of commonly diagnosed chronic pelvic pain syndromes in males. Prostatitis is one of the most frequent urologic syndromes diagnosed. Up to 50 % of adult men have had symptoms of prostatitis in the lifetime. In the majority of cases, chronic prostatitis is nonbacterial and is caused by tightness of the muscles of the pelvic floor. Pelvic floor muscles can develop “trigger points” which are painful muscle “knots” that mimic the symptoms normally attributed to prostatitis, such as pain and urinary or genital symptoms. These pelvic symptoms are termed “chronic pelvic pain syndrome” or CPPS.

According to the National Institute of Health (NIH), CPPS accounts for 90% of cases of prostatitis and is characterized by the complaint of discomfort or pain in the pelvic region for at least 3 months. (Transabdominal ultrasound measurement of pelvic floor muscle mobility in men with and without chronic prostatitis/chronic pelvic pain syndrome).

Symptoms

● The suprapubic or perineal region, testis, tip of the penis, and low back area may be
painful
● Urinary symptoms
● Sexual dysfunction

Causes

● Connective tissue mobility restrictions
● Myofascial syndromes (trigger points, muscle hypertonia) causing pain, tightness or
feeling rectal pressure
● Neural tension causing pain experienced as burning, itching or pins and needles
● Hip, lumbar or pelvic malalignment
● Visceral mobility restrictions
● Inflammatory processes, such as frequent UTI or IBS, causing pain sensitization

If Left Untreated

The prevalence of prostatitis symptoms is high and if left untreated, it may increase a man’s risk
for benign prostate hypertrophy and lower urinary tract symptoms (Epidemiology of prostatitis).

Treatment at Shift

Pelvic Floor Physical Therapy for prostatitis/chronic pelvic pain utilizes varied techniques that are chosen depending on the causes and contributing factors to the pain, such as: myofascial and trigger point release techniques, pelvic, lumbar or visceral mobilizations, lumbo-pelvic stabilization exercises, and pelvic floor muscle re-education/strengthening with biofeedback.

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