The term chronic pelvic pain in men is also known as prostatodynia. It is a pain which is associated irritative voiding symptoms and the pain located in the perineum, genitalia or groin in the absence of pyuria and bacteriuria (in the microscopic analysis of the urine is there no pus cells or bacteria). But, excess white blood cells or bacteria seen on Gram stain and the culture of expressed prostatic secretions may be found. It is a very common urological disorder which affects men of any age.
It is noticed that the chronic pelvic pain in men is a reason for 90% of cases of prostatitis. The chronic pelvic pain in men syndrome is non – bacterial manifestation of the disease and it is noticed that the pain is the primary symptom of nonbacterial prostatitis. The pelvic pain happens between the navel and groin. It can result from a urinary tract infection, sexually transmitted infection or prostatitis, which is an inflammation of the prostate. [1,2]
Chronic pelvic pain in men symptoms
Pain is the main symptom of the chronic pelvic pain. But, also there are some cases, when other symptoms can be present, such as pain relieved by a bowel movement, bloating, flatulence, incontinence, constipation and diarrhea. It is known that this condition can be treated, but it cannot be cured. If you have some of the mentioned symptoms of chronic pelvic pain, then you should make an appointment with your doctor, so he or she will give you medicines to treat your symptoms and to get a relief from them. [1,2]
Chronic pelvic pain in men causes
Here are some causes for chronic pelvic pain in men:
- Irritable bowel syndrome: The irritable bowel syndrome is causing symptoms along the intestinal tract, such as: mucus in the stool, constipation, diarrhea, bloating and painful cramps. The mentioned symptoms tend to go away temporarily after a bowel movement. Doctors can recommend lifestyle and diet changes which can help you to get a relief and medications can help to control some symptoms. [3]
- Hernia: The sudden pain in the lower abdomen can indicate a hernia. The hernia develops when a piece of tissue or intestine pushes out through a weak point in the muscles. It often forms a small and painful bulge in the area. The pain can get worse when the person strains the muscles, such as when lifting, coughing or laughing. There are some studies in which are noticed that 25% of males will experience a hernia, which is usually happening as they are getting older and the muscles become weaker. It is known that the surgery is the only treatment and it is necessary in order to prevent severe complications. [4]
- Prostatitis: This is an inflammation of the prostate which is a small gland in the male reproductive system. The prostate is producing a fluid which goes into the semen. There are few types of prostatitis – acute bacterial prostatitis (the most common symptoms include painful ejaculation; waking up many times at night to urinate; a weak or broken urine stream; urinary blockage, or being unable to urinate; frequent urination; difficulty urinating; nausea and vomiting; chills; fever; a burning feeling during urination), chronic bacterial prostatitis (the symptoms of this type of prostatitis are similar to those of acute bacterial prostatitis, but they may be less severe), nonbacterial prostatitis and asymptomatic inflammatory prostatitis (this condition can cause virtually no symptoms). [1,2]]
- Sexually transmitted infection: Some STIs, like Chlamydia and gonorrhea, can cause chronic pelvic pain in men. Symptoms include: discharge from the penis, pain in the pelvis and inflammation in the urethra. Also, Chlamydia can infect the rectum or anus, possibly causing pain there as well. [5]
- Appendicitis: We know that the appendix is a small organ on the right side of the body and the inflammation in the appendix can lead to pelvic pain. Also, there can be other symptoms, such as swelling in the lower abdomen, nausea and vomiting, loss of appetite and fever. If the sharp pain in the lower abdomen accompanies any of the mentioned symptoms, then you should ask for medical help as soon as possible. [6]
References:
[1] Harvard Medical School. Chronic nonbacterial prostatitis (chronic pelvic pain syndrome). Harvard Health Publishing. 2007. Retrieved from www.health.harvard.edu/newsletter_article/chronic-nonbacterial-prostatitis-chronic-pelvic-pain-syndrome
[2] Smith CP. Male chronic pelvic pain: An update. Indian Journal of Urology. 2016;32(1):34–9.
[3] Clemens Q, Mullins C, Ackerman AL, et al. Urologic chronic pelvic pain syndrome: insights from the MAPP Research Network. Nature Reviews Urology. 2019;16(3):187–200.
[4] Belanger GV, VerLee GT. Diagnosis and surgical management of male pelvic, inguinal, and testicular pain. Surgical Clinics. 2016;96(3):593-613.
[5] Papes D, Pasini M, Jerončić A, et al. Detection of sexually transmitted pathogens in patients with chronic prostatitis/chronic pelvic pain: a prospective clinical study.
International Journal of STD & AIDS. 2017;28(6):613-5.
[6] Mengesha MD, Teklu GG. A case report on recurrent appendicitis: An often forgotten and atypical cause of recurrent abdominal pain. Annals of Medicine and Surgery. 2018;28:16-9.
