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Pelvic pain is a widespread symptom of a multitude of disorders. This pathological condition arises in both women and men. However, if the painful sensations persist for 3-6 months, it is likely that you are facing Chronic Pelvic Pain Syndrome (CPPS). Such a condition requires immediate specialist assistance and threatens the development of psycho-emotional disorders, as well as dysfunctions of the digestive, nervous, and urogenital systems.
What is Chronic Pelvic Pain Syndrome (CPPS)?
Chronic Pelvic Pain Syndrome (CPPS) is persistent or recurrent pain in the lower abdomen or in the lesser pelvis. Its onset is not related to the menstrual cycle, pregnancy, sexual activity, or infectious diseases. The trigger mechanism for the pain can be all types of increased tonus of the pelvic floor muscles or nearby muscular formations, which explains the irradiation of pain to the rectum, bladder, glans penis, and vagina. Studies conducted have revealed, in addition to the above-mentioned causes, significant pathobiomechanical changes both directly in the pelvic area and general disturbances in the statics and dynamics of the entire musculoskeletal system. The disease significantly impairs the course of normal life, making a person nervous, partially disabled, withdrawn, and anti-social.
Prevalence of CPPS
The disease is encountered more frequently in women. Worldwide, approximately 25% of the fair sex suffer from this pathology, about 15% of whom are physically unable to go to work, and 50% experience a reduced probability of conception. It is very difficult to single out a specific group of people who most often encounter CPPS. This can be a girl suffering from frequent cystitis, or a man with sexual dysfunction.
Symptoms
Since Chronic Pelvic Pain Syndrome has an extensive and diverse symptomatology, scientists have created a classification for defining the unpleasant sensations in patients.
• Psycho-emotional symptoms: depressed mood, insomnia, feeling of inferiority.
• Urological symptoms: decrease in painful manifestations after urination, tenderness upon palpation of the prostate, weak urinary stream, frequent urges to urinate.
• Symptoms similar to infectious contamination: itching, burning, discharge from the urethra, painful sensations during ejaculation.
Alongside the painful sensations, symptoms include discomfort in the perineum and sexual dysfunction.
The pain may be localized in the:
• ureter,
• sacrococcygeal region,
• perineum,
• gluteal area,
• genitalia,
• posterior and inner surface of the thigh,
• below the navel,
• penis,
• epididymis,
• sphincter during defecation,
• pelvic floor muscles.
In recent years, the theory of functional somatic syndrome has been actively developing, and CPPS is precisely one of its manifestations. The condition may include: irritable bowel syndrome, chronic headache and atypical facial pain, fibromyalgia, dorsalgia, chest pain, chronic fatigue syndrome.
Possible Causes of CPPS
The trigger mechanisms for the onset of Chronic Pelvic Pain Syndrome can be:
• Urological causes: namely, inflammatory processes in the prostate, urethra, seminal vesicles in men, cysts, stones, and other neoplasms in the bladder, anal fissures, hemorrhoids.
• Gynecological causes: endometriosis, endometritis, adenomyosis, salpingitis, colpitis, cervicitis, menstrual cycles longer than 35 days, uterine myoma (fibroid), Allen-Masters syndrome, sexually transmitted diseases (STDs/STIs).
• Chronic diseases of the testes and epididymides: cysts in the epididymides, orchiepididymitis, orchitis.
• Gastroenterological causes: Crohn's disease, intestinal obstruction, neoplasms, irritable bowel syndrome (IBS).
• Impaired blood supply in the pelvic area: pelvic venous varicosity, congestive prostatitis, May-Thurner syndrome.
• Surgeries and traumas of the lesser pelvis: In this case, surgical intervention may affect the uterus, rectum, prostate, and bladder.
• Neurological causes: degenerative osteochondrosis, intervertebral hernias, protrusions, compression-ischemic neuropathy, diabetic polyneuropathy.
Risk Factors for CPPS
Chronic Pelvic Pain Syndrome can be a consequence not only of disease but also of lifestyle. Such factors include: sedentary lifestyle, "desk" job, irregular sexual life, frequent hypothermia, poor nutrition, frequent consumption of alcoholic beverages, chronic stress, weak immunity, lifting heavy weights, overweight/obesity, poor posture.
Diagnosis
Chronic Pelvic Pain is a complex and multifactorial disease. Often, a consultation/consilium of various specialists is gathered for the treatment of patients with CPPS. Diagnosis in women should begin with a gynecologist / urologist, and in men, with an andrologist / urologist. Specialists will identify or rule out the presence of inflammatory, infectious, or sexually transmitted diseases. If the examinations yield no results, endocrinologists, gastroenterologists, surgeons of various fields, neurologists, and other specialists will join the diagnosis of the patient's condition. Since this condition causes the patient regular discomfort in the form of pain, social inactivity, and temporary disability, a psychologist consultation may be necessary.
Treatment Methods
To begin treatment, it is very important to identify the root cause of CPPS. Specific drug therapy will proceed from this. To alleviate the syndrome, the following are primarily used: analgesics (pain relievers), non-steroidal anti-inflammatory drugs (NSAIDs), therapeutic diet, physiotherapy, acupuncture, replenishment of vitamin and mineral reserves, sedatives (calming agents).
Prevention
The main way to prevent CPPS is timely consultation with a doctor when pain of any localization appears. There is no need to wait until it becomes chronic. In addition, it is important to monitor the quality of your nutrition, posture, physical activity, and safety of sexual intercourse. Men should be more cautious when lifting heavy weights.
Chronic Pelvic Pain Syndrome (CPPS) is persistent or recurrent pain in the lower abdomen or in the lesser pelvis. Its onset is not related to the menstrual cycle, pregnancy, sexual activity, or infectious diseases. The trigger mechanism for the pain can be all types of increased tonus of the pelvic floor muscles or nearby muscular formations, which explains the irradiation of pain to the rectum, bladder, glans penis, and vagina. Studies conducted have revealed, in addition to the above-mentioned causes, significant pathobiomechanical changes both directly in the pelvic area and general disturbances in the statics and dynamics of the entire musculoskeletal system. The disease significantly impairs the course of normal life, making a person nervous, partially disabled, withdrawn, and anti-social.
Prevalence of CPPS
The disease is encountered more frequently in women. Worldwide, approximately 25% of the fair sex suffer from this pathology, about 15% of whom are physically unable to go to work, and 50% experience a reduced probability of conception. It is very difficult to single out a specific group of people who most often encounter CPPS. This can be a girl suffering from frequent cystitis, or a man with sexual dysfunction.
Symptoms
Since Chronic Pelvic Pain Syndrome has an extensive and diverse symptomatology, scientists have created a classification for defining the unpleasant sensations in patients.
• Psycho-emotional symptoms: depressed mood, insomnia, feeling of inferiority.
• Urological symptoms: decrease in painful manifestations after urination, tenderness upon palpation of the prostate, weak urinary stream, frequent urges to urinate.
• Symptoms similar to infectious contamination: itching, burning, discharge from the urethra, painful sensations during ejaculation.
Alongside the painful sensations, symptoms include discomfort in the perineum and sexual dysfunction.
The pain may be localized in the:
• ureter,
• sacrococcygeal region,
• perineum,
• gluteal area,
• genitalia,
• posterior and inner surface of the thigh,
• below the navel,
• penis,
• epididymis,
• sphincter during defecation,
• pelvic floor muscles.
In recent years, the theory of functional somatic syndrome has been actively developing, and CPPS is precisely one of its manifestations. The condition may include: irritable bowel syndrome, chronic headache and atypical facial pain, fibromyalgia, dorsalgia, chest pain, chronic fatigue syndrome.
Possible Causes of CPPS
The trigger mechanisms for the onset of Chronic Pelvic Pain Syndrome can be:
• Urological causes: namely, inflammatory processes in the prostate, urethra, seminal vesicles in men, cysts, stones, and other neoplasms in the bladder, anal fissures, hemorrhoids.
• Gynecological causes: endometriosis, endometritis, adenomyosis, salpingitis, colpitis, cervicitis, menstrual cycles longer than 35 days, uterine myoma (fibroid), Allen-Masters syndrome, sexually transmitted diseases (STDs/STIs).
• Chronic diseases of the testes and epididymides: cysts in the epididymides, orchiepididymitis, orchitis.
• Gastroenterological causes: Crohn's disease, intestinal obstruction, neoplasms, irritable bowel syndrome (IBS).
• Impaired blood supply in the pelvic area: pelvic venous varicosity, congestive prostatitis, May-Thurner syndrome.
• Surgeries and traumas of the lesser pelvis: In this case, surgical intervention may affect the uterus, rectum, prostate, and bladder.
• Neurological causes: degenerative osteochondrosis, intervertebral hernias, protrusions, compression-ischemic neuropathy, diabetic polyneuropathy.
Risk Factors for CPPS
Chronic Pelvic Pain Syndrome can be a consequence not only of disease but also of lifestyle. Such factors include: sedentary lifestyle, "desk" job, irregular sexual life, frequent hypothermia, poor nutrition, frequent consumption of alcoholic beverages, chronic stress, weak immunity, lifting heavy weights, overweight/obesity, poor posture.
Diagnosis
Chronic Pelvic Pain is a complex and multifactorial disease. Often, a consultation/consilium of various specialists is gathered for the treatment of patients with CPPS. Diagnosis in women should begin with a gynecologist / urologist, and in men, with an andrologist / urologist. Specialists will identify or rule out the presence of inflammatory, infectious, or sexually transmitted diseases. If the examinations yield no results, endocrinologists, gastroenterologists, surgeons of various fields, neurologists, and other specialists will join the diagnosis of the patient's condition. Since this condition causes the patient regular discomfort in the form of pain, social inactivity, and temporary disability, a psychologist consultation may be necessary.
Treatment Methods
To begin treatment, it is very important to identify the root cause of CPPS. Specific drug therapy will proceed from this. To alleviate the syndrome, the following are primarily used: analgesics (pain relievers), non-steroidal anti-inflammatory drugs (NSAIDs), therapeutic diet, physiotherapy, acupuncture, replenishment of vitamin and mineral reserves, sedatives (calming agents).
Prevention
The main way to prevent CPPS is timely consultation with a doctor when pain of any localization appears. There is no need to wait until it becomes chronic. In addition, it is important to monitor the quality of your nutrition, posture, physical activity, and safety of sexual intercourse. Men should be more cautious when lifting heavy weights.
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