Pelvic pain in men is a condition that often goes misdiagnosed or untreated for years. On average, it can take nearly seven years to finally identify pelvic floor dysfunction as the root cause. This is because the symptoms can closely resemble infections or prostate issues, which results in a cycle of misdirected treatments—usually antibiotics—without clear diagnostic testing. Sadly, this detour does little to address the actual problem, and men are left suffering. Another major obstacle is the limited number of therapists with expertise in male pelvic health; most providers are trained with female patients in mind. PHRC stands apart by offering specialized care designed for men. In fact, male patients are the majority in our practice, and we’ve built our services to meet their specific needs.
For men suffering from unexplained pelvic pain, receiving a prescription for antibiotics is all too common. Yet studies have shown that over 90% of these cases show no evidence of infection. What they’re often experiencing is Chronic Pelvic Pain Syndrome (CPPS), particularly NIH Categories IIIa and IIIb. These are not bacterial infections but disorders rooted in muscle dysfunction or nerve sensitivity—conditions that do not respond to antibiotic treatment.
According to the National Institutes of Health, prostatitis is divided into five main categories:
Category I: Acute bacterial prostatitis—comes on suddenly with pain, systemic symptoms like fever, and infection in the urinary tract.
Category II: Chronic bacterial prostatitis—features recurring infections and persistent bacteria in the prostate.
Category IIIa: Inflammatory CPPS—identified through pelvic pain plus white blood cells found in semen or urine, pointing to inflammation.
Category IIIb: Non-inflammatory CPPS—has similar symptoms but no lab evidence of inflammation.
Category IV: Asymptomatic inflammatory prostatitis—where inflammation is detected in lab tests even though the patient has no complaints.
