By Tiffany Yuen, DPT, PHRC Los Gatos
Did you know…
Chronic pelvic pain syndrome (CPPS) has a worldwide prevalence between 2% and 16% and is the most common urologic disease in men below 50 years old (Smith et al., 2016)
Painful ejaculation has a prevalence between 1% and 10% in the general population, but this may increase to 30% to 75% among men who suffer from CPPS (Parnham et al., 2016)
One in four patients seeking initial medical treatment for new onset erectile dysfunction (ED) is younger than 40 years of age with almost half of the young men suffering from severe ED, with comparable rates in older patients (Capogrosso et al., 2013)
Men with CPPS have more abnormal pelvic floor muscular findings compared with a group of men without pain, which may contribute to the condition (Hetrick et al., 2003)
Pelvic floor physical therapy, including manual therapy techniques, progressive muscle relaxation, flexibility exercises, and aerobic exercises have been proven to be effective in reducing pain and improving sexual function in patients with CPPS (Van Alstyne et al., 2010)
Pelvic Floor Dysfunction and Male Pelvic Pain
Symptom you may experience include:
- Pain in the lower back, abdominal, and pelvic area, including the groin, penis, perineum, scrotum/testicles, or rectum
- Pain with sitting, restricted clothing, or certain exercises
- Dysuria (pain or burning with urination)
- Increased urgency/frequency of urination
- Urinary hesitancy (difficulty initiating urine stream)
- Urinary intermittency (starting/stopping while urinating)
- Urinary retention (incomplete urination)
- Nocturia (frequent nighttime urination)
- Pain or burning during or after ejaculation
- Premature ejaculation
- Erectile dysfunction, specifically pain or difficulty with gaining and maintaining erections along with weaker erectile strength
- Decreased libido
Associated diagnoses include:
- Chronic pelvic pain syndrome
- Chronic nonbacterial prostatitis
- Interstitial cystitis/painful bladder syndrome
- Pudendal neuralgia
- Hard flaccid syndrome
- Erectile dysfunction
Mechanisms for symptom development include:
- Surgical trauma, including
- Hernia repairs (Nienhuijs et al., 2007)
- Vasectomy (Morley et al., 2012)
- Prostatectomy (Scott et al., 2020)
- Over Exercising at the gym or biking for prolonged periods of time (Sacco et al., 2010)
- Sexually transmitted diseases (Pontari et al., 2013)
- Pelvic floor dysfunction (Hetrick et al., 2003)
- Stress (Ullrich et al., 2005)
If you are experiencing any of the symptoms listed above, you may have already done an online search for “how to fix/stop male pelvic pain.” It’s also possible that you may have already sought or plan to seek care from your primary care provider or urologist. Your doctor or urologist may have examined you and recommended several diagnostic tests , including urinalyses, urine cultures, imaging, cystoscopy, or urodynamics testing. It’s been several weeks and all the tests come back negative and your doctor tells you your prostate is normal after examining it manually. Your doctor sends you home with multiple rounds of antibiotics, but your pain and symptoms remain the same after the regimen. What do you do now? This is similar to Ben’s situation in his success story.
What is PFPT for male pelvic pain and how can it help?
Assessment and treatment for male pelvic pain involves an evaluation with a pelvic floor physical therapist. During the first visit, your physical therapist asks you about your history and symptoms, screens your bladder, bowel, and sexual function, and reviews what doctors or specialists you may have seen in the past. During the physical examination, your physical therapist examines your posture and movement patterns as well as assesses the mobility of your connective tissues, muscles, joints, and nerves. After your physical therapist completes the examination, they will review their findings with you and educate you on pelvic floor anatomy as well. Your physical therapist will generate an assessment to propose how your symptoms and pain developed and create both short-term and long-term goals for your treatment plan, which is typically 12-weeks long. Along with in-person visits one to two times a week, you will be given a home exercise program, which will be progressed and modified based on your individual needs. In-person visits will usually consist of checking in with whether your symptoms have changed and performing manual therapy as well as myofascial trigger point release to address any connective tissue or musculature restrictions you may have. Most importantly, your physical therapist will understand that you may feel frustrated by the time you come to see them and will take the time to listen to what you have been going through and acknowledge your symptoms. Feel free to click here to read about a success story and how pelvic floor physical therapy can help with male pelvic pain.
YouTube Videos on Male Pelvic Pain
Additional Blog Resources on Male Pelvic Pain
Are you unable to come see us in person? We offer virtual physical therapy appointments too!
Due to COVID-19, we understand people may prefer to utilize our services from their homes. We also understand that many people do not have access to pelvic floor physical therapy and we are here to help! The Pelvic Health and Rehabilitation Center is a multi-city company of highly trained and specialized pelvic floor physical therapists committed to helping people optimize their pelvic health and eliminate pelvic pain and dysfunction. We are here for you and ready to help, whether it is in-person or online.
Virtual sessions are available with PHRC pelvic floor physical therapists via our video platform, Zoom, or via phone. For more information and to schedule, please visit our digital healthcare page.
In addition to virtual consultation with our physical therapists, we also offer integrative health services with Jandra Mueller, DPT, MS. Jandra is a pelvic floor physical therapist who also has her Master’s degree in Integrative Health and Nutrition. She offers services such as hormone testing via the DUTCH test, comprehensive stool testing for gastrointestinal health concerns, and integrative health coaching and meal planning. For more information about her services and to schedule, please visit our Integrative Health website page.
PHRC is also offering individualized movement sessions, hosted by Karah Charette, DPT. Karah is a pelvic floor physical therapist at the Berkeley and San Francisco locations. She is certified in classical mat and reformer Pilates, as well as a registered 200 hour Ashtanga Vinyasa yoga teacher. There are 30 min and 60 min sessions options where you can: (1) Consult on what type of Pilates or yoga class would be appropriate to participate in (2) Review ways to modify poses to fit your individual needs and (3) Create a synthesis of your home exercise program into a movement flow. To schedule a 1-on-1 appointment call us at (510) 922-9836
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