Understanding Male Pelvic Pain

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If you're a man suffering from pelvic pain, you should be aware that this may be caused by prostatitis, or swelling and inflammation of the prostate gland. Chronic prostatitis is common and affects up to 10% of adult men. It can be painful and difficult to treat, depending on the cause. 

Potential Causes of Pelvic Pain in Men

Men may have chronic pelvic pain from a number of disorders, including urinary dysfunction or irritable bowel syndrome (IBS). However, prostatitis is the only male-specific cause of pelvic pain. While a bacterial infection is a common cause, in many cases the cause remains unknown.

When a bacterial infection is not the cause, the condition is known by several names including chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), prostatodynia (painful prostate), and abacterial prostatitis.

The Symptoms of Male Pelvic Pain

According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), men with prostatitis may have any of the following pain symptoms:

  • Pain or burning sensation when urinating (dysuria)
  • Pain in the abdomen, groin, or lower back
  • Pain in the area between the scrotum and rectum (perineum)
  • Pain or discomfort in the penis or testicles
  • Painful orgasms (ejaculations)

The pain or discomfort may be constant or it may come and go. Some men experience depression and a lower quality of life because of the pain.

Other symptoms associated with prostatitis include:

  • Difficulty urinating, such as dribbling or hesitant urination
  • Frequent urination, particularly at night (nocturia)
  • An urgent need to urinate
  • Flu-like symptoms (with bacterial prostatitis)

Treating Male Pelvic Pain

There are tests for prostatitis. Your urine and the fluid that comes out of your prostate gland can be checked for signs of infection. Bacteria are found in prostatic fluid in around 10% of prostatitis cases. Antibiotics are often prescribed in these cases. 

Because many cases of prostatitis result from an unknown cause, finding a treatment that provides relief can take time. Unfortunately, the pain caused by prostatitis can be difficult to treat.

Chronic male pelvic pain from prostatitis that is not bacterial in nature may be treated with any of the following medications:

  • Pain medications, such as NSAIDs
  • Anti-anxiety medications, such as selective serotonin-reuptake inhibitors (SSRIs)
  • Alpha-adrenergic blockers, such as Flomax (tamsulosin)
  • Botulinum toxin A injections (research continues on its effectiveness)
  • Muscle relaxants for the pelvic floor

Other treatment approaches your doctor may wish to try to include sacral nerve stimulation—also used for urinary incontinence—or prostatic massage. Should an obstruction be suspected as the cause, surgical procedures may be used to assess this and remove any that are found.

Additionally, some men have found relief through acupuncture, biofeedback, physical therapy, or sitz baths. Your doctor may also suggest nutritional supplements, such as saw palmetto and pollen extract, or behavioral counseling to help with depression and lowered quality of life.

Your Prognosis

Unfortunately, many men with pelvic pain caused by prostatitis do not find relief. This is simply because the cause of their prostatitis is undetermined. Studies show that medications other than antibiotics for bacterial prostatitis often provide little long-term relief for men with this problem.

Complementary therapies for prostatitis have not been researched significantly. However, acupuncture appears to be a promising option.

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  1. Roberts RO, Lieber MM, Rhodes T, Girman CJ, Bostwick DG, Jacobsen SJ. Prevalence of a physician-assigned diagnosis of prostatitis: the Olmsted County Study of Urinary Symptoms and Health Status Among Men. Urology. 1998;51(4):578-584. doi:10.1016/s0090-4295(98)00034-x

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