Male Pelvic Pain
Chronic pelvic pain syndrome (CPPS) occurs in about 90 percent of all pelvic pain cases in adult males.

Pelvic pain in men typically occurs between the navel and groin. It may result from several factors; however, the most common reason is inflammation of the prostate (prostatitis).

Pelvic pain in men can be felt as discomfort or pressure in the lower abdomen or groin area and may be accompanied by other symptoms such as:

What is prostatitis?

Prostatitis is the inflammation of the prostate, which usually affects men younger than 50 years.

The prostate is a walnut-sized gland in men, located in front of the rectum and below the bladder. A tube called the urethra runs through the prostate.

The primary role of the prostate is the production of a fluid called semen.

The prostate may be a source of pelvic pain in adult males; however, in many cases, the pain does not stem entirely from issues associated with the prostate itself.

What are the types of pelvic pain?

Chronic pelvic pain syndrome (CPPS) accounts for almost 90 percent of pelvic pain cases in adult males.

The National Institute of Health has classified chronic pelvic pain syndrome into the following four categories:

  1. CPPS I
    • Also known as acute bacterial prostatitis
    • An acute sudden pelvic pain associated with fever and other signs of infection
    • Presence of bacteria in urine or prostate secretions
  2. CPPS II
    • Also known as chronic bacterial prostatitis
    • Recurrent or chronic pelvic pain not associated with fever or other signs of infection
    • Bacteria detected in urine or prostate secretions
  3. CPPS III
    • Also known as nonbacterial prostatitis or prostatodynia
    • Recurrent or chronic pelvic pain with no bacterial detection in urine or prostate secretions
    • It is subdivided into:
      • Type A: Inflammatory cells are found in urine or prostate secretions
      • Type B: Inflammatory cells are not found in urine or prostate secretions
  4. CPPS IV
    • Inflammatory cells are detected in urine or prostate secretions but no symptoms present

What are the risk factors for pelvic pain in men?

Risk factors may include:

  • Diabetes
  • Immunosuppression
  • Prostate enlargement
  • Congenital urinary tract abnormality
  • Urinary issues
  • Problems of the pelvic floor musculature
  • Recent catheterization (urethral instrumentation)

QUESTION

Testosterone is a chemical found only in men. See Answer

How is pelvic pain diagnosed?

Along with a detailed history and physical examination of the genitals, the urologist may recommend the following tests:

  • Digital rectal exam (to examine the prostate and determine if it is tender or swollen)
  • Urine examination (to analyze the presence of infection or inflammation)
  • Prostate-specific antigen test (blood test)
  • Cystoscopy (the prostate is examined internally by using a fiberoptic camera)
  • Imaging tests such as abdominal ultrasound, CT scan, or MRI

How is pelvic pain in men treated?

The treatment of pelvic pain in men aims to identify the cause and treat it accordingly.

  • Over-the-counter nonsteroidal anti-inflammatory drugs, such as aspirin for pain relief
  • Oral antibiotics
  • Muscle relaxants
  • For severe and acute infections, intravenous antibiotics and hospitalization may be required
  • Surgery might be required for:
  • Physical therapy for pelvic floor muscle dysfunction
  • Warm baths or heat therapy to strengthen the muscles of the pelvic region

What are the other causes of pelvic pain in men?

Pelvic pain in men can result from a variety of conditions, which include:

The non-bacterial causes of pelvic pain may include:

  • Bicycle riding
  • Past prostatitis infections
  • Chemical irritation
  • Sexual abuse
  • Psychological stress

When should you see a doctor?

Consult a medical professional immediately if you experience any of the following symptoms:

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Medically Reviewed on 11/2/2022
References
Image Source: iStock image

Chronic Urogenital Pain in Men NIH https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4589937/

Treating prostatitis: Any cause for optimism? Harvard Health Publishing https://www.health.harvard.edu/blog/treating-prostatitis-any-cause-for-optimism-20091103211

Prostatitis (male pelvic pain) University of California https://urology.ucsf.edu/patient-care/adult-non-cancer/male-sexual-and-reproductive-health/prostatitis