Chronic Pelvic Pain—Male
Definition
Pelvic pain occurs between the belly button and the hips and groin. It is chronic when it lasts for 6 months or more.
Includes bladder, prostate (under bladder), and the colon.
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Causes
Many health problems can cause chronic pelvic pain, such as:
- Infections, such as those in the bladder or urinary tract
- Sexually transmitted infections (STIs)
- Problems with nerves and muscles
- Constipation
- Irritable bowel syndrome (IBS)
- Depression
- Inflammatory bowel disease
- Diverticulitis
- Cancer
- Prior physical or sexual abuse
Risk Factors
The risk of chronic pelvic pain is higher in men who have any of the problems listed above.
Symptoms
Common problems are:
- Constant pain or a dull ache in the pelvis
- Burning, shooting pain
- An urgent need to pass stool or urine
- Pain that comes and goes
- Pain that ranges from mild to severe
- Pain with certain activities
- Pain while sitting for a long time
Diagnosis
The doctor will ask about your symptoms and health history. A physical exam will be done. You will also be asked about your pain.
Other tests may be:
- Blood and urine tests
- Cultures and swabs
- Tests for STIs
- Imaging tests, such as:
-
Scoping tests to view structures on a video screen:
- Laparoscopy—belly and pelvis
- Cystoscopy—bladder
- Colonoscopy—large intestine
Treatment
The cause will need to be treated. It may involve one or more methods. Choices are:
- Medicines, such as:
- Antibiotics to treat certain types of infections
- Pain relievers
- Antidepressants
- Muscle relaxants
- Nerve blocks to ease pain
- Surgery to treat the cause
- Counseling to learn how to cope with stress and pain
Prevention
There are no known guidelines to prevent this health problem. It has many causes.
RESOURCES:
Family Doctor—American Academy of Family Physicians
https://familydoctor.org
International Pelvic Pain Society
https://www.pelvicpain.org
CANADIAN RESOURCES:
Canadian Association of Gastroenterology
https://www.cag-acg.org
The College of Family Physicians of Canada
https://www.cfpc.ca
REFERENCES:
Chronic pelvic pain. Family Doctor—American Academy of Family Physicians website. Available at: https://familydoctor.org/condition/chronic-pelvic-pain. Accessed November 24, 2020.
Chronic prostatitis/chronic pelvic pain syndrome. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/chronic-prostatitis-chronic-pelvic-pain-syndrome. Accessed November 24, 2020.
Engeler D, Baranowski AP, et al. European Association of Urology (EAU). EAU guidelines on chronic pelvic pain. EAU 2015.
Pelvic pain. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/gynecology-and-obstetrics/symptoms-of-gynecologic-disorders/pelvic-pain. Accessed November 24, 2020.
5/18/2015 DynaMed Systematic Literature Surveillance https://www.dynamed.com/condition/chronic-prostatitis-chronic-pelvic-pain-syndrome: Zhang R, Chomistek AK, et al. Physical activity and chronic prostatitis/chronic pelvic pain syndrome. Med Sci Sports Exerc. 2015 Apr;47(4):757-764.
Last reviewed September 2020 by EBSCO Medical Review Board Marcin Chwistek, MD Last Updated: 4/20/2021