Cause of Male Pelvic PainMale pelvic pain is usually caused by prostatitis -- inflammation of the prostate gland. Though men may have chronic pelvic pain from other disorders, such as urinary dysfunction or irritable bowel syndrome (IBS), prostatitis is the only male-specific cause of pelvic pain. While a bacterial infection is a common cause of prostatitis, the cause of male pelvic pain associated with prostatitis often remains unknown.
Symptoms of Male Pelvic PainChronic male pelvic pain caused by prostatitis may lead to generalized pain and discomfort around the pelvis, though pain may also be in and around the penis, testes, anal area or lower back. The pain or discomfort may be constant, or it may come and go. Sometimes chronic pelvic pain associated with prostatitis is more severe during urination or ejaculation.
Treatment of Male Pelvic PainMale pelvic pain caused by prostatitis can be difficult to treat. If the cause is known to be bacterial, antibiotics will be prescribed. However, because many cases of prostatitis result from an unknown cause, finding treatment that provides relief can take time.
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 (currently undergoing research)
- Muscle relaxants for the pelvic floor
Other treatment approaches to male pelvic pain caused by prostatitis include:
- Sacral nerve stimulation (also used for urinary incontinence)
- Prostatic massage
- Surgical procedures to assess for and remove potential obstructions
- Nutritional supplements, such as saw palmetto and pollen extract
Prognosis for Male Pelvic Pain
Unfortunately, many men with pelvic pain caused by prostatitis do not find relief, 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.
Alexander R.B., et al. Treating Men with Chronic Prostatitis/Chronic Pelvic Pain Syndrome Annals of Internal Medicine. 19 October 2004. Volume 141, Issue 8 Page I-8
Capodice Jillian L et al. Complementary and Alternative Medicine for Chronic Prostatitis/Chronic Pelvic Pain Syndrome. Evidence Based Complementary and Alternative Medicine. 2005 December; 2(4): 495–501
The Merck Manuals Online Medical Library. Prostatitis (Prostatodynia). Accessed 7/22/09. http://www.merck.com/mmpe/sec17/ch240/ch240c.html
National Pain Foundation. Pelvic Pain: Causes. Accessed 7/19/09. http://www.nationalpainfoundation.org/articles/717/causes
Wagenlehner Florian ME, et al. Prostatitis and Male Pelvic Pain Syndrome: Diagnosis and Treatment. Deutsches Arzteblatt International. 2009 March; 106(11): 175–183