Urinary Health

Do What it Takes to Fight Groin Pain

What's in a name? Sometimes referred to as prostatitis, chronic pelvic pain syndrome is really a condition onto itself. Men who have either problem may suffer from groin pain, urination difficulties and even erectile problems. But instead of bacterial infections that are clearly linked to prostatitis, the causes of pelvic pain syndrome are unknown. And there is no simple antibiotic that can ease symptoms.

What can be done? Dr. Anthony Schaefer, urologist at the Feinberg School of Medicine at Northwestern University in Chicago, explains how men can combat this mysterious and frustrating syndrome.

What is chronic pelvic pain syndrome?
It's a pain syndrome, and although prostatitis is a name that is used by lay people, we tend to call it chronic pelvic pain syndrome to be more accurate. The name reflects the fact that we don't know exactly where the pain is coming from, and in some cases it could be from the prostate, but not necessarily. The prostate may or may not be involved.

What are the main symptoms?
Chronic pelvic pain syndrome causes pain in the pelvic region with or without urinary symptoms, such as an urgency or frequency in the need to go to the bathroom.

How common is chronic pelvic pain syndrome?
The estimates vary depending where you are, but anywhere from two to six percent of men in different parts of the world have chronic pelvic pain.

Do we know what causes chronic pelvic pain?
In general, there are more white blood cells on average in a patient's prostatic fluid, but it's not a clear-cut point. I think one of the more interesting observations is that cytokines, which help control inflammation and can actually attract white blood cells to organs, are found in greater amounts in the prostatic fluid of some men with this condition. That suggests that maybe the prostate is a component of the syndrome.

These cytokines are similar to ones that would draw white blood cells to the joints and cause arthritis. So there may be logical explanations of why some men to have these pelvic pain symptoms.

How do you diagnose chronic pelvic pain syndrome?
The diagnosis is self-made. There is a questionnaire we use to quantify the symptoms. By definition, a syndrome is not a disease. It's not like a tissue diagnosis or a blood test.

Is there any way to treat it?
There's no effective therapy at this point. In the controlled studies that we've done, most notably the one where we gave patients an antimicrobial or an alpha blocker [antibiotics like Cipro or high blood pressure medications like Cardura], the patients did not show any improvement. Now, the negative aspect of the study was that we chose men for the study who had already been exposed to those drugs, and they had pretty severe symptoms. So, it's possible that those drugs may benefit some men who have the earlier onset of the condition.

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