IMR Press / JOMH / Volume 18 / Issue 2 / DOI: 10.31083/j.jomh1802050
Open Access Original Research
Urological Chronic Pelvic Pain Syndrome improves when underlying neuromuscular dysfunction is addressed in an outpatient, multimodal treatment protocol
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1 Department of Physical Medicine and Rehabilitation, Pelvic Rehabilitation Medicine Clinical Research Foundation, West Palm Beach, FL 33409, USA
2 Department of Physical Medicine and Rehabilitation, Feinstein Institute for Medical Research, Manhasset, NY 11030, USA
*Correspondence: (Soha Patil)
J. Mens. Health 2022, 18(2), 50;
Submitted: 27 September 2021 | Accepted: 8 November 2021 | Published: 10 February 2022
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.

Background: Urological chronic pelvic pain syndrome (UCPPS) combines two of the most widespread chronic urological pain disorders: interstitial cystitis (IC)/bladder pain syndrome (BPS) and chronic prostatitis (CP)/chronic pelvic pain syndrome (CPPS). This manuscript aims to assess the effectiveness of an outpatient, multimodal treatment protocol for men with UCPPS. Methods: A retrospective study of 58 male patients was done on an institutional review board approved protocol consisting of pelvic floor physical therapy (PFPT) in concomitance with the pelvic floor muscles receiving ultrasound guided trigger point injections and peripheral nerve blocks weekly for six weeks. Patients rated their levels of pelvic pain, performance, and quality of life via Visual Analogue Scale (VAS), Functional Pelvic Pain Scale (FPPS), and NIH-Chronic Prostatitis Symptom Index (NIH-CPSI) at their new patient consult and 3-month follow up. Results: Initial average VAS was 6.24 ± 2.26 and average VAS after treatment reduced to 4.25 ± 2.8. Initial average FPPS score was 9.21 ± 5.24. Final average FPPS reduced to 7.28 ± 5.03. Initial average total NIH-CPSI score was 24.55 ± 6.43 and after treatment reduced to 18.36 ± 7.62. Initial average NIH-CPSI pain, urinary symptoms, and quality of life sub scores were 11.28 ± 3.46, 3.41 ± 3.31, and 9.86 ± 2.05, respectively. After treatment, they decreased to 8.34 ± 4.14, 2.47 ± 2.45, and 7.55 ± 2.74. Differences in pre and post treatment outcomes were statistically significant. Conclusions: This shows the protocol was successful at improving pain and performance in male UCPPS patients. This supports the validity of a multimodal treatment protocol given patients failed to improve after a full course of PFPT by itself. However, they improved once PFPT was combined with other treatment modalities, alleviating the underlying neuropathic and myofascial pain seen in UCPPS.

Chronic pelvic pain syndrome
Chronic prostatitis
Pelvic floor muscle dysfunction
Male pelvic pain
Multimodal therapy
Fig. 1.
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