Chronic Pelvic Pain Syndrome


Chronic pelvic pain syndrome (CPPS) is a comprehensive term encompassing a wide range of symptoms accompanying a condition of chronic pelvic pain. Pelvic pain is essentially termed as ‘chronic’ if it lasts for more than six months.

The term is also used to refer to the group of emotional and behavioral changes that occur due to the duration of the pain and stress produced by the discomfort.

Specifically in men, the term, chronic pelvic pain syndrome is a sensation of chronic discomfort or pain felt in the lower pelvic region, mainly at the base of the penis and around the anus. This is reportedly caused due to an inflammation or other conditions of the prostrate gland.

The condition of CPPS is quite common in women of reproductive age, especially 26-30 years.

Characteristics of Pain

According to the International Pelvic Pain Society, the pain involved in the chronic pelvic pain syndrome has the following typical six characteristics:

i) Pain has lasted continuously for six months or more

ii) Conventional medical or surgical treatment gives little relief

iii) Pain is not proportionate to tissue damage

iv) Signs of depression exist (sleep disturbances, constipation, slow body movements)

v) Physical activity gets limited

vi) Altered family roles

Causative Factors

Some of the most prominent causes of the chronic pelvic pain include:

• Endometriosis

• Interstitial cystitis (IC)

• Trigger points

• Adhesions

• Vulvar vestibulitis

• Ovarian cysts

• Ovarian remnant

• Tension in the pelvic floor muscles

• Fibroids

• Irritable bowel syndrome

• Nerve entrapment pain

• Psychological factors

Diagnosis of CPPS

Diagnosis of chronic pelvic pain syndrome generally follows a process of elimination, since numerous other disorders could be responsible for the pain.

You will be asked for a series of details including the type of pain, when it occurs, duration, how long it lasts, how severe it is and what improves or worsens the pain.

Various tests or exams might also be suggested by the doctor if the presence of CPPS is suspected. These mainly include:

• Pelvic examination

• Cultures

• Laparoscopy

• Imaging studies

• Pain mapping

Elements of Treatment

The treatment plan for CPPS is devised in accordance with typical symptoms, severity and other medical history. Some of the constituents of treatment for the chronic pelvic pain syndrome include:

• Painkillers, such as paracetamol or ibuprofen

• Antibiotics and antidepressants

• Hormonal treatments

• Trigger point injections

• Nerve separation

• Alpha-blockers

• Surgical options

• Removal of prostrate (in men)

• Other medicines, such as bioflavinoids, allopurinol

• Physical therapy

• Psychological support

• Counseling

• Stress management

• Relaxation techniques

Complementary and Alternative Therapies

• Biofeedback

• Acupuncture

• High frequency Electrostimulation

• Hyperthermia

• Herbal and Nutritional Supplements