Chronic pelvic pain in men

Chronic pelvic pain is a common condition in men that is defined as 3 months of pain or discomfort in the pelvic region associated with urinary symptoms and/or sexual dysfunction. It is a diagnosis of exclusion and the aetiology is poorly understood. Hypotheses include increased pelvic floor tone as well as infective and inflammatory causes. Given the wide variation in symptoms and potential causes, it is important to spend time collating an individual patient's symptom profile so that the management plan can be tailored appropriately. A national multidisciplinary consensus guideline recommends a multidisciplinary team approach with pharmacotherapeutic, physical and psychosocial components integrated into a holistic treatment programme individualized to the patient. Management is likely to include a combination of interventions such as antibiotics, α-adrenergic antagonists and simple analgesics, alongside pelvic floor relaxation and psychological support. Detailed discussion with patients about the feedback loops involved in pelvic muscle tension and pelvic pain has also been found to be therapeutically beneficial.