Male Pelvic Pain Disorder - An Overview.

Introduction

Male pelvic pain disorder can occur for many reasons, such as prostate inflammation, urinary tract infection, sexually transmitted diseases, and prostatitis. The condition is prevalent in males and occurs in 10 % to 15 % male population. Pelvic pain usually occurs with other underlying medical conditions and symptoms and is treated accordingly to rule out the cause. However, the causes of male pelvic pain are not very severe but can gradually worsen the condition and lead to long-term complications such as infertility if not treated promptly.

What Are the Causes of Male Pelvic Pain Disorder?

The causes of male pelvic pain disorder include:

• Prostatitis - The condition occurs due to an inflammation of the prostate gland mainly because of nerve damage in the urinary tract or bacterial infection. Prostatitis produces various other symptoms apart from pelvic pain, such as blood urine, painful urination, genital pain, painful ejaculation, frequent urination, pain in the rectum and scrotum, lower back and abdomen pain, and cloudy urine.

• Urinary Tract Infection (UTI) - Bacterial growth in the urinary system (urethra, ureters, bladder, and kidneys) causes urinary tract infection. The condition leads to severe pelvic pain and other symptoms such as bloody urine, pelvic pressure, frequent urination, burning sensation, fever, and painful urination. Urinary tract infections are more prevalent in females, but men can also get infected.

• Hernia - The condition causes bulging of the intestinal tissue through the abdomen muscles. A person can have sudden pain in the lower abdomen region. The most common type of hernia in men is an inguinal hernia that presents as a groin or lower abdomen lump. The lump may disappear in the lying position and be pushed back. Apart from causing pelvic pain, hernia leads to feelings of fullness, pain in the groin, and severe pain while bending over, coughing, and laughing.

• Urinary Stones - Mineral deposits in the urine, mainly calcium, cause this condition. Urinary stones are formed by crystallization or accumulated clumps of these mineral deposits. They are present both in the urinary bladder and kidneys. Urinary stones usually do not cause symptoms, but their movement can cause pelvic pain in a person.

• Cystitis - Inflammation of the urinary bladder is called cystitis, mainly caused by urinary tract infection (UTI). The pain of cystitis originates in the pelvic region and causes other symptoms like burning urination, frequent urination, bloody urine, and smelly and cloudy urine.

• Appendicitis - An appendix is a small finger-shaped organ attached to large intestines on the right side of the body. Inflammation or appendicitis of this organ causes pelvic pain in a person. The pain originates from the belly button up to the lower right abdomen and gets exaggerated with sneezes or coughs.

• Sexually Transmitted Disease - The infections caused through sexual contact also lead to pelvic pain in men. In men, gonorrhea and chlamydia can be the reason for severe pelvic pain.

• Irritable Bowel Syndrome (IBS) - This condition arises due to poor function of the large intestine caused by gastrointestinal disorders. Irritable bowel syndrome can lead to abdominal and pelvic pain caused by digestive problems. In addition, IBS causes other symptoms such as bloating, diarrhea, cramping, gas, and constipation.

• Urethral Strictures - Urethral tube connects the bladder and the penis. The urethra carries semen and also passes out urine from the body. The narrowing of this tube can occur through injury, inflammation, or infection called urethral strictures. Pelvic pain is the most common symptom of urethral strictures.

• Prostatic Hyperplasia - Prostate enlargement causes the condition due to prostatitis, benign prostate hyperplasia, and prostate cancer. The enlarged prostate can lead to severe bladder issues and pelvic pain; sometimes no symptoms may be present.

What Are the Symptoms of Male Pelvic Pain Disorder?

The symptoms of male pelvic pain disorder are as follows:

• Frequent urination.

• Painful urination.

• Difficulty in urinating.

• Pain during ejaculation.

• Erectile disorders.

• Pain in groin, abdomen, bladder, and anus.

• Chills.

• Fever.

How Is Male Pelvic Pain Disorder Diagnosed?

Male pelvic pain disorder is diagnosed in the following ways:

• First, the doctor does a physical examination of a person to know the severity, duration, type, frequency, and onset of the pain. The doctor may also ask about the associated symptoms of this condition.

• Physical examination includes palpation in the area of pain, which can identify a hernia.

• Digital rectal examination (DRE) can also be done depending on the symptoms present during the physical examination.

• In addition, blood tests are also given by the doctor for bladder inflammation, or infection is suspected.

• A blood test is also used to detect prostate cancer via prostate-specific antigen (PSA) testing.

• Radiological examinations such as X-rays (abdominal and pelvic), computed tomography (CT scans), magnetic resonance imaging (MRI), and ultrasounds are also used by doctors to detect tumors, kidney stones, enlarged prostate, pelvic infection, appendicitis, and gastrointestinal diseases.

How Is Male Pelvic Pain Disorder Managed?

Male pelvic pain disorder is managed by treating the cause of pelvic pain and underlying medical conditions. Different types of pelvic pain are treated differently. For example, drinking lots of water or surgical removal is recommended if a person has kidney stones, antibiotics are given to treat bacterial infections, and surgery, radiation, or chemotherapy is advised for tumors.

Treatments for male pelvic pain disorder include:

• Antidepressants are used for pain management.

• Non-steroidal anti-inflammatory drugs (NSAIDs) and Acetaminophen are used to treat pain.

• Botulinum toxin A injection or oral muscle relaxants treat bladder muscle spasticity.

• For prostate hypertrophy, Tamsulosin (alpha-adrenergic blocker) is given.

What Are the Preventive Measures for Male Pelvic Pain Disorder?

• Digestive disorders such as irritable bowel syndrome, constipation, and other digestive problems should be managed well by a person to avoid pelvic pain. Take proper medication and diet from the doctor.

• Sexually transmitted diseases can lead to pelvic pain in males. Therefore, practicing safe sex can be beneficial to avoid the cause by using barrier protection methods.

• Drinking enough water to avoid dehydration can prevent bladder infections and kidney stones. Fluid can help treat these conditions and reduce or prevent pelvic pain.

• Prostate and colon cancer screening tests should be done as recommended to avoid life-threatening consequences and severe causes of pelvic pain.

Conclusion

Pelvic pain disorder is a complication if the symptoms are not treated on time due to delayed medical intervention. In addition, the condition can cause long-term effects in males and often lead to infertility. Therefore, a person experiencing pain in the pelvic region should consult the doctor to get a proper diagnosis of the case and recommended treatment to avoid fatal consequences.