Prolonged, ongoing pain in your pelvis must be treated.
Chronic Pelvic Pain Syndrome is an umbrella syndrome that can comprise of pain that can arise from your prostate, the muscle that make up your pelvic floor and even the nerve and blood vessels that supply the pelvis. Men who suffer from it often brush it off as a urinary tract infection (UTI) or even a sexually transmitted disease (STD) due to the similar symptoms.
Did you know? Pelvic pain is especially common among people who cycle because of the pressure it puts on your pelvic floor. This affects both male and female cyclists.
Common symptoms include:
• lower abdominal and groin discomfort
• the need to urinate often
• burning sensation when passing urine
• pain or discomfort with ejaculation
If your symptoms are prolonged and recurrent, there is a possibility that they are associated with Chronic Pelvic Pain Syndrome instead of a UTI or STD.
FAQ
What is the source of my pelvic pain?
Pelvic pain can be caused by anything that sits on or occupies your pelvis, such as your prostate gland or muscles.
How does my pelvic floor muscle cause pelvic pain?
Chronic Prostatitis is often painful and can affect sexual and urinary function. The symptoms can continue for 3 months or longer and include aches or sharp pain near the genital area, getting up several times a night to go to the bathroom, pain or difficulty when ejaculating, or signs of an infection such as fever, chills, nausea and vomiting.
How is Chronic Pelvic Pain diagnosed?
Your doctor should first rule out any obvious urinary tract infections or sexually transmitted diseases that may explain your symptoms.
A rectal exam will then be performed to check the prostate for swelling or inflammation, while looking out for signs of infection, such as discharge from the penis or swollen lymph nodes.
Benign Prostatic Hyperplasia (BPH)
BPH is a non-cancerous enlargement of the prostate gland that commonly affects aging men, leading to urinary issues that impact daily life.
What are the symptoms of BPH?
Symptoms range from mild to severe and may include:
- Weak or interrupted urine flow
- Frequent urination or urgency
- Straining or painful urination
These symptoms can disrupt work, travel, and social activities.
Did you know? Erectile dysfunction (ED) is common in men with BPH. Studies suggest up to 96% of BPH patients may also experience ED. Discussing both conditions with a healthcare provider is important, as treatments are available for both.
FAQ
What treatments are available for BPH?
- Medications:
- Alpha-blockers (e.g., alfuzosin, tamsulosin): These relax prostate and bladder neck muscles, improving urine flow.
- 5-alpha-reductase inhibitors (5-ARIs) (e.g., finasteride, dutasteride): These shrink the prostate but may cause side effects such as decreased libido, erectile dysfunction, or ejaculatory issues.
- Side effects of BPH medications:
- Alpha-blockers: Dizziness, fatigue, headaches, and potential low blood pressure.
- 5-ARIs: Reduced libido, erectile dysfunction, and decreased ejaculate volume. Long-term use may also increase the risk of breast tenderness or enlargement.
How do 5-alpha-reductase inhibitors (5-ARIs) affect PSA levels?
5-ARIs can lower Prostate-Specific Antigen (PSA) levels by up to 50%. This can make it harder to interpret PSA test results. To get an accurate reading, men taking 5-ARIs should multiply their measured PSA value by 2.
What if medications aren’t effective?
For men who don’t respond to medications or have severe symptoms, surgical options such as UroLift, Rezum, and Transurethral Microwave Therapy (TUMT) may be recommended. These newer minimally invasive techniques are effective alternatives.
Can prostate surgery cause urinary or sexual complications?
Yes, extensive prostate surgery (whether for BPH or prostate cancer) can lead to complications such as urinary incontinence, erectile dysfunction, and absent ejaculation. However, with proper counseling, steps can be taken before surgery to minimize these risks and improve recovery.
- Medications: Starting daily Cialis (tadalafil 5mg) can increase blood flow to the penis and pelvic region, helping with erectile function.
- ESWT (Extracorporeal ShockWave Therapy): Both before and after surgery, ESWT can help prevent erectile dysfunction.
- Pelvic floor physiotherapy: This is crucial for preventing urinary incontinence after surgery.
- Sex therapy: Counseling can help couples adjust sexual expectations and find new ways to achieve sexual satisfaction.
Taking these preventive measures can allow for a smoother recovery and better outcomes post-surgery.
Our Doctors
Dr Samuel
MB BCh, BaO (Ireland),
MRCS (England)
Dr Jess
BSc (S’pore), MBBS (Aus)
FECSM (Fellow of the European Committee Sexual Medicine)
Your Health, Your Confidence.
Don’t let health concerns hold you back. Early intervention can significantly improve quality of life.
