Chronic Pelvic Pain Syndrome or also abbreviation of CPPS or Chronic prostatitis (CP) is a urology disorder which is a long term non bacterial infection with lower urinary tract symptoms. This affects the men about 15% prevalence from the population. CPPS should last more than 3 months persistently without infection. The symptoms are such as discomfort pain in the pelvic region, suprapubic area, and also most common areas will be perianal region, with or without ejaculation and voiding problems. The pain is wax and wane, it may radiate to the back and rectum which makes sitting discomforts. Pain may present in the perineum, tip of penis, testicles, pubic area or even bladder area. They might present with dysuria, arthralgia, myalgia, abdominal cramps, lethargic, or increase urinary frequency and urgency (Cystitis). Some will have impotency.Post ejaculation pain is the distinctive feature of this condition. Treatment categorized to pharmacology or non- pharmacology. The pharmacology treatments are antibiotics, analgesics, anti-inflammatory, alpha-receptor blockers (terazosin) and 5 alpha-reductase inhibitors (Tamsulosin).There are recent alternative therapy available in market now, such as acupuncture,balloon dilatation, hyperthermia, physiotherapy, laser coagulation and inject a botulinum toxin A intra-prostatic. The newest non-invasive therapy available is ESWT (extracorporeal shock wave therapy), which has been showing a successful rate in treatment of CPPS. ESWT can act as antispasmodic, analgesics and antiinflammatory effect and shows an effective treatment in CPPS.
While chronic pelvic pain in women is non cyclical persistent pain which can last more than 6 months or more. It is typically conceptualized as functional somatic pain syndrome and involves mental health disorders. The identifiable disease could be endometriosis, painful bladder syndrome and comorbid depression. The pharmacological treatment options are beneficial with NSAIDS, neurontin (gabapentin), contraceptive injection (IM depot medroxyprogesterone, GnRH (gonadotropin-releasing hormone agonists) with or without hormonal therapy. Conservative management will be physiotherapy for pelvic floor muscle exercise, behavioural therapy for some, or neuromodulation of sacral nerve may be beneficial. At last hysterectomy will be the option when the pain from the uterine in origin but significant improvement only for one-half of the cases.
Effective treatment with ESWT
Chronic pelvic pain is a patient centered approach and collaborative measured with the patient. The newest non-invasive therapy available is ESWT (extracorporeal shock wave therapy), which has been showing a successful rate in treatment of CPPS. ESWT can act as antispasmodic, analgesics and antiinflammatory effect and shows an effective treatment in CPPS. Randomized studies have been done with 40 people and the study revealed that radial shocks are really effective and safe modality in treating CPPS cases for a short-term follow up.