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Query: UMLS:C0030794 (pelvic pain)
 4,056 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Difficulties encountered in diagnosing and effectively treating chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is frustrating for clinicians and patients. Scientific evidence cannot establish an exact relationship between the prostate and the symptoms of CP/CPPS, and the prostate continues to be the diagnosis of convenience in this complex syndrome in men. However, if the pain is not the prostate's, whose pain is it? A heterogeneous group of insults can result in a common neurogenic pain response, resulting in recurring pain and voiding or sexual dysfunction. To add to this dilemma, certain life-threatening diagnoses, such as carcinoma-in-situ, is in the differential diagnosis and must be excluded. Urodynamics may be useful in evaluating and treating patients whose voiding symptoms predominate. However, many patients with CP/CPPS will not have measurable abnormalities by conventional methods and likely suffer from a functional somatic syndrome that is best treated with a multimodality approach.
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PMID:Chronic prostatitis and sensory urgency: whose pain is it? 1554 Dec 12

Neuromodulation in one form or another has been studied for decades for various disease states. Although its mechanism of action remains un-explained, numerous clinical success stories suggest it is a therapy with efficacy and durability. Controlled studies have led to the approval of sacral neuromodulation for urinary urgency and frequency, urinary retention, and urinary urge incontinence. The future holds hopeful possibilities for the application of neuromodulation, namely in the areas of interstitial cystitis, in-tractable pain syndromes, fecal incontinence and constipation, spinal cord injury, and erectile dysfunction. Neuromodulators have also been used in nonurologic conditions, including chronic headaches and intractable chest pain. In adults and children, in the neurologically intact and neurologically impaired, neuromodulation has been shown to improve the quality of life of those suffering chronic disease states. Neuromodulation is changing the future of urology. Treatment of voiding dysfunction and likely other disorders, such as pelvic pain, sexual dysfunction, and bowel disorders, will no longer rely only on medications that are "OK" or destructive-reconstructive procedures that suffer from significant complications. Rather, by modulating the nerves, the urologists will treat these disorders in a minimally invasive fashion and neuromodulation will become the first-line therapy before any major surgery is undertaken.
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PMID:Expanding indications for neuromodulation. 1569 77

The purpose of this study was to determine the frequency of incontinence in men and women in different age groups. In a representative survey, 883 men and 1,182 women with a mean age of 50 years (18-92 years) were studied based on standardized questionnaires on physical and psychological complaints, and quality of life. Participants suffering from involuntary loss of urine were considered "incontinent". The frequency of incontinence strongly increased with age, from 6.9% among the 18-40 year old population to 9.5% among the 41-60 year olds and 23% over the age of 60 years. Women complained more frequently of incontinence (15%) than men (9.5%; total of 12.6% in the population). The majority of the participants with incontinence also suffered from urinary urge, multiple disorders of digestion, pelvic pain and sexual dysfunction. There was also a strong increase in exhaustion, gastric pain, joint pain and cardiac complaints. The younger participants were more strongly affected by incontinence. When patients complain of incontinence, strong impairments in physical and psychological well-being, and quality of life are to be expected.
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PMID:[Prevalence of urinary incontinence in the German population]. 1574 5

Premature ejaculation is a common male sexual dysfunction. Treatment modalities as recommended by the British Association of Sexual Health and HIV include behavioural therapy, tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRIs) and local anaesthetic creams. We audited the clinical cohort from our dedicated sexual dysfunction clinic to determine the success of prescribed treatment and co-existing prostatitis/male pelvic pain, erectile dysfunction, phosphodiesterase-5 (PDE5) inhibitor use and anxiety. The use of SSRIs was successful in the treatment of premature ejaculation with or without the use of local anaesthetic cream. Co-existing prostatitis/male pelvic pain, erectile dysfunction, PDE5 inhibitor use and anxiety were high.
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PMID:Pharmacological treatment for premature ejaculation. 1621 22

The aims of the study were to determine the prevalence of sexual dysfunction, its subtypes and associated risk factors in women with chronic pelvic pain (CPP) as compared to a general female population. We evaluated 112 women (mean age 34.73 +/- 8.07; age range 18-50) complaining of CPP with a comprehensive history including female sexual function index (FSFI) and several general assessment questions (GAQs), a complete physical examination and routine laboratory tests. A group of 108 healthy women (mean age 33.28 +/- 7.95; age range 19-52) without CPP were enrolled as cross-sectional controls. According to the general population, the incidence of female sexual dysfunction (FSD) was 67.8% in women with CPP and 32.2% in women without CPP (P < 0.0001). Among 112 CPP patients, 78 (69.6%) of them had FSD and 34 (30.4%) patients did not have FSD in the study (P < 0.0001). In that 78 patients, 42 patients (53.8%) had hypoactive sexual desire disorder, 26 patients (33.3%) had sexual arousal disorder, 17 patients (21.7%) had orgasmic disorder and finally 58 patients (74.3%) had sexual pain disorder. The FSFI scores in both groups were as follows: (patients vs. controls; median value; P value, respectively): desire: 3.31 versus 3.98 (P < 0.0001); arousal: 3.58 versus 4.35 (P < 0.0001); lubrication: 4.20 versus 4.88 (P < 0.0001); orgasm: 3.70 versus 4.48 (P < 0.0001); sexual satisfaction: 3.80 versus 4.64 (P < 0.0001); sexual pain: 2.75 versus 4.98 (P < 0.0001) and total FSFI score: 21.35 versus 27.29 (P < 0.0001). The prevalence of FSD was higher in women with CPP than in a general healthy population not complaining of CPP. Investigation of female sexuality was essential for these patients.
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PMID:The prevalence of sexual dysfunction and associated risk factors in women with chronic pelvic pain: a cross-sectional study. 1670 63

Sexual abuse, particularly childhood sexual abuse, has been linked to chronic pelvic pain and to sexual dysfunction, though the sexual functioning of survivors of sexual abuse has not been studied in a chronic pain population. Sixty-three women with chronic pelvic pain completed measures of sexual function, sexual abuse, and pain. Using an index of the extent of sexual abuse experiences in childhood and adolescence/adulthood, higher scores were related to lower rates of sexual activity, less satisfaction with orgasm and feelings of closeness with sexual partners, and greater severity of and interference from pain. Findings point to the importance of controlling for relationship status in analyses of long-term effects of sexual abuse and of assessing chronic pelvic pain patients for histories of sexual abuse using measures that address the extent or severity of abuse.
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PMID:Sexual abuse and sexual functioning in a chronic pelvic pain sample. 1689 19

Prostatitis (chronic prostatitis/chronic pelvic pain syndrome ) is a common condition in men that accounts for a significant number of visits to a medical doctor or urologist. It is one of the most widely diagnosed conditions in men who attend urologic clinics. Erectile dysfunction, defined as the consistent inability to obtain and/or maintain a penile erection sufficient for adequate sexual relations, also is a common problem. This review explores the links between sexual dysfunction and prostatitis. Most of the data linking lower urinary tract symptoms and erectile dysfunction suggest that lower urinary tract symptoms impair the overall quality of life and that a low quality of life contributes to or causes erectile dysfunction. Prostatitis-like symptoms such as perineal, penile, and suprapubic discomfort or pain during or after ejaculation and voiding complaints such as irritative and obstructive voiding symptoms (urinary frequency, urgency, and dysuria) may affect the global emotional well-being of a man. Erectile dysfunction also is strongly associated with a negative impact on the quality of life. The available literature demonstrating the influence of CP/CPPS on the incidence of erectile dysfunction is scant. From the literature, it is known that lower urinary tract symptoms and benign prostatic hyperplasia are definitely related to erectile dysfunction. Any kind of pain is likely to be the most significant symptom in men with CP/CPPS as it relates to sexual dysfunction. Sexual dysfunction such as ejaculation discomfort is described as a symptom of CP/CPPS. Most of the data linking the two suggest that CP/CPPS impairs the overall quality of life and it is this that contributes to or causes erectile dysfunction.
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PMID:Sexual dysfunction in the patient with prostatitis. 1693 May 2

Despite a large number of reports exploring the links between diseases of the prostate and effects on sexuality, the relationship between prostatitis and sexual dysfunction has not been as thoroughly investigated. A number of reports have focused on the adverse effects of prostatitis on quality of life, with resultant indirect effects on sexuality. More detailed studies are available on the links between ejaculation and the chronic prostatitis/chronic pelvic pain syndrome subgroup of prostatitis. Improvement of sexual dysfunction following treatment of prostatitis has been reported in a few studies, most notably in association with alpha-blocker therapy. This review addresses some of the more relevant reported links between prostatitis and sexual function.
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PMID:Sexual dysfunction and prostatitis. 1705 45

Genitourinary changes following childbirth and pregnancy are common, and include urinary and anal incontinence, pelvic pain, sexual dysfunction, and pelvic organ prolapse. At present, it is unclear whether or not these changes are a result of the pregnancy itself or the mode of delivery (cesarean section or vaginal birth). In this article, the authors aim to describe genitourinary postpartum pelvic floor changes, and review the literature regarding the impact of pregnancy or childbirth on these changes. Data is needed that compare the effects of pregnancy alone, cesarean delivery (labored and unlabored), and vaginal birth, so that physicians can better advise patients about the postpartum genitourinary tract changes they might expect.
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PMID:Postpartum genitourinary changes. 1714 56

This study compared the sexual and relationship functioning of 38 male patients with Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) to that of their female partners, and of both the men and women in these couples to those in 37 control couples. Male sexual function was also examined as a predictor of partner sexual function. In comparison to control males, the men with CP/CPPS reported significantly more sexual dysfunction and symptoms of depression. Furthermore, symptoms of depression mediated the relationship between some aspects of sexual function and male participant status as a patient or control. However, men with CP/CPPS did not report significantly decreased sexual satisfaction or relationship functioning compared to controls. Partners of men with CP/CPPS reported significantly more pain upon intercourse, vaginismus, and depressive symptoms when compared to control females. In addition, patients with CP/CPPS and their partners did not differ significantly from each other with regard to sexual functioning and satisfaction, relationship functioning, and symptoms of depression. Patient sexual functioning significantly predicted female partner sexual functioning. This study was the first to evaluate partners of men with CP/CPPS. Patients and partners in this study reported lower levels of sexual functioning in some domains, yet were comparable to control couples on measures of satisfaction and relationship functioning. Furthermore, the sexual and relationship functioning of patients and partners was significantly associated. The results of this study have implications for the assessment and management of CP/CPPS and for future research in this area.
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PMID:Sexual and relationship functioning in men with chronic prostatitis/chronic pelvic pain syndrome and their partners. 1718 30


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