Chronic Pelvic Pain Syndrome (CPPS) describes chronic pelvic pain syndrome, a difficult-to-treat condition. A combination of factors is the reason for the symptoms that accompany it.
What is chronic pelvic pain syndrome?
Chronic Pelvic Pain Syndrome is a pain condition in the pelvic area. Men in particular are affected by the condition. In the past, the symptoms were grouped under painful prostate (prostatodynia). Chronic Pelvic Pain Syndrome (CPPS) is an insidious condition, as treatment has proven difficult to date.
Causes
Causes of chronic pelvic pain syndrome (CPPS) include autonomic dysregulation triggered by stress. Due to venous congestion of the venous plexuses lodged around the prostate, the accompanying sensitive nerves become irritated. The pain and insensations lead to the symptoms. According to an American study, the symptoms of Chronic Pelvic Pain Syndrome (CPPS) are based on an interplay between psychological factors and a dysfunction in the immune system. This includes, for example, a dysregulation of the local nervous system resulting from previous trauma or infection. This causes sufferers to tense the pelvic area due to suppressed feelings of anxiety, which can lead to repeated inflammation. The reason for this is that the nerves in the pelvic area are chronically activated. Cold is also suspected as a possible trigger or amplifier for Chronic Pelvic Pain Syndrome (CPPS). Many sufferers feel relief once heat is applied to the affected area.
Symptoms, complaints, and signs
Chronic Pelvic Pain Syndrome (CPPS) causes pain in the pelvis, but it does not result from a urinary tract infection. Symptoms may increase or decrease, and the pain may be mild or very severe. In the latter case, it is often no longer even possible to assume a normal sitting posture. Other signs often include difficult urination, a frequent urge to urinate, pain in the joints and muscles, fatigue, abdominal pain, a burning sensation in the penis, pain after ejaculation, and itching, stinging, and cramping of the anus. These symptoms may occur individually or in combination. Depression, a withdrawal from the social environment, problems in the partnership and a despondency are also possible due to the chronic pain condition and the heavy burden of Chronic Pelvic Pain Syndrome (CPPS). This can even extend to occupational disability and addiction.
Diagnosis and course
There are no definitive tests to date to clearly diagnose Chronic Pelvic Pain Syndrome (CPPS). Pressure pain can usually be elicited at the lower testicular or operatic pole. Through the anus (rectally), an inconspicuous and nonpressure-sensitive prostate is palpated. The renal bearings are free of tap pain on both sides. Physicians also use digital rectal palpation of the prostate. This is followed by bacterial pathogen localization using the 4-glass specimen (first urine, midstream urine, prostatic secretion, and the urine after prostatic massage). Other diagnostic methods include analysis of ejaculate, ultrasound (sonography), or uroflowmetry to determine functional or anatomic urinary obstruction. Chronic Pelvic Pain Syndrome (CPPS) usually resolves slowly over several days to weeks. However, it may recur due to adverse circumstances or reexertion.
Complications
In general, chronic pelvic pain syndrome is a disease that is difficult to cure. Most often, the syndrome causes the patient to experience severe pain, mainly in the pelvis. The pain itself can also take the form of pain at rest and often prevents the sufferer from maintaining a healthy and usual sitting posture. There is also pain in joints and in muscles. Likewise, the patient suffers from fatigue, which is not compensated with the help of sleep. During urination there is a burning sensation and pain, the pain can also occur during ejaculation, negatively affecting sexual life. Often, those affected also suffer from psychological discomfort and depression as a result of the symptoms. Social contacts are severely limited. In many cases, the patient can also no longer pursue any occupation.Treatment of Chronic Pelvic Pain Syndrome is primarily directed at reducing pain. Many patients also require psychological counseling, which can be supported by medication. No other complications occur, but chronic pelvic pain syndrome extremely limits the patient’s life and leads to a greatly reduced quality of life.
When should you see a doctor?
A physician should always be consulted for chronic pelvic pain, fatigue, and frequent urination. The symptoms are usually based on a serious disease, which must be clarified by a medical professional and treated if necessary. Whether the underlying condition is chronic pelvic pain syndrome can be determined by a digital-rectal palpation of the prostate and some other examinations. Once the diagnosis is made, comprehensive medical treatment is indicated. The sufferer should consult with the doctor regularly and inform him or her of any unusual symptoms. If psychological complaints such as depression or anxiety disorders are also present, a therapist can be consulted in consultation with the physician. For chronic pain, relaxation therapy is also helpful to reduce physical and mental stress. Nocturnal pelvic pain and possible accompanying symptoms such as cramps at the anus, joint and muscle pain or itching are a case for emergency medical services. If symptoms are severe, the affected person should be taken to the nearest clinic for further evaluation.
Treatment and therapy
After other functional disorders have been ruled out, heat has an immediate effect. This can be a hot water bottle or a hot sitz bath. Increased exercise is also helpful, although no pressure should be exerted on the perineum, as is the case when riding a bicycle, for example. The use of pumpkin seed and grass pollen extracts has also proven effective. Good support is also provided by pelvic floor training to slowly relearn how to use the muscle properly. This can be done via electrical stimulation, which uses a probe to deliver a painless current to the tense areas, helping to reduce pain. These devices are available for home use and are very easy to use. Since Chronic Pelvic Pain Syndrome (CPPS) can also be triggered by anxiety or panic, psychological treatment and relaxation therapy are also helpful in reducing stress levels. Acupuncture and medication can also help improve symptoms, with alpha-blockers seeming to have the greatest effect. Success has also been observed with antibiotics, although there is controversy about this type of treatment.
Outlook and prognosis
Chronic pelvic pain syndrome has an unfavorable prognosis. Cure of the disease is considered difficult and is not achieved in a large number of patients despite great efforts. It often takes many years from the initial manifestation for a diagnosis to be made. In many cases, the patient has already consulted several physicians and had numerous tests performed. Since there are no specific tests for recognizing Chronic Pelvic Pain Syndrome, establishing the disease is considerably more difficult. This delays the start of treatment. In addition to the discomfort and immense emotional challenges of dealing with the condition, there are often secondary symptoms. These worsen the prospect of cure and prolong the recovery path. Nevertheless, it is possible to alleviate the symptoms. In addition to drug treatment, emotional and mental strengthening is of great importance. With an optimistic attitude towards life, a reduction of stress and a stable psyche, health can be improved. The symptoms may fluctuate in intensity. In addition, episodes in which there is hardly any impairment or freedom from symptoms are possible. Often, symptoms gradually diminish over several days until the patient is free of pain or other impairment. However, recurrence during challenging periods is very likely.
Prevention
Everyone reacts differently to stress. How pronounced this is depends on the physical and mental condition of the person. The more balanced and healthy a person is, the lower the risk of developing Chronic Pelvic Pain Syndrome (CPPS).Therefore, it is very important to avoid stress as much as possible, so that the pelvic area is not tense again and again, which often happens unconsciously. The same applies to avoiding cold, as this could also be identified as a trigger. Many sufferers get good relief from the symptoms as soon as they feel warmth in the corresponding areas. Long-term stabilization of Chronic Pelvic Pain Syndrome (CPPS)can generally be achieved through a healthy diet, optimal lifestyle, and sufficient recovery periods, as the condition usually results from a combination of various unfavorable factors.
Follow-up
As a rule, Chronic Pelvic Pain Syndrome cannot be treated completely, so that in the process the options for aftercare are also very limited in most cases. The affected person is primarily dependent on an early diagnosis in order to prevent further complications or a further worsening of the symptoms. The earlier chronic pelvic pain syndrome is diagnosed, the better the further course of the disease usually is. In this disease, a lot of exercise can have a positive effect on the symptoms. In general, the affected person should lead a healthy lifestyle and eat a healthy diet. Sports activities that challenge the entire body are also very useful and can alleviate the symptoms. Physiotherapy measures can also be used, although many exercises from such therapy can also be performed at home. In some cases, it is also necessary to take medication to treat Chronic Pelvic Pain Syndrome. If antibiotics are taken, it should be noted that they are not combined with alcohol. As a rule, chronic pelvic pain syndrome does not reduce the patient’s life expectancy.
Here’s what you can do yourself
According to current knowledge, Chronic Pelvic Pain Syndrome (CPPS) results from a combination of psychological factors and an impairment of the immune system. Constant stress is considered to be the main cause, as sufferers in this emotional state tend to tense the pelvic area severely, leading to inflammation that does not heal properly or recurs repeatedly. Therefore, the best means of self-help is to avoid anxiety, stress and other exceptional emotional situations that can cause tension in the pelvic area. This is not always possible. However, those affected can learn to cope better with stress. A number of relaxation techniques are available for this purpose. The most common are yoga and autogenic training. Corresponding courses are now regularly offered by adult education centers, even in small towns. In all larger cities there are institutes or freelance teachers who introduce interested people to these techniques. In acute attacks, warmth helps most of those affected. Warm full baths or sitz baths are particularly helpful. Chemical hand warmers, which can be placed inconspicuously in the underwear and then warm the pelvic area, are helpful when traveling or during acute attacks at work. Some sufferers are also helped by naturopathic treatments such as taking pumpkin seeds or traditional healing methods such as acupuncture.
