Male Pelvic Pain

Pelvic Pain in men has many potential causes. Medically pain can be classified into 4 categories:

(i) Acute bacterial prostatitis:

An acute infection, usually caused by bacteria in the urinary tract (the kidneys, bladder, and the tubes that connect them) entering the prostate. Symptoms include fever, chills, pain in the low back and genital area, body aches, urinary frequency, nocturia (night-time frequency), painful urination (typically burning) and possible penile discharge. The symptoms are severe and develop suddenly; this is rare, but can be serious and requires immediate treatment. See your GP immediately for antibiotic treatment if you suspect you have this condition.

(ii) Chronic bacterial prostatitis:

Recurrent infection of the prostate. This condition is rare (less than 5 percent of patients diagnosed). The symptoms mimic intermittent acute bacterial prostatitis. The treatment is a prolonged course of antibiotics. Men with this condition may require physical therapy if antibiotics don’t help. Recurrent infections may be caused by incomplete urinary evacuation or by prostatic stones.

(iii) Chronic non-bacterial prostatitis / chronic pelvic pain syndrome (CPPS)

CPPS forms the majority of male pelvic pain cases (fewer than 10% of male pelvic pain cases are caused by bacterial infection). The majority of cases have no evidence of a urinary tract infection. Pain may be located in or around the groin, genitalia or perineum.

This may or may not occur with inflammation. Symptoms can include a combination of any of the following (reference Pelvic Pain: The Ultimate Cock Block by Dr Susie Gronski)

• Groin Pain
• Tail bone or butt pain
• Burning or sharp pain at the tip, shaft or base of the penis
• Uthrethral pain
• Feeling like your penis is 'engorged' 'hard' 'rubbery' 'uncomfortable' 'veiny' 'alien' or weird'
• Pain during or after ejaculation
• Pain during or after urination
• Ache in the scrotum or rectum
• Tight or tense feeling in the scrotum, penis or rectum
• Feeling of pressure in the prostate or rectum
• Pain while sitting
• Having to wee all the time
• Abdominal pain
• Testicle or scrotal discomfort
• Pain between the scrotum and anus
• Lower back pain
• Pain during sex
• Finding it impossible to sleep during the night without waking up to wee
• Feeling like you don't empty your bladder all the way
• Changes in urine stream
• Discomfort with bowel movements
• Straining with bowel movement

This condition is considered chronic as it lasts longer than 3 months but that should not be confused with permanent. The majority of this type of pelvic pain is treatable by a Pelvic Health Physiotherapist who specialise in treating male pelvic pain. 

(iv) Asymptomatic inflammatory prostatitis:

Typically, a person with this condition has no genitourinary symptoms, but higher levels of white blood cells have been identified during evaluation. Prostate cancer needs to be ruled out through a PSA (prostate-specific antigen) test given by your urologist.

Other Persistent Conditions?

You may have heard other terms relating to pelvic floor dysfunction in men that may cause pain, examples include Proctalgia Fugax, Levator Ani Syndrome, Anismus, Coccydynia, Pudendal Neuralgia and Sexual Dysfunction. These conditions are recognised by the type, location and frequency of the pain and muscle spasming. They are often linked to other symptoms such as constipation or sexual dysfunction due to the involvement of the pelvic floor in bladder, bowel and sexual function.

We highly recommend Dr Susie Gronski'd book, Pelvic Pain The Ultimate Cock Block which can be found in our library as a easy to digest manual to help you understand pelvic pain and give you the tools you need to recover.

You can view a video on Male Pelvic Pain with Gerard Greene here or visit our shop if you wish to incorporate a wand (therapeutic aid for internal massage) in your treatment and wish to purchase EZMagic.