Male Pelvic Pain

Symptoms of male pelvic dysfunction include pain and discomfort in the pelvic area, urinary and gastrointestinal issues, and sexual problems.

The underlying causes of these symptoms include surgical trauma, orthopedic injuries, biomechanical issues, lifestyle factors, and pelvic floor dysfunction. Our treatment approach involves a thorough evaluation and a personalized treatment plan focusing on manual therapy techniques like massage, stretching, and mobilization. This approach aims to reduce pain, improve muscle function, and enhance quality of life, with noticeable improvements often seen early in the course of treatment.

Symptoms

• Pain in the pelvic region, including the penis, scrotum, testicles, perineum, and/or anal area

• Discomfort aggravated by sitting, certain exercises, and specific types of clothing

• Urinary issues such as urgency, frequency, hesitancy, and a slower or diminished urinary stream

• Pain or discomfort in the genital area during or after ejaculation

• Erectile dysfunction and reduced ejaculation strength

• Gastrointestinal distress, including bloating and constipation

Causes

• Surgical trauma (e.g., vasectomy, BPH treatments, prostatectomy)

• Orthopedic injuries/traumas (e.g., spine, hip, knee, ankle)

• Biomechanical/structural issues (e.g., hip dysfunction, piriformis syndrome, scoliosis, leg length discrepancy)

• Excessive or changed exercise routines

• Prolonged sitting

• Chronic constipation/straining

• Genital enhancement attempts (e.g., jelqing, foreskin regeneration)

• Rarely, post-infection issues (bladder, prostate, STIs)

• Majority have pelvic floor dysfunction, with/without urinary or bowel symptoms

Diagnostic challenges

Diagnosing male pelvic pain often takes up to seven years for an accurate diagnosis due to symptoms that mimic prostate, bladder, or sexually transmitted infections. Research reveals that over 90% of men with genitourinary symptoms of pelvic pain are misdiagnosed with prostatitis and inappropriately treated with antibiotics, despite not having an infection.[1] Instead, these men typically have Chronic Pelvic Pain Syndrome (CPPS), falling under the National Institutes of Health's categories IIIa and IIIb. This issue is compounded by a general lack of awareness among medical providers about men's susceptibility to pelvic floor dysfunction, and many pelvic floor therapists are primarily trained to treat women.

How we can help

During your initial evaluation, our physical therapists will conduct an in-depth evaluation of your medical history, symptoms, and previous treatments. This is followed by a thorough physical assessment of your muscles, tissues, joints, nerves, and movement patterns, including initial treatment with manual therapy techniques like massage and mobilization. These techniques target the pelvic floor muscles to relieve pain, improve circulation, and reduce inflammation. After the examination, we discuss our findings and create a personalized treatment plan with short and long-term goals. Physical therapy treatment for pelvic pain in men typically involves one session weekly or every other week for about 3-4 months. You should see an improvement even after your first appointment and significant improvement by the third visit.

[1] Smith CP. Male chronic pelvic pain: An update. Indian J Urol. 2016 Jan-Mar;32(1):34-9. doi: 10.4103/0970-1591.173105. PMID: 26941492; PMCID: PMC4756547.