Three treatments for chronic pelvic pain syndrome in men were found to be effective in curing or reducing symptoms of the often puzzling condition, according to a recent analysis of published research.
The treatments are: Antibiotics, anti-inflammatories, and alpha-blockers or nerve inhibitors.
The review, published in the January 5 issue of the Journal of the American Medical Association, noted that about nine per cent of men in the United States suffer from different types of inflammation of the prostate gland, accounting for about two million medical visits annually.
Symptoms include pain in the pelvis, urethra or penis, back pain, trouble urinating and frequent urination.
Up to 95 per cent of these cases are caused by chronic pelvic pain syndrome triggered by chronic prostatitis, an inflammation of the prostate gland that surrounds the male urethra.
The condition — usually caused by a chronic bacterial infection — is most likely to affect men between the ages of 35 and 45, according to government statistics.
Not enough research has been done on effective treatments for this condition, one expert said, noting that only 23 studies met the researchers’ criteria for inclusion.
“This is a very ambitious study, and it appears to shed some light on a very challenging condition,” said Paul C. Cook, a urologist at the Hermann Memorial Medical Centre in Houston, who was not connected to the study.
“The fact that they distilled it down to only 23 studies in all the literature that met their criteria exemplifies that there [are so few] really good controlled studies out there.”
The most effective treatment for chronic pelvic pain syndrome was the combination of antibiotics and alpha-blockers, particularly when the main symptom was pain while urinating, but “anti-inflammatory medications remain an option for patients” who seek help for pain, according to the authors of the report.
The researchers noted that the role of antibiotics was unclear, since infection has to be ruled out before a man is diagnosed with chronic pelvic pain syndrome.
They speculated that the antibiotics might work against unrecognised germs and noted that antibiotics such as quinolones also have anti-inflammatory properties.
Chronic pelvic pain, or pain lasting three of the previous six months, can be very debilitating, said Dr Cook. Symptoms include pain in the pelvis, urethra or penis, back pain, sexual difficulties and frequent urination.
Alpha-blockers, used to block the nerves going into the muscles of the prostate, are often prescribed along with antibiotics for the condition.
If that doesn’t work, another antibiotic is tried. But a man with chronic pelvic pain shouldn’t just keep switching around “from one antibiotic to another,” Dr Cook said.
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