Salient points

Chronic pelvic pain syndrome (CPPS) is a complex clinical condition which is characterised by pain in the pelvic zone. Its causes remain obscure in the majority of the cases. This phenomenon is often responsible for serious discomfort which affects the quality of life for both sexes. The chronic pain in male patients is localised in the lowest part of the abdomen, therefore it could be caused by any part of the genital apparatus (prostate, seminal vesicle, testicle, spermatic chord) or part of the lower urinary apparatus (bladder and urethra) or the relevant muscles, bones or neurological structures in the pelvis. Patients tend to report different types of pains. The pain’s intensity could vary from vague discomfort to unbearable, which patients tend to describe it as a stabbing pain. In some cases it seems that the painful sensation relates to the emptying and filling of certain pelvic organs (bladder or rectum). In other cases it is provoked by certain position such as sitting or by pressure of specific points on the pelvic area, which medical terminology calls as trigger points.

Although the main symptom of CPPS is aching type of pain, however, there are often other kinds of symptoms are connected with it in the lower urinary tract (increased urinary frequency, burning sensation during urination, urgency to urinate), intestinal problems and sexual dysfunctions (erectile dysfunction and premature ejaculation). In order to establish a diagnosis the physician needs to exclude local pathologies such as infections or tumours. Search for the real causes often remain fruitless frustrating the physicians’ efforts to find a specific therapy.

Currently a specific therapy for CPPS has not been identified. Clinicians’ experience is essential to institute tailor-made treatments for these patients. The use of extracorporal showckwave therapy seems to give very positive and long lasting results recently.