Chronic Pelvic pain Syndrome (CPPS) /
Chronic Prostatitis (CP)
Chronic Pelvic pain Syndrome (CPPS) /
Chronic Prostatitis (CP)
Symptoms can vary from voiding symptoms, pain located in the groin, genitalia, perineum, testes, penis, or bladder. Rectal pain, reduced libido, stress, anxiety, and pain during or after sex are the main symptoms.

Pelvic floor muscle dysfunctions include incoordination, spasms, muscle hypertonicity, muscle shortness, trigger points, scar adhesions, pelvic floor.

Conditions
Interstitial Cystitis /
Painful Bladder Syndrome
Interstitial cystitis (IC), or painful bladder syndrome causes pain in the bladder, urethra, and pelvic region. It is often mistaken for urinary tract infection, but the urine test is normal.
Pain or pressure is experienced during the filling phase of the bladder and may subside after urination.

Symptoms of Interstitial Cystitis may include:

  • Pain in the pelvis.
  • Pain in the penis or tip of penis.
  • Pain between the scrotum and anus.
  • Pain in the lower abdomen or lower back.
  • Chronic pelvic pain.
  • Pain like a urinary tract infection but without an infection.
  • Frequent urination, usually only in tiny amounts.
  • Persistent, urgent need to urinate.
  • Pain when the bladder is full and relief after emptying the bladder.
  • Painful orgasm or ejaculation.

Physiotherapy treatment may include:

Physiotherapy:
Patients with IC/BPS often have tenderness and/or pain in the pelvic floor area, and sometimes manual physical therapy can reduce symptoms.

Please do not do any strengthening of your pelvic floor muscle without the supervision of your pelvic floor physiotherapist!

There is evidence that physical therapy exercises to strengthen the pelvic floor muscles do not improve symptoms and often make them worse, so activities such as Kegel exercises are not recommended for patients with IC/BPS.

Pudendal Neuralgia
Pudendal neuralgia can arise from mechanical or non-mechanical injuries.
The mechanical injury can be due to compression, traction, or stretching for e.g.
excessive bike riding, horse riding, deadlifts, pelvic surgery, prolonged sitting, and constipation that can cause nerve irritation.

Pain of a severe, throbbing, or stabbing character in the course or distribution of the nerve can be experience.

Common Symptoms of Pudendal Neuralgia are:

  • Pain with sitting, decreased with standing and sitting on a toilet.
  • Urinary dysfunction-Urinary frequency and or urgency, pain during or after voiding, slow hesitant or interrupted urine stream.
  • Bowel dysfunction- Pain before, during or after bowel movement. Constipation or difficulty with evacuating, feeling of fullness in rectum.
  • Sexual dysfunction- painful ejaculations, erectile disorders
  • Pain in the distribution of the pudendal nerve- Genital, perineum, anal pain, and lower urinary tract.
  • Burning, shooting, stabbing pain.
  • Foreign body sensation in the anus, rectum, urethra
  • Decreased tolerance for exercise.