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Third International Chronic Prostatitis Network

Pelvic muscle evaluation in men with chronic pelvic pain and controls

D. Hetrick,1 M. Ciol,3 J. Turner,2 I. Rothman,1 MS Frest,1 R.E. Berger 1
Departments of 1 Urology, 2 Psychiatry and Behavioral Sciences, and 3 Rehabilitation Medicine,
University of Washington, Seattle, WA.
Introduction
Men with chronic pelvic pain syndrome (CPPS) experience pelvic pain that may be related to muscle dysfunction. Since few studies have attempted to document pelvic floor muscle function in men with CPPS we performed a comparative study of the pelvic floor muscles in men with CPPS and men without pain.
Methods
To date, 30 men with CPPS and 51 controls under-went a standardized physical therapy evaluation. The evaluation was done in an unblinded manner by a licensed physical therapist (D.H.) specializing in pelvic floor dysfunction.
Results
Pelvic floor muscle tone increase was found in 16/30 (53%) of patients and 5/50 (10%) of controls (p-value<0.001). Increased pain with palpation of pelvic floor muscles was found in 21/30 (70%) of patients and 2/51 (4%) of controls (p-value<0.001). Pelvic floor muscle spasms were detected in 7/29 (24%) of patients and 0/51 (0%) of controls (p-value=0.004). Abdominal myofascial tension with palpation was found in 7/30 (23%) of patients, and 9/51 (18%) of controls (p-value=0.01). Abdominal myofascial pain with palpation was found in 7/30 (23%) of patients and 2/51 (4%) of controls. (p-value=0.01). Pelvic floor quick contractions were found to be of normal strength in 8/29 (28%) of patients and 23/51 (45%) of controls (p-value=0.036). Ten second contractions of the pelvic floor muscle showed the same results as for the quick contraction.
Conclusions
Men with CPPS have more abnormal pelvic floor and abdominal muscular pathologic findings as compared with a group of men without pain.
Addendum
It was decided that blinding the PT during evaluations would be useful to further validate the data. Starting in July 2000, the Physical Therapist was blinded for evaluations. A preliminary look at that data indicates that many of the findings continue to follow the trends described above.
Supported by the Paul G. Allen Foundation for Medical Research

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