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Abstract 18

Perception of Pain in Men with Chronic Pelvic Pain Syndrome and Controls

JC Lee, C Yang, B Stromm, RE Berger

University of Washington, Department of Urology, Seattle, WA

Introduction Male Chronic Pelvic Pain Syndrome (CPPS) may be a manifestation of a more generalized pain disorder. if so, then men with CPPS may have altered pain perceptions. We used a well-established measure of pain sensitivity (von Frey hairs) and of pain response to temperature stimuli to evaluate both men with CPPS and controls.

Methods CPPS patients and controls underwent testing with von Frey hairs to establish threshold levels for sensation. They then underwent temperature stimuli testing using sequential rapid bursts of heat to a maximum temperature of 50_ C. The temperature probe was tested on the anterior thigh and on the perineum. Subjects used a computer-generated visual analog scale (COVAS) to dynamically report the discomfort they felt. The peak of the COVAS and slope were analyzed using a Mann-Whitney U test.

Results Men with CPPS reported pain sooner and at higher intensities in response to increasing heat intensity than did controls (p=0.03). CPPS men had higher peak COVAS scores on perineal testing than controls, but this difference did not reach statistical significance. There was no significant difference between CPPS patients and controls in first sensation, sharp sensation, and pain sensation using the von Frey hairs. There was also no difference in temperature testing on the anterior thigh between the two groups.

Conclusions Patients with CPPS have an altered sensation of perineal pain after temperature stimulation. This may represent an altered central nervous system processing of pain.

(Supported by the Paul Allen Foundation for Medical Research)