Chronic Pelvic Pain Syndrome

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Chronic pelvic pain syndrome (CPPS) – sometimes called prostatodonia – is an umbrella phrase used to describe chronic pelvic pain in men. But it turns out that CPPS in men is actually not a syndrome at all, as that word implies there is a discrete pallet of symptoms, and that's just not the case. Your doctor may describe your ailment as CPPS if:

  • You have a variety of long-standing symptoms, a significant number of which relate to anatomical structures located within an arbitrary radius of the prostate gland
  • He can find no objective explanation for your symptoms
  • He can offer no satisfactory treatment, let alone a cure, for your symptoms

The root cause of CPPS is unknown. Research notes that the condition’s symptoms seem to arise from the interaction between psychological factors and immune, neurologic, and endocrine system dysfunction. The alternate name, prostadonia, implied that the source of all the symptoms lies within the prostate gland, but the current research belies that.

There appears to be a genetic predisposition for CPPS. The production of inflammation-inducing compounds called cytokines is believed to play a part in the pain of CPPS, and these are regulated at the DNA level.

Autoimmunity also may play a role. Some scientists believe that the pain of CPPS is the result of the body trying to “reject” its own prostate.

Since testosterone has been shown to protect against inflammation within the prostate, it is possible that low testosterone – or a malfunctioning of testosterone's ability to reduce inflammation – may be a contributor in some cases of CPPS.

An increase in a compound known as “nerve growth factor” (NGF),  manufactured by your central nervous, can also be a source of CPPS.  NGF can cause an increase in the number and the sensitivity of the pelvic nerves that transmit pain.

...or it could all be in your head. Depression and stress have long been associated with flare-ups of CPPS. Whether it is purely psychological, or whether your stress triggered an increase in cytokine production, is more difficult to determine.

Where CPPS can be traced to inflammation within the prostate (prostatitis), the culprit is usually bacterial. In these cases, your doctor will likely prescribe a regimen of antibiotics. Your doctor may even prescribe antibiotics if your CPPS is “abacterial,” as otherwise benign bacteria have been known to trigger pain and inflammation in men with CPPS.