Q
: What ’ s chronic pelvic pain in men and what are the main symptoms ?
A
: Often called chronic prostatitis , male chronic pelvic pain syndrome ( CPPS ) can affect around 10 percent of men , most commonly those under 50 . The four main categories of symptoms in CPPS are pain , urination issues , sexual dysfunction , and other symptoms :
• The pain usually comes on suddenly and may be present on and off for months . Most often located at the perineal ( area between the scrotum and anus ), it is often described as “ like sitting on a tennis ball ”. It can also occur in other regions such as the lower abdomen , penis , scrotum , rectum , and lower back . The intensity of pain can be quite severe and bothersome .
• Urinary symptoms , such as frequent or urgent urination or slow urinary stream , are common .
• Pain during or after ejaculation , erection issues , and poorer sex drive may also be present .
• Other symptoms include generalised muscle or joint aches and unexplained fatigue .
Q
: What are the available treatments ?
A
: CPPS may be caused by bacterial infection , dysfunction of the pelvic muscles , or psychological issues , such as anxiety , stress , and depression . In an individual patient , one or more of these may be present .
As such , treatment may involve a combination of antibiotics , anti-inflammatory medication , muscle relaxants , pelvic floor physiotherapy , and psychological support .
Q
: Should patients with the condition follow a specific diet ?
A
: CPPS patients should avoid consumption of alcohol , spicy food , pepper , chilli , and coffee . They should also increase their intake of fruits , vegetables , and foods rich in natural fibres , such as dark bread , vegetables , and spinach .
Q
: Are there any lifestyles or other ways to prevent or reduce the risk of having chronic pelvic pain ?
A
: Lifestyle modifications alone may not work but are important in combination with medications , physiotherapy , and psychological therapy in the treatment of men with CPPS .
These lifestyle changes include :
• Avoid having two ejaculations during the same day .
• Avoid periods of sexual abstinence longer than four days .
• Do not try to delay ejaculation in both intercourse and masturbation .
• Avoid sports that can be traumatic for your prostate ( bicycling , motorcycling , horse riding ).
• Instead , walk and practice relaxing sport activities ( swimming , jogging , free exercises ).
• Avoid sedentary activities and sitting for long periods of time . Use a donut-shaped cushion if seated for prolonged periods or consider a standing desk .
• Avoid wearing tight underpants or trousers .
• Take hot baths or bidets which can relax and release pelvic muscle tension .
Q
: Could infertility be a side effect of chronic pelvic pain ?
A
: Chronic pelvic pain syndrome can affect the number and quality of a man ’ s sperm , leading to reduced fertility . Thus , it ’ s important for men planning to start a family to see a urologist to quickly treat this .
Q
: Do you have any advice for patients to improve their sexual health ?
A
: Avoid smoking as it can cause blockages to the blood vessels in your penis and result in erectile dysfunction .
Avoid excess alcohol consumption . As a depressant , alcohol can dampen mood , decrease sexual desire , and make it difficult for men to achieve or maintain their erections .
Exercise regularly and maintain a healthy diet . This improves the health of the blood vessels and encourages good circulation and strong erections .
Manage anxiety and stress as they can interrupt how the brain sends messages to the penis when it needs extra blood flow to get an erection .
Dr Lincoln Tan
Dr Lincoln Tan is director and consultant urologist at Tan Urology , Gleneagles Medical Centre , in Singapore .
GlobalHealthAsiaPacific . com MARCH 2022
11