Musculoskeletal Dysfunction in Men With Chronic Pelvic Pain Syndrome Type III: A Case-control Study

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Abstract
Men with chronic pelvic pain syndrome (CPPS) type III experience pelvic pain of uncertain etiology. Pain has been attributed to prostatic, bladder and muscular origins. Few studies have documented pelvic and abdominal muscle function in men with CPPS or compared their muscular examination to that of men without pain. We hypothesized that the musculoskeletal examinations of men with CPPS types IIIA and IIIB would show more spasm, tenderness and dysfunction than in men without CPPS. A total of 62 men with CPPS and 89 healthy men without pelvic pain underwent a standardized musculoskeletal examination by a licensed physical therapist. Controls and patients with pain showed a significant difference in muscle spasm, increased muscle tone, pain with internal transrectal palpation of the pelvic muscles, and increased tension and pain with palpation of the levator ani and coccygeus muscles (p <0.001). Patients with pain also had significantly greater pain and tension with palpation of the psoas muscles and groin. Patients and controls did not differ significantly in strength testing of the lower abdominal and oblique muscles. Men with CPPS have more abnormal pelvic floor muscular findings compared with a group of men without pain. Abnormalities of the pelvic muscles may contribute to this pain syndrome.