Impaired Ability to Relax Pelvic Floor Muscles in Men with Chronic Prostatitis/Chronic Pelvic Pain Syndrome.

Excessive pelvic floor muscle activity has been suggested as a source of pain in chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). Our objective was to determine whether men with CP/CPPS have changes in neural drive that impair their ability to relax pelvic floor muscles.

We recruited 90 men (42 with CP/CPPS and 48 in the control group [without a history of pelvic pain]). All completed the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI). We quantified the ability to relax by comparing resting pelvic floor muscle activity under 2 conditions: a "rest-only" condition, in which participants were instructed to simply relax, and a "rest-between-contraction" condition, in which participants were instructed to rest for several seconds in between voluntary pelvic floor muscle contractions. We used multivariate mixed-effects models to examine differences between the groups (men with CP/CPPS and men in the control group) as well as the effect of 6 symptoms captured by the NIH-CPSI: pain related to location (perineum, testicles, penis, suprapubic region) and activity (urination, ejaculation).

Men with CP/CPPS were significantly different from men in the control group; men with CP/CPPS had higher resting activity in the rest-between-contraction condition than in the rest-only condition, whereas men in the control group had similar resting activities in both conditions. This effect was strongest in men who reported ejaculation-related pain, which was 70% of the CP/CPPS group.

Men without a history of pelvic pain were able to relax their pelvic floor muscles back to baseline after performing voluntary pelvic floor muscle contractions. In contrast, men with CP/CPPS, particularly those with ejaculation-related pain, had an impaired ability to relax their pelvic floor muscles.

Physical therapy. 2022 May 14 [Epub ahead of print]

Moheb S Yani, Sandrah P Eckel, Daniel J Kirages, Larissa V Rodriguez, Daniel M Corcos, Jason J Kutch

Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, 90033, USA., Division of Biostatistics, Department of Preventive Medicine, University of Southern Los Angeles, CA, 90033, USA., Department of Urology, University of Southern California, Los Angeles, CA, 90033 USA., Department of Physical Therapy & Human Movement Sciences, Northwestern University, Chicago, IL, 60611, USA.

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