This Guideline covers the evaluation and treatment of men who present to a clinician with a complaint of chronic pelvic pain. This is Part I of a three-part series focusing on the evaluation of such patients. The presentation of these men is widely variable. In addition to pelvic pain, they may also have pain in many body areas outside of the pelvis. The wide variety of clinical presentations and multidisciplinary diagnostic and treatment considerations makes management challenging. For discussion of treatment of chronic prostatitis/ chronic pelvic pain syndrome (CP/CPPS) and treatment of chronic scrotal content pain (CSCP), refer to Parts II and II of this series.
The systematic review that informs the Guideline statements was based on searches in Ovid MEDLINE (1946 to June 6, 2023), the Cochrane Central Register of Controlled Trials (through May 2023), and the Cochrane Database of Systematic Reviews (through May 2023). An updated search was conducted in June 2024.
The Chronic Pelvic Pain Panel developed evidence- and consensus-based statements to provide guidance for the diagnosis and evaluation of male patients who experience chronic pelvic pain.
While the etiology of chronic pelvic pain is unknown, clinicians have a much better understanding of the pathophysiology from the last 25 years of research. Further progress in diagnosis and evaluation of men with suspected CP/CPPS and CSCP will require better understanding of what is causing persistence of the pain in addition to investigation of associated conditions.
The Journal of urology. 2025 Apr 17 [Epub ahead of print]
H Henry Lai, Michel A Pontari, Charles E Argoff, Larissa Bresler, Benjamin N Breyer, Roger Chou, J Quentin Clemens, Elise Jb De, R Christopher Doiron, Dane Johnson, Erin Kirkby, Susan M MacDonald, Jill H Osborne, Sijo J Parekattil, Beth Shelly
Department of Urology, Washington University Medicine, St Louis, Missouri., Department of Urology, Fox Chase-Temple Urological Institute, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania., Department of Neurology, Albany Medical Health System, Albany, New York., Department of Urology, Northwestern University, Chicago, Illinois., Department of Urology, University of California San Francisco, San Francisco, California., Pacific Northwest Evidence-Based Practice Center, Oregon Health & Science University, Portland Oregon., Department of Urology, University of Michigan, Ann Arbor, Michigan., Department of Urology, Queen's University, Ontario, Canada., American Urological Association, Linthicum, Maryland., Department of Urology, Penn State Health, Hershey, Pennsylvania., Interstitial Cystitis Network, Healdsburg, California., Avant Concierge Urology, Winter Garden, Florida., Beth Shelly Physical Therapy, Moline, Illinois.