Although we have come a long way in understanding and treating female pelvic pain, our knowledge of pelvic pain in men lags far behind. Once thought of as a “female disorder,” Chronic Pelvic Pain Syndrome (CPPS) – and associated sexual dysfunction – may actually affect from five to 15 per cent of men worldwide according to recent research.
In an effort to help men with CPPS, MUHC researchers and clinicians are opening a multidisciplinary sexual pain clinic for men. This innovative collaboration among a team of urologists, psychologists, and physical therapists is expected to lead to new strategies for assessment and treatment of the CPPS-related pain and sexual dysfunction.
Distancing ourselves from the prostate
Until recently, urologists were the only available resource for male CPPS sufferers. Working on the assumption that pain throughout the pelvic region must result from infection and inflammation of the prostate, health professionals diagnosed any male pelvic pain which had no identifiable cause as prostatitis, a sort of “catch-all” condition. However, in 90 per cent of reported cases, patients’ prostates appeared to be healthy.
“It was the parallel to women that struck me,” explains the clinic's lead researcher and clinician, Dr. Irv Binik, Director of the Sex and Couple Therapy Service at the MUHC and professor of psychology at McGill University. “In the past, because health care professionals couldn’t treat pelvic pain, they tended to act as if it didn’t exist. Today, nobody likes to treat these men, just as, a few years ago, nobody liked to treat these women. Why? Because there is no simple and obvious cure. Approaching this problem from a multidisciplinary front is a very positive strategy and is one that has already been proven therapeutically useful for women suffering from genital and pelvic pain.”
Managing chronic pain and relationships
For many CPPS sufferers, pain can dramatically reduce quality of life. Often located in the perineum, testicles or penis, pain can also radiate to the lower abdomen, upper legs, and lower back. It can occur with or without sexual activity and it can get in the way of even the most basic activities, including sexual relations, sports or work.
This is especially unfortunate, as most CPPS sufferers are active young men – most often in their 30s and 40s. In fact, CPPS is the most common reason why men under 50 visit a urologist. For these patients, pain and associated sexual dysfunction can cause significant psychosocial difficulties, since they are more likely than older men to be in or forming new relationships. “For men with CPPS, the mere anticipation of pain during sex can affect their relationships and sexual functioning,” adds Dr. Binik. “It can be a real problem – but one we are working to correct.”
This multidisciplinary clinic will serve both a clinical and research purpose. Patients who attend this clinic will also be considered for the research study which is expected to lead to new strategies for assessment and treatment of the CPPS-related pain and sexual dysfunction.
Patients who wish to learn more about sexual pain in men, to visit the clinic or to be involved in this study should contact:
Caroline Maykut, Research Coordinator
caroline [at] ego.psych.mcgill.ca