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  • Category 3 non-bacterial prostatitis
  • Chronic prostatitis/chronic pelvic pain syndrome CP/CPPS
  • Levator ani syndrome
  • Prostatodynia
  • Urogential pain disorders

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  • 338.4 Chronic pain syndrome
  • 601.1 Chronic prostatitis

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  • G89.4 Chronic pain syndrome
  • N41.1 Chronic prostatitis
  • R10.2 Pelvic and perineal pain
  • Symptom specific diagnoses
    • N53.12 Painful ejaculation
    • N94.1 Dyspareunia
    • K59.4 Anal spasm

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  • 564.6 Anal spasm
  • 569.42 Anal or rectal pain
  • 719.45 Pain in joint, pelvic region and thigh
  • 724.7 Disorders of coccyx
  • 728.2 Muscular wasting and disuse atrophy, not elsewhere classified
  • 728.85 Spasm of muscle
  • 728.89 Disorders of muscle, ligament, and fascia
  • 729.1 Myalgia and myositis, unspecified
  • 729.2 Neuralgia, neuritis, and radiculitis, unspecified
  • 729.9 Other and unspecified disorders of soft tissue

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Description

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  • Pelvic pain or regional pelvic pain syndrome (perineal pain, penile pain, testicular pain, suprapubic pain, groin pain) without detectable pathology
  • No evidence of infection or inflammation

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Essentials of Diagnosis

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  • Unknown etiology
  • Rule out bacterial prostatitis and other organ pathology
  • Symptoms may be initiated by an acute infection, injury, or inflammation of a pelvic or urogential organ; however, pain persists beyond the duration of the original inciting event or disease

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General Considerations

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  • Chronic pain condition
  • Eitiology is unknown
  • Diagnosis is a process of exclusion
  • Urogenital pain disorders frequently affect nearby body areas, especially back, pelvic, hip, and groin regions
  • PT intervention is often appropriate for associated musculoskeletal impairments
  • May mimic other visceral pain conditions including colon cancer or tumor, irritable bowel, colitis

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Demographics

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  • 2% to 9% of men report prostatitis-like symptoms
  • Exact prevalence of chronic pelvic pain is not known, estimates vary in the literature from 3.8% to 24%4

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  • Report of perineal pain, penile pain, testicular pain, suprapubic pain, and/or groin pain
  • Symptoms often worsened by prolonged sitting or standing, anxiety, bowel movements, physical activity, or sexual intercourse
  • Pain that starts in the afternoon and becomes progressively worse throughout the day
  • Constellation of symptoms that include painful ejaculation, low back pain, bowel symptoms of constipation, diarrhea, excessive flatus, painful defecation or a sensation of incomplete evacuation, and urinary symptoms of frequency, urgency, or nocturia

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Signs and Symptoms

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  • Perineal pain, penile pain, testicular pain, suprapubic pain, and/or groin pain
  • Pain during sexual intercourse
  • Irritative voiding secondary to urinary discomfort, frequency, or urgency
  • Irritable bowel: diarrhea and/or constipation
  • Pelvic pain
  • Bladder pressure and pain
  • Burning with urination

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Functional Implications

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  • Pain
  • Painful urination, defecation, and sexual activity
  • Incomplete defecation or urination
  • Urinary and fecal urgency ...

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