Review article
Chronic Pelvic Pain in Men
Kristian Krpina
Abstract
The EAU (European Association of Urology) defines chronic pelvic pain as pain enduring at least three months, either continuous or with recurring flareups. Chronic Primary Pelvic Pain Syndrome (CPPPS) is a condition in which chronic pain exists without proven infection or another pathology. The diagnosis is based on excluding other possible causes and relying primarily on symptomatology and clinical examination. The prevalence of CPPPS in the general populace is not yet fully determined due to limited epidemiological data. Although peripheral nociceptive stimuli can trigger the development of CPPPS, many patients undergo sensitization within the central nervous system (CNS), contributing to the maintenance of symptoms and development of chronic pain, regardless of the presence of active peripheral pathology. Patient history plays a key role in the management of CPPPS. This presupposes the omission of pain related to specific diseases such as bacterial infections, malignant diseases, primary anatomical or functional disorders of the pelvic organs, and neurogenic disorders. To better understand CPPPS, various clinical models such as UPOINT classification have been developed. Assessment of pain intensity, related symptoms and therapy response can also be carried out using structured symptom assessment tests such as I-PSS, ICSI, IBS-SSS or IIEF. The treatment of CPPPS is based on a holistic approach whereby active patient participation is key. Individual facets of treatment such as psychotherapy, physiotherapy, pharmacologic or a potentially more invasive treatment must be considered as a comprehensive, personalized therapeutic strategy.
Keywords
pain, pelvis, chronic prostatitis, pharmacotherapy, quality of life
Hrčak ID:
345157
URI
Publication date:
26.2.2026.
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