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Chronic Urogenital Pain in Men
1Consultant in Pain Medicine and Anaesthesia, University College, London.
Reviews in Pain
|November 4, 2015
Summary
Chronic urological pain in men often involves central sensitization, leading to pelvic hyperalgesia and functional disturbances. Effective management requires a multidisciplinary approach, moving beyond outdated infection-focused terminology.
Area of Science:
- Urology
- Pain Medicine
- Neuroscience
Background:
- Current urological pain terminology relies on outdated 2008 guidelines, with historical terms suggesting inflammation or infection, which are infrequently identified.
- Central sensitization plays a significant role in pelvic pain, causing visceral and muscle hyperalgesia.
Purpose of the Study:
- To highlight the importance of central sensitization in chronic urological pain conditions.
- To emphasize the overlap between various urogenital pain conditions.
- To underscore the functional disturbances associated with chronic urological pain in men.
Main Methods:
- Review of current terminology and guidelines in urological pain.
- Discussion of the neurobiological mechanisms, including central sensitization.
- Analysis of the impact on urinary, bowel, and sexual function.
Main Results:
- Central sensitization is a key factor in pelvic hyperalgesia.
- Significant overlap exists between different urogenital pain syndromes.
- Chronic urological pain in men frequently presents with concurrent urinary, bowel, and sexual dysfunction.
Conclusions:
- A shift in terminology is needed, moving away from infection-based terms towards understanding central sensitization.
- Recognizing the overlap and functional disturbances is crucial for accurate diagnosis and treatment.
- A multidisciplinary team approach, including urologists, is essential for managing these complex conditions.
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