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Abstract 35

Preliminary Results of Pelvic Floor Physical Therapy in the Treatment of Select Patients Diagnosed with Chronic Pelvic Pain Syndrome

JM Potts, N Fynn

Cleveland Clinic Foundation,
Department of Urology, Cleveland, OH

Introduction NIH Category III Prostatitis is also defined as Chronic Pelvic Pain Syndrome (CPPS). Dysfunctional voiding that may contribute to prostatic inflammation may be related to abnormal pelvic floor muscular tension. We reviewed the results of physical therapy that was prescribed to men previously diagnosed with prostatitis, based on clinical or urodynamic findings.

Methods Charts from 103 consecutive prostatitis consults were reviewed. Data collected included patient age, symptom characteristics, physical findings, culture results, urodynamics, and patient response to therapy. All patients were evaluated by a single medical urology.

Results Patients had a mean age of 43.7 years (ranges 21 to 71) with a duration of symptoms ranging from 7 months to 10 years. fifty-seven percent of patients were married. While pain was the prominent feature of the patients' complaints, 25/103 (24%) also reported sexual dysfunction and 55/103 (53%) reported voiding dysfunction. Based on clinical findings that included abnormal/ hyperactive anal sphincter tone (22 patients) or evidence of pseudo-dyssynergia with urodynamic testing (19/28 patients), patients were counseled about the benefits of pelvic floor exercises and referred to our department of physical therapy for evaluation and instruction. These patients had negative cultures at the time of referral. At the 3-month followup, 21/41 (51%) of patients had complied with the regimen and 15/21 (71%) had a > 50% improvement in symptoms. Only one patient continued to have persistent pelvic pain.

Conclusions While compliance with such a regimen may be difficult, physical therapy provides a safe and effective means of improving symptoms in select CPPS sufferers.