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Original Research

Open Access

Urological Chronic Pelvic Pain Syndrome improves when underlying neuromuscular dysfunction is addressed in an outpatient, multimodal treatment protocol

  • Soha Patil1,2,*,
  • Gabrielle Daniel1,2
  • Julia Gonzalez Engle1,2
  • Janaki Natarajan1,2
  • Yogita Tailor1,2
  • Rakhi Vyas1,2
  • Neha James1,2
  • Erika Moody1,2
  • Allyson Shrikhande1,2

1Department of Physical Medicine and Rehabilitation, Pelvic Rehabilitation Medicine Clinical Research Foundation, West Palm Beach, FL 33409, USA

2Department of Physical Medicine and Rehabilitation, Feinstein Institute for Medical Research, Manhasset, NY 11030, USA

DOI: 10.31083/j.jomh1802050 Vol.18,Issue 2,February 2022 pp.1-8

Submitted: 27 September 2021 Accepted: 08 November 2021

Published: 28 February 2022

*Corresponding Author(s): Soha Patil E-mail:


Background: Urological chronic pelvic pain syndrome (UCPPS) combines two of the most widespread chronic urological pain disorders: interstitial cystitis (IC)/bladder pain syndrome (BPS) and chronic prostatitis (CP)/chronic pelvic pain syndrome (CPPS). This manuscript aims to assess the effectiveness of an outpatient, multimodal treatment protocol for men with UCPPS. Methods: A retrospective study of 58 male patients was done on an institutional review board approved protocol consisting of pelvic floor physical therapy (PFPT) in concomitance with the pelvic floor muscles receiving ultrasound guided trigger point injections and peripheral nerve blocks weekly for six weeks. Patients rated their levels of pelvic pain, performance, and quality of life via Visual Analogue Scale (VAS), Functional Pelvic Pain Scale (FPPS), and NIH-Chronic Prostatitis Symptom Index (NIH-CPSI) at their new patient consult and 3-month follow up. Results: Initial average VAS was 6.24 ± 2.26 and average VAS after treatment reduced to 4.25 ± 2.8. Initial average FPPS score was 9.21 ± 5.24. Final average FPPS reduced to 7.28 ± 5.03. Initial average total NIH-CPSI score was 24.55 ± 6.43 and after treatment reduced to 18.36 ± 7.62. Initial average NIH-CPSI pain, urinary symptoms, and quality of life sub scores were 11.28 ± 3.46, 3.41 ± 3.31, and 9.86 ± 2.05, respectively. After treatment, they decreased to 8.34 ± 4.14, 2.47 ± 2.45, and 7.55 ± 2.74. Differences in pre and post treatment outcomes were statistically significant. Conclusions: This shows the protocol was successful at improving pain and performance in male UCPPS patients. This supports the validity of a multimodal treatment protocol given patients failed to improve after a full course of PFPT by itself. However, they improved once PFPT was combined with other treatment modalities, alleviating the underlying neuropathic and myofascial pain seen in UCPPS.


Chronic pelvic pain syndrome; Chronic prostatitis; Pelvic floor muscle dysfunction; Male pelvic pain; Multimodal therapy; Psychometrics; Questionnaire

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Soha Patil,Gabrielle Daniel,Julia Gonzalez Engle,Janaki Natarajan,Yogita Tailor,Rakhi Vyas,Neha James,Erika Moody,Allyson Shrikhande. Urological Chronic Pelvic Pain Syndrome improves when underlying neuromuscular dysfunction is addressed in an outpatient, multimodal treatment protocol. Journal of Men's Health. 2022. 18(2);1-8.


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