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A Comprehensive Review of the Diagnosis, Treatment, and Management of Urologic Chronic Pelvic Pain Syndrome

  • Other Pain (AD Kaye and N Vadivelu, Section Editors)
  • Published:
Current Pain and Headache Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Urologic chronic pelvic pain syndrome (UCPPS) is a chronic, noncyclic pain condition which can lead to significant patient morbidity and disability. It is defined by pain in the pelvic region, lasting for greater than 3 to 6 months, with no readily identifiable disease process. The aim of this review is to provide a comprehensive update of diagnosis and treatment of UCPPS.

Recent Findings

UCPPS encompasses chronic pelvic pain syndrome or chronic prostatitis (CP/CPPS) in men and interstitial cystitis or painful bladder syndrome (IC/PBS) in women. Underlying inflammatory, immunologic, and neuropathic components have been implicated in the pathogenesis of UCPPS.

Summary

For optimal patient management, an individualized and multimodal approach is recommended. Medical management and physical therapy are the mainstays of treatment. Injection therapy may offer additional relief in medically refractory patients. Further minimally invasive management may include spinal cord and peripheral nerve stimulation, though evidence supporting efficacy is limited.

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Authors and Affiliations

  1. Creighton University School of Medicine, Omaha, NE, USA

    Leena Adamian, Dylan Hoyt & Rebecca Driessen

  2. Beth Israel Deaconess Medical Center, Department of Anesthesia, Critical Care, and Pain Medicine, Harvard Medical School, Boston, MA, USA

    Ivan Urits & Vwaire Orhurhu

  3. Department of Anesthesiology, Mayo Clinic, Phoenix, AZ, USA

    John A. Freeman

  4. Department of Anesthesiology and Pharmacology, Toxicology, and Neurosciences, Louisiana State University School of Medicine, Shreveport, LA, USA

    Alan D. Kaye, Rachel J. Kaye & Andrew J. Garcia

  5. Department of Anesthesiology, LSU Health Shreveport, Shreveport, LA, USA

    Elyse M. Cornett

  6. Department of Anesthesiology, Creighton University School of Medicine, Omaha, NE, USA

    Omar Viswanath

  7. Valley Anesthesiology and Pain Consultants—Envision Physician Services, Phoenix, AZ, USA

    Omar Viswanath

  8. Department of Anesthesiology, University of Arizona College of Medicine–Phoenix, Phoenix, AZ, USA

    Omar Viswanath

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  1. Leena Adamian
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Correspondence to Ivan Urits.

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Conflict of Interest

Leena Adamian, Ivan Urits, Vwaire Orhurhu, Dylan Hoyt, Rebecca Driessen, John A. Freeman, Rachel J. Kaye, Andrew J. Garcia, Elyse M. Cornett, and Omar Viswanath declare no conflict of interest. Alan Kaye is a section editor for Current Headache and Pain Reports. He has not been involved in the editorial handling of this manuscript. Dr. Kaye is also a speaker for Merck.

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Adamian, L., Urits, I., Orhurhu, V. et al. A Comprehensive Review of the Diagnosis, Treatment, and Management of Urologic Chronic Pelvic Pain Syndrome. Curr Pain Headache Rep 24, 27 (2020). https://doi.org/10.1007/s11916-020-00857-9

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