Hetrick Diane C, Ciol Marcia A, Rothman Ivan, Turner Judith A, Frest Margaret, Berger Richard E
Department of Urology, University of Washington, 1959 N.E. Pacific Street, Seattle, WA 98195, USA.
J Urol. 2003 Sep;170(3):828-31. doi: 10.1097/01.ju.0000080513.13968.56.
Men with chronic pelvic pain syndrome (CPPS) type III experience pelvic pain of uncertain etiology. Pain has been attributed to prostatic, bladder and muscular origins. Few studies have documented pelvic and abdominal muscle function in men with CPPS or compared their muscular examination to that of men without pain. We hypothesized that the musculoskeletal examinations of men with CPPS types IIIA and IIIB would show more spasm, tenderness and dysfunction than in men without CPPS.
A total of 62 men with CPPS and 89 healthy men without pelvic pain underwent a standardized musculoskeletal examination by a licensed physical therapist.
Controls and patients with pain showed a significant difference in muscle spasm, increased muscle tone, pain with internal transrectal palpation of the pelvic muscles, and increased tension and pain with palpation of the levator ani and coccygeus muscles (p <0.001). Patients with pain also had significantly greater pain and tension with palpation of the psoas muscles and groin. Patients and controls did not differ significantly in strength testing of the lower abdominal and oblique muscles.
Men with CPPS have more abnormal pelvic floor muscular findings compared with a group of men without pain. Abnormalities of the pelvic muscles may contribute to this pain syndrome.
III型慢性盆腔疼痛综合征（CPPS）男性患者经历病因不明的盆腔疼痛。疼痛归因于前列腺、膀胱和肌肉起源。很少有研究记录CPPS男性患者的盆底和腹部肌肉功能，或比较他们与无疼痛男性的肌肉检查结果。我们假设，IIIA型和IIIB型CPPS男性患者的肌肉骨骼检查将显示出比无CPPS男性更多的痉挛、压痛和功能障碍。
共有62例CPPS男性患者和89例无盆腔疼痛的健康男性接受了有执照的物理治疗师的标准化肌肉骨骼检查。
对照组和疼痛患者在肌肉痉挛、肌张力增加、经直肠盆腔肌肉触诊疼痛以及提肛肌和尾骨肌触诊时张力和疼痛增加方面存在显著差异（p<0.001）。疼痛患者在腰大肌和腹股沟触诊时也有明显更大的疼痛和张力。患者和对照组在下腹部和斜肌力量测试方面无显著差异。
与一组无疼痛男性相比，CPPS男性患者有更多异常的盆底肌肉表现。盆腔肌肉异常可能导致这种疼痛综合征。
