Radical Cure Article

Chronic Pelvic Pain Syndrome(2)

The diagnosis of CPPS is exclusive. CPPS is a common reaction to different types of damage caused by various causes. In addition to pain, patients are also often accompanied by other sensory, functional, behavioral, and psychological changes. During the diagnosis process, the clinical manifestations of each patient should be carefully recorded.
1. Medical history
The time when pelvic pain occurs, whether it is a continuous pain, intermittent pain or periodic pain;
The inducement of pain, the relationship between pain and emotional change should also be paid attention to;
Relationship between pain and body position change;
The location of the pain is limited to a specific organ or involves multiple organs in the pelvis.
If necessary, relevant quantitative tables can be used for quantification and evaluation, such as pain level (assessed by cognitive and emotional variables), international erectile function index (IIEF), intravaginal ejaculation latency (IELT), depression score, quality of life score (QOL), etc.
It is important to understand anxiety, depression, and sexual problems for pain assessment and treatment planning whether patients have suffered sexual, physical, or emotional abuse or not, and the social-psychological state when pain occurs.
2. Physical examination
Whether the pelvic pain has a clear location, if there is any organic change in the pain site, such as the size, texture, mass, tenderness of testis, epididymis, prostate, etc. Examine the trigger point of myofascial pain and the muscle pain that may span (referred pain). The function of pelvic floor muscles can be known by digital rectal examination.
3. Laboratory examination
Including urine routine analysis and urine sediment examination, EPS routine examination, four-cup (or two-cup) bacteriological examination, etc.
4. Special inspection
Including cystourethroscopy, external genitalia ultrasound, transrectal prostate ultrasound, CT, and MRI imaging if necessary. EMG is an optional CPP assistant examination.
The purpose of diagnosis is to exclude the specific diseases of pelvic pain, such as infection, tumor, etc. Once the obvious pathogenic factors are eliminated, there is no need to repeatedly or excessively concentrate on further identifying the pathogenic factors.

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