Long term pain affecting the bladder, prostate. pelvis and genitalia can be very distressing. Key to management is identifying any cause or trigger, and then based on careful evaluation modifying lifestyle, and trialling various options to help. Patients should be fully assessed and managed by the appropriate Specialists, and a thorough history, examination and investigations including urine and blood tests, scans and possibly cystoscopy will follow. Below are some common types of pain syndrome, and links to self help and management advice.
BLADDER PAIN SYNDROME
Pain in the bladder region accompanied by either pain on bladder filling or increased urinary frequency. Infection and tumours are excluded first, and simple measures for overactve bladder (see management of urinary symptoms pages) have failed. This term has largely replaced less helpful names such as "interstitial cystitis".
PROSTATE PAIN SYNDROME
Key here is the distinction of prostatic infection - which can present acutely with pain, fever and difficulty passing urine, or with repeated bacterial infections in the urine, and can be called "bacterial prostatitis" vs the alternative of non-infective pain in the prostate or perineum (the saddle area behind the scrotum) which is more correctly known as Chronic Pelvic/Perineal Pain Syndrome. Exclusion of infection or prostate cancer, a trial of antibiotics and then other options including prostate medication, painkillers and pelvic floor relaxation exercises. can all be helpful. Below is a link to an excellent booklet from Prostate Cancer UK, though this is not a cancer diagnosis.
SCROTAL PAIN SYNDROME AND SWELLINGS
Chronic pain in the scrotum is common and can be associated with identifiable abnormalities such has cysts, fluid around the testicle (hydrocoele), varicose veins (varicocele), previous vasectomy, infection and sometimes with no identifiable cause. Careful discussion and examination is crucial to identify the trigger to pain, and identify treatment options. The link below takes you to a range of patient leaflets regarding scrotal procedures for swellings or pain.