Pelvic and perineal pain in men
Bóle obszaru miednicy mniejszej i bóle krocza u mężczyzn
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Chronic pelvic and perineal pain in men include orchialgia, scrotal pain, urethral syndrome, penile pain, prostatodynia, coccygodynia, perineal pain and rectal pain. These syndromes have either well defined reasons of pain either it is difficult to determine any evident reason of pain. Recent changes in the IASP taxonomy of these syndromes was directed to change the organ classification of pain syndromes to the classification based on pathogenesis in case of the unsure diagnosis of pain. Good orientation in the neuroanatomical conditions of the pelvic and perineal region, understanding of the pathophysiology of pain let to better diagnosis and treatment, particularly rarely psychological mechanism lie on the base of the pathophysiology of perineal pain in men. Treatment can be empirical or according to the algorithms, eg. in coccygodynia. Pharmacotherapy of this pain include drugs of All steps of the analgetic WHO ladder with adjuvants use particularly In neuropathic and visceral pain. Hydroxizine, antibiotics, blockers, cimetidine, sodium pentosapolysulfate are useful in some kinds of pain syndromes. Physical therapy consist of biofeedback, realaxation, acupuncture, massage and chiropractic therapy. Interventional treatment can include: trigger points blockades, peripheral nerves blockades, radiofrequency thermolysions, stimulations of the sacral nerves, spinal cord and peripheral nerves and also a surgical treatment. Specialistic urological consultation, psychological examination and often multidisciplinary specialists access is essential to treat the perineal and pelvic pain in men.
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