Chronic pelvic and urogenital pain is more common than we think and it is a debilitating problem that has a high negative impact on the quality of life of patients. We present a typical case of ca variety of chronic urogenital pain.

A 55-year-old male patient visited our clinic with complaints of chronic pain, numbness and tingling in the pelvic area and thighs since 3 years. It started with cold sensations in the medial thighs, and later on affecting also the perineum. The pain was more severe when sitting, but sleep was undisturbed, and pain was not noticeable lying down or walking.The urologist did not find any objective cause, and based on the symptoms the diagnosis was: pudendal neuropathy. When the patient visited our clinic, his pain scored 8 on an 11-points Numeric Rating Scale (NRS).We treated this patient topically, administrating 5% amitriptyline cream once daily. The pain severity decreased more than 50% after the first application (NRS 3-4). Adding topical capsaicine 0,025% after 4 weeks, helped to decrease the pain even more.

And a further talk on the same patient:

Chronic pelvic and urogenital pain questioned

Chronic pelvic and urogenital pain is more common than previously thought. Data in a male population are rare, but epidemiological data from the USA show that 14.7% of women of reproductive age reported chronic pelvic pain and that the estimated number of female pelvic pain sufferers is 9.2 million.

Many therapists question the existence of chronic pelvic and urogenital pain in patients if the diagnostic workup does not reveal any logial pathology as in our patient.

In these cases, it is important to recognize that the patient is suffering from a chronic pain variety, localized in an arearelated to sexual function, defecation, and urination are that complians in these areas are often considered by patients to be taboo.

We are therefore grateful to our patient being to open to discuss the issue on our youtube video and thus helping other patients suffering from comparable sympsoms to find relief. 

More info on this topic.

Prof.dr. Jan M. Keppel Hesselink, MD, PhD, and David J. Kopsky, June 2010