Male Chronic Pelvic Pain: AUA Guideline: Part I Evaluation and Management Approach

Abstract

Purpose: This Guideline covers the evaluation and treatment of men who present to a clinician with a complaint of chronic pelvic pain. This is Part I of a three-part series focusing on the evaluation of such patients. The presentation of these men is widely variable. In addition to pelvic pain, they may also have pain in many body areas outside of the pelvis. The wide variety of clinical presentations and multidisciplinary diagnostic and treatment considerations makes management challenging. For discussion of treatment of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and treatment of chronic scrotal content pain (CSCP), refer to Parts II and II of this series.

Materials and methods: The systematic review that informs the Guideline statements was based on searches in Ovid MEDLINE (1946 to June 6, 2023), the Cochrane Central Register of Controlled Trials (through May 2023), and the Cochrane Database of Systematic Reviews (through May 2023). An updated search was conducted in June 2024.

Results: The Chronic Pelvic Pain Panel developed evidence- and consensus-based statements to provide guidance for the diagnosis and evaluation of male patients who experience chronic pelvic pain.

Conclusions: While the etiology of chronic pelvic pain is unknown, clinicians have a much better understanding of the pathophysiology from the last 25 years of research. Further progress in diagnosis and evaluation of men with suspected CP/CPPS and CSCP will require better understanding of what is causing persistence of the pain in addition to investigation of associated conditions.