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Improving clinical practice and service delivery
P144 Chronic pelvic pain syndrome: should we be managing patients with this complex condition?
  1. M Crofts1,
  2. K Mead2,
  3. P Horner1
  1. 1Bristol Sexual Health Centre, Bristol, UK
  2. 2University of Bristol, Bristol, UK

Abstract

Background Chronic pelvic pain syndrome (CPPS) affects 2%–6% of men who present to GUM departments. It is associated with a significant morbidity and there are no reliably effective treatments.

Aim To evaluate the management of men with CPPS attending a dedicated clinic.

Methods We performed a retrospective study on men with CPPS attending between September 2010 and November 2010. We extracted information regarding patient's clinical presentation, management and outcome. Outcome was quantified by the difference between the first and last scores generated by the National Institute of Health Chronic Prostatitis Symptoms Index (NIH-CPSI). A 4–6 point fall or a >25% reduction in score is considered significant. Scores can range between 0 and 43, with scores closer to 0 reflecting a more favourable status.

Results Notes were available for 19 men, mean age 38 years (Range 23–59 years). The average number of clinic visits prior to referral to the specialist clinic was 9 (Median 3.00), with a mean of 98 days from onset of symptoms (Range 21–365). 21% had urethritis and the mean number of courses of antibiotics prior to attendance was 3 (Range 0–15). All patients had a discussion on the aetiology of CPPS and the importance of pelvic floor relaxation. 16 patients received antibiotic therapy, 12 received α-blockers, 8 tricyclic antidepressants and 10 were referred to urology. The mean number of consultations was 8 (Range 2–35). The mean NIH-CPSI score fell by 8.1 (36%) (p<0.01). 13 out of 19 patients (68%) found a >25% improvement in their symptoms score after attending the clinic (see abstract P144 table 1).

Abstract P144 Table 1

NIH-CPSI score before and after attending dedicated clinic for CPPS

Conclusions A significant fall in NIH-CPSI was observed in men with CPPS attending a dedicated clinic indicating that this condition can be successfully managed in GUM departments. Earlier identification and effective management may lead to better outcomes.

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