Other treatments included steroids, phytotherapy (plant-based alternative medicines), finasteride (also used to treat enlarged prostate) and gabapentinoids, which are used to treat nerve pain. The researchers found that phytotherapies and finasteride might benefit some patients, but added that more research was needed.
Another expert said the study was important because chronic pelvic pain syndrome can cause "enormous frustration" and can interfere with sexual function and overall quality of life.
"For the most part they [patients] fare well," said Dr. David Samadi, vice chairman of urology at Mount Sinai Medical Center in New York City. "Everyone's regimen is a little different. But there are patients who go on for years [with symptoms] and end up trying alternative medicines because they become desperate."
And, he added, 20 to 25 percent of patients with chronic pelvic pain fail to find effective treatment.
A very stubborn bacteria may sometimes be the cause, said Samadi, also chief of robotics and minimally invasive surgery at Mount Sinai.
"We have tried injecting antibiotics directly into the prostate" in such cases, said Samadi, "with some success." He cautioned against overusing alpha-blockers because they can cause drowsiness, headaches and low blood pressure.
Factors that predispose men to the pelvic pain syndrome include infection, hormone imbalance, allergic and immune system triggers, and psychological and hereditary traits, according to the researchers. Samadi also noted that men who are not sexually active for a long time may be a bit more prone to the syndrome.
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