Clemens J. et al. (2000) Biofeedback, pelvic floor re-education, and bladder training for male chronic pelvic pain syndrome. Urology Vol56, Issue 6: 951-955.

This study confirms that a formalised program of neuromuscular re-education of the pelvic floor muscles together with interval bladder training can provide significant and durable improvement in objective measures of pain, urgency, and frequency in patients with CPPS.

Duclos A et al. (2007) Current treatment options in the management of chronic prostatitis. Therapeutics and Clinical Risk Management Aug;3(4):507-512.

Given current data, we favour a complete examination of the patient followed by multimodal therapy. In a treatment naive patient, a 2–4 week course of antibiotics is reasonable, but should not be continued if cultures are negative and there is no improvement in symptoms. If cultures are negative, we then use a combination of an alpha blocker (tamsulosin, alfusozin) and anti-inflammatory phytotherapy (quercetin and bee pollen, for instance 1 capsule of Q-Urol (Farr Labs, Santa Monica CA) twice daily) for 6–12 weeks. If not successful, we use neuromuscular therapies such as pelvic muscle physical therapy, amytriptiline or gabapentin. In patients who don’t respond to conventional therapy and have prostatic stones on transrectal ultrasound, we use an anti-nanobacterial therapy such as Calciclear (Calgenex Corp, Tampa FL). In the minority of patients who do not improve with these therapies, referral to a pain management specialist is appropriate.

Kim et al (2013) The Efficacy of Extracorporeal Magnetic Stimulation for Treatment of Chronic Prostatitis/Chronic Pelvic Pain Syndrome Patients Who Do Not Respond to Pharmacotherapy. Urology 82:894-898.

The finding of this study demonstrate that extracorporeal magnetic stimulation is effective in terms of the primary endpoint, total and pain scores of the National Institutes of Health Chronic Prostatitis Symptom Index. This is an important finding because CP/CPPS is one of the most difficult conditions in urologic practice.

Paick et al (2006) More effects of extracorporeal magnetic innervation and terazosin therapy than terazosin therapy alone for non-inflammatory chronic pelvic pain syndrome: a pilot study. Prostate Cancer and Prostatic Diseases 9,261-265.

ExMI therapy offers a new approach for pelvic floor stimulation that improves CP/CPPS. A longer follow-up is required to determine how long the benefits of treatment will last and whether retreatment will be necessary. In addition, the next step in future research will be to determine possible mechanisms of action of ExMI and to identify factors influencing the outcomes. The early results suggest that ExMI combined with a- blocker therapy may have better effect than a-blocker monotherapy for the treatment of CP/CPPS.

Row et al (2005) A prospective, randomised, placebo controlled, double-blind study of pelvic electromagnetic therapy for the treatment of chronic pelvic pain syndrome with 1 year of followup. J Urol. Jun:173(6):2044-7.

Results: A total of 21 men with a mean age of 47.8 years (range 25 to 67) were analysed. Mean symptom scores decreased significantly in the actively treated group at 3 months and 1 year (p <0.05), unlike the placebo group, which showed no significant change (p >0.05). Sub analysis of those receiving active treatment showed that the greatest improvement was in pain related symptoms.

Conclusion: The novel use of pelvic floor electromagnetic therapy may be a promising new noninvasive option for chronic pelvic pain syndrome in men.