One of the often mistaken perceptions of IC/BPS and pelvic pain is that it predominantly affects women. This, of course, is not true. An estimated 1 to 4 million men suffer from sometimes agonizing symptoms of frequency, urgency, pressure and pain. Like so many women, men often feel ignored and disrespected with subtle “be a man” messaging that they might receive from family members, friends and even doctors. Pelvic pain can certainly disrupt their ability to work, play sports, enjoy family time and enjoy intimacy, with some men describing pain so severe that it’s as if a knife is being shoved into their penis.

It’s Not Always The Prostate

Anytime a man presents with urinary symptoms, there is a presumption that their prostate is the problem. Many are prescribed antibiotics for extended periods of time despite no evidence of infection. Others may stay on prostate medications with little relief. Today, we now recognize the roles that injured nerves and muscles can play in male pelvic pain, that pain can originate outside of the bladder/prostate and is often the result of past pelvic injuries (i.e. football, bike riding, falls, etc.). With proper treatment, many men can find relief.

“We usually think of pain in response to tissue injury that resolves with healing, but we now know that pain can also derive from a neurologic origin,” notes Dr. Michel Pontari. “As our understanding of the underlying causes of chronic pelvic pain continues to evolve, we’ll gain a greater understanding of effective treatment strategies to improve overall patient quality of life.”

New Guidelines Will Improve Diagnosis & Treatment

We are delighted to announce the release of the 2025 AUA Guidelines on Chronic Pelvic Pain in Men. I was honored to be invited to serve on this committee with many of the best clinicians and researchers in the world. This document is a game changer that will help clinicians identify the underlying cause of pelvic pain and provide the most effective treatments for each individual patient. It is particularly helpful for men with more complex pelvic pain presentations and includes discussions of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and chronic scrotal content pain (CSCP).

“Chronic pelvic pain, including chronic prostatitis and chronic scrotal pain, affects millions of men in the United States. The presentation is quite variable, and their management is challenging. This new Guideline provides the much-needed evidence-based approach to the diagnosis and management of male chronic pelvic pain,” said Dr. Henry Lai, chair of the Guideline.

It has 44 recommendations and is a useful reference for effective evidence-based care related to chronic pelvic pain in men, including:

  • Recommended approaches to patient evaluation, including discussion of confusable disorders for CP/CPPS and differential diagnosis of scrotal pathology.
  • Review of pelvic floor myalgia and the role of pelvic floor physical therapy.
  • Evaluation of management approaches for pelvic pain with an emphasis on shared decision-making and multi-disciplinary care.
  • Discussion of research gaps and potential future treatment options.

How You Can Help

One of the challenges that we face is getting your local doctors read the guidelines. Thus, I ask for your help. You can read the guidelines at the links below but could you also print them out and hand deliver them to your doc at your next appointment. Truly, it takes a village. If we are going to improve pelvic pain care, we must find new ways to deliver this information.

Find The Guidelines Here

The full guideline is now available at www.auanet.org/ChronicPelvicPain

Lai HH, Pontari MA, Argoff CE, et al. Male Chronic Pelvic Pain: AUA Guideline: Part I Evaluation and Management Approach. J Urol. 0(0). https://www.auajournals.org/doi/10.1097/JU.0000000000004564

Lai HH, Pontari MA, Argoff CE, et al. Male Chronic Pelvic Pain: AUA Guideline: Part II Treatment of Chronic Prostatitis/Chronic Pelvic Pain Syndrome. J Urol. 0(0).  https://www.auajournals.org/doi/10.1097/JU.0000000000004565

Lai HH, Pontari MA, Argoff CE, at al. Male Chronic Pelvic Pain: AUA Guideline: Part III Treatment of Chronic Scrotal Content Pain. J Urol. 0(0).  https://www.auajournals.org/doi/10.1097/JU.0000000000004566