Cornel EB et al. (2005) The effect of biofeedback physical therapy in men with chronic pelvic pain syndrome type III. Eur Urol 47: 607–611

It has recently been suggested that (nonbacterial) chronic prostatitis (CP) or chronic pelvic pain syndrome (CPPS) may be associated with pelvic-floor muscle dysfunction. Cornel et al. therefore investigated the effect of pelvic-floor biofeedback physical therapy on men with symptoms of CPPS.

In this study, 33 men diagnosed with CP/CPPS took part in a biofeedback re-education program. The therapy consisted of six to eight sessions and included paramedical anamnesis, inspection of position, mobility and breathing technique. Patients were also taught how to relax and constrict their pelvic-floor muscles. Biofeedback measurements were performed using a one-channel electromyography biofeedback apparatus (Pelvined 932, Enraf-Nonius, The Netherlands). The National Institutes of Health–Chronic Prostatitis Symptom Index questionnaire was used to monitor the effects of therapy.

In total, 31 patients underwent the full treatment program. The results showed that mean total Chronic Prostatitis Symptom Index score decreased after treatment in 30 patients. Improvement was seen in all subdomains of the questionnaire, including pain, quality of life and micturition. Post-treatment electromyography values showed that the mean pelvic-floor muscle tonus decreased significantly.

The authors conclude that there is a significant positive effect of pelvic-floor biofeedback physical therapy for men with CP/CPPS, suggesting that the pelvic floor plays an important role in the pathopysiology of CP/CPPS. The authors note that the long-term durability of these outcomes has not yet been investigated.