{"paper_id":"0e3e9c81-438b-4e56-9e69-73b778e6d5a4","body_text":"Abstract\nThe dilemma of managing patients with chronic pelvic pain syndromes continues to frustrate physicians confronted with these complaints. Multiple diagnoses traditionally label this condition in men and women and, typically, implicate a pelvic-organ system when, in fact, very little objective evidence for a pathophysiologic process exists. Traditional therapies, consisting of antibiotics, anti-inflammatories, and muscle relaxants, simply do not work, and their lack of efficacy compared with placebo has been documented by randomized clinical trials in the US that were sponsored by the NIH. What do we do now? This review article attempts to describe the clinical efforts of several investigators and to put their patients' outcomes in perspective, and thereby suggest alternative therapies to help these patients.\nKey Points\n-\nTraditional therapy for chronic pelvic pain (CPP) relies on conventional oral agents that have been used for many years without substantial evidence for efficacy\n-\nCarefully conducted, randomized, placebo-controlled trials show no efficacy for antibiotic therapy in nonbacterial pelvic pain syndromes\n-\nThere is clear evidence that α-blocker therapy could be beneficial in male CPP syndrome\n-\nThere is very little published evidence that CPP implies an inflammatory process, although emerging studies have demonstrated the upregulation of proinflammatory and inflammatory cytokines as well as neurotransmitters\n-\nPilot exploration of therapeutic trials designed to inhibit neuromuscular transmission of painful stimuli seem promising, but randomized, controlled studies are necessary\n-\nCPP, like other chronic pain syndromes, seems to occur as a biopsychosocial phenomenon\nThis is a preview of subscription content, access via your institution\nAccess options\nSubscribe to this journal\nReceive 12 print issues and online access\n176,64 € per year\nonly 14,72 € per issue\nBuy this article\n- Purchase on SpringerLink\n- Instant access to the full article PDF.\n39,95 €\nPrices may be subject to local taxes which are calculated during checkout\nSimilar content being viewed by others\nReferences\nSchaeffer AJ et al. 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(1999) Results of pudendal nerve neurolysis-transposition in twelve patients suffering from pudendal neuralgia. Dis Colon Rectum 42: 186–192\nAuthor information\nAuthors and Affiliations\nCorresponding author\nEthics declarations\nCompeting interests\nThe author declares no competing financial interests.\nRights and permissions\nAbout this article\nCite this article\nAnderson, R. Traditional therapy for chronic pelvic pain does not work: what do we do now?. Nat Rev Urol 3, 145–156 (2006). https://doi.org/10.1038/ncpuro0438\nReceived:\nAccepted:\nIssue date:\nDOI: https://doi.org/10.1038/ncpuro0438\nThis article is cited by\n-\nThe role of pelvic floor therapies in chronic pelvic pain syndromes\nCurrent Prostate Reports (2008)\n-\nFrequency, urgency, and pelvic pain: Treating the pelvic floor versus the epithelium\nCurrent Urology Reports (2006)","source_license":"CC0","license_restricted":false}