Men & IC
Although IC can affect both women and men and girls and boys, it has traditionally been considered a "women's" disease. For both sexes, many of the challenges are similar, even with intimacy-related pain.
But men with IC face challenges of their own. Often, the IC diagnosis is missed because IC is less common in men than women, and its symptoms overlap with those of more common conditions in men. In addition, men face their own obstacles in pain control.
Interstitial cystitis symptoms in men are similar to those experienced by women—pelvic pain, urinary urgency, and urinary frequency. But these symptoms overlap with conditions that are more common in men, especially chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), and also urinary tract and prostate infection and benign prostatic hyperplasia or prostate enlargement.
Is it CP/CPPS or IC?
CP/CPPS is a recent term used to describe what used to be called prostatodynia or chronic nonbacterial prostatitis.
Some researchers believe that CP/CPPS and IC may really be the same condition or at least that a significant percentage men diagnosed with CP/CPPS actually have IC. On the other hand, study of the IC urine marker antiproliferative factor (APF) in men showed differences. Men with definite IC had APF and men with CP/CPPS did not, but a number of men diagnosed with CP/CPPS who had voiding symptoms typical of IC had APF and should have been classified as having IC.
If a man with apparent CP/CPPS also has chronic lower urinary tract symptoms, such as urgency, frequency, nocturia, pain with bladder filling, suprapubic pressure, or painful urination, and does not respond to standard therapies for prostatitis, he may have IC. Clinical experience suggests that if these patients are treated specifically for IC, they tend to do better than if they are treated only with typical CP/CPPS therapies, such as alpha blockers
It is very important for male patients to have a thorough diagnostic workup, which may include cystoscopy and hydrodistention under general or regional anesthesia. This workup will help rule out other medical conditions and will help to rule in IC as a diagnosis.
Men and Pain Control
Men are more reluctant than women to say they have pain. Sociologic studies show that tendency is ingrained early. By age 5 or 6, boys are less likely than girls to express hurt or distress. In addition, men have been shown to be more reluctant to admit pain to women researchers—and probably to women healthcare providers—than to men. Research also shows men do not have pain coping skills as developed as women do. These tendencies mean that men may not seek pain control as soon as they need to and may need more help developing the skills to cope with it.
Just as in women, pelvic floor dysfunction and genital pain often accompany IC. For men, however, getting treatment for these pains and pain generators can be more challenging.
Physical therapy for the pelvic floor can be very helpful for both men and women, but more physical therapists are prepared to treat the dysfunction in women than in men. Because internal pelvic floor massage for men must be done through the rectum, men may be more reluctant than women to get this type of therapy or may have a more difficult time continuing this kind of therapy on their own.
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Revised May 10, 2010