IC/BPS in Men

Interstitial cystitis/bladder pain syndrome (IC/BPS) affects both women and men—and both girls and boys. Though IC/BPS has traditionally been considered a “women’s” disease, men also get IC/BPS. For both sexes, many of the challenges are similar, even with regard to intimacy-related pain.

But men with IC/BPS face challenges of their own. The IC/BPS diagnosis is often missed because IC/BPS is less common in men than in women, and its symptoms overlap with those of more common conditions in men. In addition, men face their own obstacles in IC/BPS and pelvic pain control.

IC/BPS 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/BPS?

CP/CPPS is a relatively new term used to describe what used to be called prostatodynia or chronic nonbacterial prostatitis.

Some researchers believe that CP/CPPS and IC/BPS may really be the same condition, or at least that a significant percentage men diagnosed with CP/CPPS actually have IC/BPS. On the other hand, study of the IC/BPS urine marker antiproliferative factor (APF) in men showed differences. Men with definite IC/BPS 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/BPS had APF and should have been classified as having IC/BPS.

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/BPS. Clinical experience suggests that if these patients are treated specifically for IC/BPS, 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/BPS as a diagnosis.

Men & Pain Control

Men are more reluctant than women to say they have pain and may be less apt to share that they have bladder and pelvic pain. Sociological studies show that this tendency is ingrained early. By age five or six, 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 that men’s coping skills are not as well developed women’s. 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/BPS. For men, however, getting treatment for these kinds of 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 IC/BPS and pelvic floor 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 more difficulty in continuing this kind of therapy on their own.