Chronic Pelvic Pain Syndrome, also known as CPPS, is characterized by pelvic pain in men that persists for a minimum of three months. Chronic pelvic pain is a symptom that occurs in various health conditions, making the diagnosis of CPPS particularly challenging.

The hallmark of this condition is that urine and swab analyses do not reveal the presence of microorganisms that would indicate an infection. Additionally, patients diagnosed with CPPS do not produce defensive cells that the body typically generates in increased quantities during an infection.

Read on to discover the main symptoms of CPPS, how this condition is treated, and whether it can be caused by chronic prostatitis.

Chronic pelvic pain is the primary symptom of CPPS.

Chronic Pelvic Pain Syndrome can occur in men regardless of age, but it most commonly manifests between the ages of 35 and 45.

Symptoms of CPPS may include discomfort and pain in the pelvic region, difficulties with urination, as well as pain during ejaculation and erectile dysfunction.

However, the main symptom is undoubtedly pelvic pain, which patients often describe as:

  • Pain in the pelvic bone
  • Pain in the pelvis and legs
  • Pain in the pelvis and back
  • Pain in the sitting part of the pelvis
  • Right-sided pelvic pain
  • Pain in the pelvis and loins
  • Pain in the pelvic bone
  • Pain in the lower pelvis

The pain may extend throughout the lower back and buttocks, making sitting uncomfortable. Additionally, pain may be present in the perineum, testicles, pubic bone area, or bladder. One characteristic of this condition may be the spontaneous alleviation of pain, followed by the sudden return of symptoms without prior warning.

Secondary symptoms include myalgia, unexplained fatigue, and a constant sensation of "tingling" in the penis. Some patients may notice a reduced desire for sex and problems with erection. Similar symptoms may indicate a condition called prostatitis.

A lack of information and awareness about this condition leads to delays in diagnosis and, consequently, treatment. Therefore, it is crucial to reconsider the presence of these symptoms and seek professional help if you experience them.

What is prostatitis?

The condition that is the most common cause of chronic pelvic pain is chronic prostatitis.

Prostatitis is a condition characterized by inflammation of the prostate, a gland located beneath the bladder in the male body. Inflammation can be acute, accompanied by rapid and intense symptom development. In the chronic form of the disease, symptoms develop more slowly but are persistent.

In cases of prostatitis, pain may occur in the area below and behind the genital organ, in the lower abdomen and back, and there may be difficulties with urination or frequent urination with smaller amounts of urine. In addition to prostatitis accompanied by chronic pelvic pain, there is also a condition known as asymptomatic inflammatory prostatitis. Namely, asymptomatic prostatitis does not manifest painful symptoms, but the presence of inflammatory cells in the prostate can be determined through analysis.

Although asymptomatic prostatitis does not lead to discomfort and pain, it can adversely affect a man's reproductive health in the long term if the problem is neglected. The diagnosis of prostatitis is based on a urological examination, interpretation of symptoms, and analysis of samples. Treatment of this condition depends on the type of prostatitis diagnosed. Antibiotics and pain relief medications may be prescribed in therapy. In addition to medications, physiotherapy can yield excellent results in certain cases.

Does prostatitis cause chronic pelvic pain syndrome?

Chronic pelvic pain syndrome (CPPS) and prostatitis can be interconnected. CPPS can be caused by various health conditions, with one of the most common being prostatitis. Both CPPS and prostatitis can be either inflammatory or non-inflammatory, with or without the presence of inflammatory cells.

In addition to prostatitis, CPPS can be triggered by conditions not directly related to prostate issues.

How is the diagnosis of chronic pelvic pain syndrome established?

Diagnosing and treating CPPS pose a challenge for urologists because there is no specific test that definitively establishes the diagnosis.

Furthermore, diagnosis can take time as symptoms often misleadingly point to other conditions such as infections and inflammations.

Due to the complexity of the diagnostic process, it is crucial to choose an experienced urology specialist who can promptly provide an accurate diagnosis.

Timely diagnosis is essential for determining the course of treatment and selecting an appropriate therapeutic approach.

The treatment of CPPS, in addition to medication and physiotherapy, often involves lifestyle changes.

To establish a CPPS diagnosis, pelvic pain must be present for more than three months, with the intensity of pain varying from mild to extremely severe.

During a urological examination, it is important to inform the doctor about all details of the symptoms present to avoid the possibility of an incorrect diagnosis.

For example, frequent urination and the inability to retain urine may indicate inflammation of the bladder rather than the prostate. This way, the urologist can exclude the possibility of other diseases that present similar symptoms to CPPS.

If a patient also experiences erectile dysfunction, the urologist will assess during the diagnostic examination whether impotence is a result of CPPS or if there is suspicion of erectile dysfunction.

Discretion is guaranteed during treatment at Uronova.

Many men avoid urological examinations due to discomfort and fear of compromising their privacy during such procedures.

Uronova Center guarantees maximum discretion; during the urological examination, only the patient and the urologist are present in the room.

The ethics and professionalism of our urological team are of the highest standard, ensuring that our patients feel comfortable and secure at Uronova Center. This builds trust with patients, who will consequently feel free to share all essential information with the doctor.

Urological examinations at Uronova Center are conducted by Dr. Milan Višekruna, a specialist in urology with over 30 years of experience in treating urological conditions.

Before the examination begins, Dr. Milan Višekruna will provide the patient with information about the procedure. Patients should feel free to ask any questions or express concerns about the symptoms they are experiencing.

Timely diagnosis enables successful treatment and pain reduction.

Various factors can contribute to pelvic pain in men, including infections, inflammations, muscle issues, or nerve problems.

However, Chronic Pelvic Pain Syndrome (CPPS) is undoubtedly a condition that many men face.

Once the underlying cause is identified, chronic pelvic pain can rapidly decrease or completely disappear with the appropriate treatment approach. Establishing a timely diagnosis for chronic pelvic pain syndrome is also crucial for successful treatment.

Therefore, do not delay your visit to a urologist and overcome pelvic pain with expert assistance and support.


Schedule an appointment and consultation with urologist Dr. Milan Višekruna at phone number 062 616 804.

The entire treatment program consists of 6 painless 20-minute therapeutic procedures conducted once or twice a week, depending on the doctor's assessment of the degree of dysfunction.

The cost of each therapeutic procedure is 25,200 RSD.

The cost of the examination is 6,000 RSD.