Brian P. Jacob, David C. Chen, Bruce Ramshaw, Shirin Towfigh (eds.) - The SAGES Manual of Groin Pain-Springer International Publishing (2016)

10. Groin Pain Etiology: Spermatic Cord and Testicular Causes
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(CP). However, with new understanding of the pelvic floor, symptoms
previously described as idiopathic chronic scrotal pain are now being
classified within CPPS as chronic scrotal pain syndrome (CSPS) . The EAU
definitions of chronic pelvic pain are listed in Table 10.4 [78 ].
Isolated pelvic organ complaints may link to a more generalized pelvic
floor dysfunction. For example, Planken and colleagues found that of
41 patients with chronic testicular pain, 93 % had at least one symptom
Table 10.4. European Association of Urology definitions of chronic pelvic pain.
Terminology
Chronic pelvic
pain
Pelvic pain
syndrome
Bladder pain
syndrome
Prostate pain
syndrome
Scrotal pain
syndrome
Pelvic floor
muscle pain
syndrome
Description
Nonmalignant pain perceived in structures related to the pelvis
of both males and females. In the case of documented
nociceptive pain that becomes chronic, pain must have been
continuous or recurrent for at least 6 months. If nonacute and
central sensitization pain mechanisms are well documented,
the pain may be regarded as chronic, irrespective of the time
period. In all cases, there are often associated negative
cognitive, behavioral, sexual, and emotional consequences.
Chronic pelvic pain is subdivided into pelvic pain syndromes
and non-pelvic pain syndromes
Persistent or recurrent episodic pelvic pain associated with
symptoms suggesting lower urinary tract, sexual, bowel,
or gynecological dysfunctions. No proven infection or other
obvious pathology
Suprapubic pain is related to bladder filling accompanied by
other symptoms such as increased daytime and nighttime
frequency. No proven urinary infection or other obvious
pathology
Persistent or recurrent episodic prostate pain, associated
with symptoms suggestive of urinary tract and/or sexual
dysfunction. No proven infection or other obvious pathology.
Definition adapted from the NIH consensus definition and
classification of prostatitis and includes conditions described
as “chronic pelvic pain syndrome”
Persistent or recurrent episodic scrotal pain associated with
symptoms suggestive of urinary tract or sexual dysfunction.
No proven epididymoorchitis or other obvious pathology
Persistent or recurrent episodic pelvic floor pain with associated
trigger points either related to the micturition cycle or
associated with symptoms suggestive of urinary tract, bowel,
or sexual dysfunction. No proven infection other obvious
pathology
From Fall et al. [ 78 ] with kind permission from the EAU
NIH U.S. National Institutes of Health