Imaging of male pelvic pain, research in progress

Latest research and happenings
Post Reply
jcacciat
Intermediate Member
Intermediate Member
Posts: 62
Joined: Mon Jul 25, 2011 4:42 pm
Location: Des Moines, Iowa

Imaging of male pelvic pain, research in progress

Post by jcacciat »

Mates,

Here is a link to a USC research website article that describes a new study "to identify a set of neuromuscular biomarkers for chronic prostatitis/chronic pelvic pain syndrome patients using sonographic imaging and electromyographic recording that will enhance the current clinical phenotyping system for referral and treatment of patients with this pain syndrome." The article says that a significant minority of male pelvic pain patients do not respond in any meaningful way to physical therapy, and that a system needs to be designed to identify those who will respond.

http://ot.usc.edu/research/active/CPPS
Imaging of Male Chronic Pelvic Pain
Integrating Electromyography and Sonographic Imaging for Evidence-Based Physical Therapy for Chronic Pelvic Pain

Principal Investigator: Shawn Roll
Co-Investigators: Jason Kutch
Funding Source: USC Keck School of Medicine-Southern California Clinical Translational Science Institute (SC CTSI)
Project Period: 07/01/2012 – 06/30/2013
Total Award: $30,000


Specific Aim: To identify a set of neuromuscular biomarkers for chronic prostatitis/chronic pelvic pain syndrome patients using sonographic imaging and electromyographic recording that will enhance the current clinical phenotyping system for referral and treatment of patients with this pain syndrome.

Abstract: Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) is present in 6-12% of men and is the most frequent urological diagnosis for men younger than 50 years old. CP/CPPS significantly reduces quality of life, even below that of other prevalent chronic conditions (e.g. congestive heart failure, diabetes). CP/CPPS patients are a highly heterogeneous group, with varied pathophysiology. One identified mechanism for CP/CPPS is involuntary localized neuromuscular activity. Physical therapy has emerged as one primary treatment modality for CP/CPPS, but up to 41% of patients report little to no improvement or a worsening of symptoms after a course of physical therapy treatment. There is currently no method for stratifying CP/CPPS patients to ensure that appropriate treatments are being provided. There is an urgent need to identify patients, before treatment begins, who are likely to respond positively to physical therapy. We aim to identify a set of neuromuscular biomarkers for CP/CPPS patients using sonographic imaging (i.e. 2D & 3D, spectral analysis, and elastography) and EMG recording, and to determine the ability of neuromusuclar biomarkers to enhance current clinical phenotyping.
Age: 45 | Onset Age: 45 | Symptoms: Pain/discomfort in shaft, pain/pressure in perineum, rectal pain, occasional testicle pain; some frequency and nocturia (but decreasing). | Helped By: Aerobic exercise. | Worsened By: Sitting is horrible.
User avatar
webslave
Maintenance
Maintenance
Posts: 11390
Joined: Wed Oct 30, 2002 3:18 pm
Location: Please give your location so we can help better
Contact:

Re: Imaging of male pelvic pain, research in progress

Post by webslave »

  1. Not published research. Never draw conclusions from unpublished research.
  2. Investigator is an occupational therapist (not a medical doctor, not a physiotherapist).
  3. He is deriving his treatment outcomes ("up to 41% of patients report little to no improvement or a worsening of symptoms after a course of physical therapy treatment") from the Wise-Anderson studies.
  4. I suggest that you read the Wise-Anderson Protocol study abstracts I link above and decide yourself if he is justified in cherry-picking the 41% figure (he derived it from the statement: "Global response assessment revealed that 82% of subjects reported improvement (59% marked to moderate, 23% slight).")
Essentially, he took one study of men who had only 6 days of Wise-Anderson Protocol treatment and that found 59% of patients had a marked improvement, 26% had a slight improvement (so after only 6 days of treatment 83% of men were improved when asked about 6 months later), and turned it into a 41% failure rate.

Remember that the Wise-Anderson Protocol treatment is most successful after months of diligent application, not days. We have no idea how diligently these men continued with the protocol, if at all, after the initial 6-day treatment clinic. Based on what I've seen written on this forum, I'd say a significant minority of men comply poorly with the protocol, specifically in the psychological sphere (compulsive anxiety and tension).

There are some people who are not helped by the Wise Anderson treatment. If his imaging studies can identify them, it would be helpful.
HAS THIS SITE HELPED YOU?
Say Thanks! by making a small donation
PayPal link at end of page ↓
Please fill out your signature, click here for how to do it
jcacciat
Intermediate Member
Intermediate Member
Posts: 62
Joined: Mon Jul 25, 2011 4:42 pm
Location: Des Moines, Iowa

Re: Imaging of male pelvic pain, research in progress

Post by jcacciat »

Stumbled onto this and thought it would be of some interest to the forum. I didn't have the time to scrutinize, but the main point is that research to identify neuromuscular biomarkers in our population could be a good thing. He is correct that there is no method for statifying CPPS patients. But it was not my intention to cast doubt on the W-A protocol, which has brought me significant relief. I am glad that the research is aimed at neuromuscular activity.

Having said all that, I am trying to determine whether Webslave's post was intended as a lecture? Not only the 4-point dissertation ("never draw conclusions;" "I suggest you read"), but the statement that men are not complying with the protocol in the psychological sphere. It seems to me that men with compulsive anxiety need prolonged professional assistance to overcome that problem, and one of the shortcomings of the W-A program is that a person attends a 6 day immersion seminar and is sent out to the world without a lot of support or follow-up. I say this as someone who attended the clinic. It is a very useful seminar, and I would have paid the 4k just for the wand, but as treatment and recovery progress, the support is almost non-existent. Not everyone has access to local resources (pelvic floor PTs; cognitive behavioral therapists, etc.). So, my take on this is that many men can be forgiven for not overcoming compulsive anxiety using the W-A protocol as a self-treatment program.
Age: 45 | Onset Age: 45 | Symptoms: Pain/discomfort in shaft, pain/pressure in perineum, rectal pain, occasional testicle pain; some frequency and nocturia (but decreasing). | Helped By: Aerobic exercise. | Worsened By: Sitting is horrible.
User avatar
webslave
Maintenance
Maintenance
Posts: 11390
Joined: Wed Oct 30, 2002 3:18 pm
Location: Please give your location so we can help better
Contact:

Re: Imaging of male pelvic pain, research in progress

Post by webslave »

research to identify neuromuscular biomarkers in our population could be a good thing
I agreed with that in my response.
I am trying to determine whether Webslave's post was intended as a lecture?
Not at all; that's my normal mode of communication. :wink:
It seems to me that men with compulsive anxiety need prolonged professional assistance to overcome that problem, and one of the shortcomings of the W-A program is that a person attends a 6 day immersion seminar and is sent out to the world without a lot of support or follow-up
That's a valid criticism. Ongoing psychotherapy would be very expensive, I would imagine. DW had the advantage of being a psychotherapist himself, of course, when he used a form of the Wise-Anderson Protocol to cure himself.

Not sure how to fix this, other than engaging a psychotherapist long-term.
HAS THIS SITE HELPED YOU?
Say Thanks! by making a small donation
PayPal link at end of page ↓
Please fill out your signature, click here for how to do it
Post Reply