Author: Florian Beer
Supervisor: Dr.Thomas Frischer
Background: Urologic Pelvic pain is characterised by pain in the pelvic region associated with impaired urinary- and sexual function. Some studies showed improvement of that organ-impairment after manual therapy. Hence the European and American urological association included manual therapy as part of their recommended therapy guideline for interstitial cystitis/bladder pain syndrome. Literature also reported symptomatic improvement of patients with prostate pain syndrome through manual therapy. Aim of this literature review is to describe potential structural and/or neurovegetative mechanisms of visceral function manipulation in patients with urologic pelvic pain.
Method: The online medical libraries Pubmed, Pedro, Chochrane, GoogleScholar, Ostmed.Dr. and Osteopathic Research were searched for pathomechanisms associated with urologic pelvic pain as well as postulated mechanisms of manual therapy that could influence visceral function.
Results: The pelvic floor of most patients with urological pelvic pain exhibit myofascial triggerpoints. Subsequent dysfunction could deteriorate visceral function by functional-anatomic and neurovegetative mechanisms. Conceptionally manual therapy of the pelvic floor could improve visceral function. However, there is lack of well conducted clinical trials.
Conclusions: Triggerpoints as well as loss of function of the pelvic floor lead to typical symptoms by centrally mediated neurologic as well as local functional mechanisms. The assessment and therapy of the pelvic floor of patients with urological pelvic pain should be integrated in a manual therapy approach.