Aim: Examine the effects of treating underlying neuromuscular dysfunction in chronic pelvic pain (CPP) patients.Methods: A retrospective longitudinal study of 200 female and male patients with CPP was performed upon an Institutional Review Board (IRB) approval (IRB# 17-0761). The outpatient protocol consisted of ultrasound-guided trigger point injections to the pelvic floor musculature with peripheral nerve blocks once a week for 6 weeks in an outpatient setting. Pelvic pain and functionality were measured before and after treatment using the Visual Analogue Scale and the Functional Pelvic Pain Scale. Functionality categories assessed were intercourse, bladder, bowel, working, walking, running, lifting, and sleeping. Results: Pretreatment, mean VAS score was 6.44 (standard deviation [SD] = 2.50; p < 0.05, 95% confidence interval [CI] = 6.09-6.79). Posttreatment mean VAS score was 4.25 (SD = 2.63; p < 0.05, 95% CI = 3.88-4.61). The mean FPPS score before treatment was 10.77 (SD = 6.39; p < 0.05, 95% CI = 9.88-11.65). Posttreatment mean FPPS score was 7.42 (SD = 5.87; p < 0.05, 95% CI = 6.61-8.23). Analysis of subcategories within FPPS indicated statistically significant improvement in the categories of intercourse, working, and sleeping. Conclusion: Findings show the treatment was efficient at decreasing pain in CPP patients. Results show promise for improving overall pelvic functionality, particularly within the categories of intercourse, sleeping, and working. K E Y W O R D S chronic pelvic pain, chronic prostatitis, endometriosis, pelvic floor dysfunction, pelvic floor myalgia, pelvic pain 1 | INTRODUCTION Chronic Pelvic Pain (CPP) is characterized by noncyclical pain in the pelvis or abdomen present for 3-6 months, interfering with daily function. 1 CPP is also known as Urological Chronic Pelvic Pain (UCPPS) and Chronic Pelvic Pain Syndrome (CPPS), 2 for the purposes of this study, CPP will be the consistent nomenclature. Rather than being perceived as a single disorder, CPP should be viewed as a pattern of symptoms caused by overlapping

Understanding the complex, multifactorial nature of chronic pelvic pain can help physicians determine the pain's etiology and thus refer specialists to include in the multidisciplinary treatment required.

Objectives: Bladder pain syndrome (BPS)/interstitial cystitis (IC) is a debilitating condition characterised by bladder/pelvic pain and pressure as well as persistent or recurrent urinary symptoms in the absence of an identifiable cause. It is hypothesised that in addition to organ specific visceral hypersensitivity, contributions of the hypertonic pelvic floor, peripheral sensitisation, and central sensitisation exacerbate this condition. The aim of this paper is to investigate outcomes of treating underlying neuromuscular dysfunction and neuro-plastic mechanisms in BPS/IC patients.Methods: A retrospective chart review of 84 patients referred to an outpatient pelvic rehabilitation centre with a diagnosis of BPS/IC given to them by a urologist. All 84 patients failed to progress after completing 6 weeks of pelvic floor physical therapy and underwent an institutional review board approved protocol (IRB# 17-0761) consisting of external ultrasound-guided trigger point injections to the pelvic floor musculature, peripheral nerve blocks of the pudendal and posterior femoral cutaneous nerves and continued pelvic floor physical therapy once weekly for 6 weeks. Pelvic pain intensity and functionality were measured pretreatment and 3 months posttreatment using Visual Analogue Scale (VAS) and Functional Pelvic Pain Scale (FPPS).Results: Pretreatment, mean VAS was 6.23 AE 2.68 (95% CI 5.65 to 6.80). Posttreatment mean VAS was 3.90 AE 2.63 (95% CI 3.07-4.74). Mean FPPS before treatment was 11.98 AE 6.28 (95% CI 10.63 to 13.32). Posttreatment mean FPPS was 7. . Analysis of subcategories within FPPS indicated highest statistically significant improvement in the categories of bladder, intercourse and working.Conclusions: Analysis suggests the treatment was effective at ameliorating bladder pain and function including urinary urgency, frequency, and burning in BPS/IC patients.

The purpose of this paper is to evaluate the efficacy of a multimodal, outpatient neuromuscular protocol in treating remaining sensitization and myofascial pain in endometriosis patients post-surgical excision. Patients and Methods: A retrospective longitudinal study was conducted for women aged 22 to 78 with a history of surgically excised endometriosis. 60 women with an average duration of pain of 8.63 ± 7.65 years underwent a treatment protocol consisting of ultrasound guided trigger point injections, peripheral nerve blocks, and pelvic floor physical therapy for 6 weeks. Concomitant cognitive behavioral therapy once weekly for a total of 12 weeks was also undertaken. Pain intensity and pelvic functionality were assessed at new patient consults and 3-month follow ups using Visual Analogue Scale (VAS) and Functional Pelvic Pain Scale (FPPS).