Study design, materials and methods
This retrospective, institutional review board approved study analyzed eight male patients aged 24-61 with UCPPS. All patients had a trial of antibiotic therapy, and had pelvic floor physical therapy pre and post taking part in the study. Patient’s scores on the Visual Analogue Scale (VAS) and Functional Pelvic Pain Scale (FPPS) were collected pre-treatment (Figure 1). While continuing physical therapy, patients underwent ultrasound guided pelvic floor trigger point injections to the iliococcygeus, pubococcygeus, and puborectalis. The first two injections combined 1% lidocaine with dexamethasone, while the next 4 injections consisted of 1%lidocaine with traumeel (a homeopathic, plant derived anti-inflammatory medication). Concomitantly, patients received peripheral nerve hydrodissection performed on the pudendal nerve and the posterior femoral cutaneous nerve. These treatments allow the nerves to reset, decreasing hypersensitivity. These treatments lasted for 6 weeks. After completion of treatment, each patient retook the VAS and FPPS.
Interpretation of results
Our results show promise for a novel, non-opiod based treatment for UCPPS by using ultrasound guided pelvic floor trigger point injections combined with peripheral nerve hydrodissection with lidocaine, traumeel, and dexamethasone along with a pelvic floor physical therapy program.