title: Use of pelvic floor ultrasound to assess pelvic floor muscle function in Urological Chronic Pelvic Pain Syndrome in men.
abstract: BACKGROUND
  An important cause or maintaining factor for pain in Urological Chronic Pelvic Pain Syndrome (UCPPS) may be pelvic floor muscle (PFM) dysfunction, which may also be implicated in sexual dysfunction and influenced by psychosocial factors. Pelvic floor ultrasound is a noninvasive, reliable, and relatively simple method to assess PFM morphology and function and can be assessed by the anorectal angle (ARA) and levator plate angle (LPA).
  
  
  OBJECTIVE
  The aim of the present study was to examine PFM morphology in men with UCPPS as compared with controls and to examine the correlation with pain and psychosocial measures.
  
  
  METHODS
  Our participants were 24 men with UCPPS and 26 controls. A GE Voluson E8 ultrasound probe was placed on the perineum, and three-dimensional images were taken at rest and during PFM contraction.
  
  
  METHODS
  The main outcomes were ARA and LPA at rest and contraction. Participants also completed the National Institute of Health (NIH) Chronic Prostatitis Symptom Index, Male Sexual Health Questionnaire, State Anxiety Inventory, and Pain Catastrophizing Scale.
  
  
  RESULTS
  Men with UCPPS had more acute ARAs than controls both at rest and during contraction. The two groups did not differ in LPA at rest; however, men with UCPPS had significantly more acute angles during contraction and LP excursion. Acute ARAs were positively correlated with greater pain report and sexual dysfunction. Anxiety was correlated with more acute ARAs and more obtuse LPAs.
  
  
  CONCLUSIONS
  Three implications can be drawn from the findings. First, ARA at rest and during contraction as well as LP angle during contraction and LPA excursion separates men with UCPPS from controls. Second, ARA at rest and during contraction was correlated with pain and sexual dysfunction, while LPA at rest was related to anxiety. Third, pelvic floor ultrasound has the potential to be a useful and objective method of assessing PFM morphology in UCPPS.
authors: Department of Psychology, McGill University, Montreal, QC, Canada. seth.davis@mail.mcgill.ca
authors: Seth N
authors: SN
authors: Davis
authors: Melanie
authors: M
authors: Morin
authors: Yitzchak M
authors: YM
authors: Binik
authors: Samir
authors: S
authors: Khalife
authors: Serge
authors: S
authors: Carrier
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D059350:Chronic Pain / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D008297:Male; D009119:Muscle Contraction / Q000502:physiology; D018482:Muscle, Skeletal / Q000000981:diagnostic imaging* / Q000503:physiopathology; D015588:Observer Variation; D010147:Pain Measurement / Q000379:methods; D017773:Pelvic Floor / Q000033:anatomy & histology / Q000000981:diagnostic imaging* / Q000503:physiopathology; D017699:Pelvic Pain / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011472:Prostatitis / Q000000981:diagnostic imaging / Q000503:physiopathology; D011584:Psychology; D013577:Syndrome; D014463:Ultrasonography