John J. Bauer, M.D. www.flinturology.com Urology Services, Inc. G-1121 West Hill Rd. Flint, Michigan 48507 Tel: 810.232.8888 Fax: 810.232.9190 Email: jbauer@flinturology.com [map]

---

Myofascial syndrome is a term used to describe the type of pain some men experience in their testicles, groin and prostate. Prior to this diagnosis, a thorough history, physical exam, urine tests, and occasionally, radiology tests are performed.

First, a quick anatomy lesson: sperm are made in the testicles. They then travel trough the spermatic cord and into the prostate and urethra where they are emitted during ejaculation. The spermatic cord is attached to the testicle. It runs though the groin and inguinal canal, then down to the deep pelvis where the prostate is located. Around the entire cord is a layer of muscle, called the cremasteric muscle and its fibers. The prostate also is composed of muscles and gland-forming cells.

After an injury or infection, the organs in this area become inflamed, which can cause pain. This pain can radiate anywhere along the spermatic cord, depending on the intensity of the inflammation. Often, the inflammation persists and recurs even though the original injury or infection has passed. Because all the muscles and fibers are connected, inflammation originating in the testicle can cause pain to radiate all the way up the cord and to the prostate and penis. It is not uncommon to have impotence associated with flare-ups of this condition.

Treatment for these symptoms consists of the following:

1. Antibiotics: a long course of antibiotic is required to permeate the organs involved and eradicate any persistent bacteria causing the inflammation
2. Anti-inflammatory drugs: these drugs reduce inflammation in the affected region. They must be taken regularly in order to maximally reduce the symptoms.
3. Warm soaks: Soaking the groin and bottom in a luke-warm tub for 5-10 minutes a day (at least) will allow vessels and muscles in the area to dilate. This optimizes the effect of the medications and also assists the body's own defense system.
4. Pelvic floor rehabilitation: Recently some studies have suggested that electrical stimulation therapy and extracorporeal magnetic pulsation therapy (Neotonus, Inc.) may be beneficial for chronic pain syndromes of the bladder and prostate.

While the treatment is usually effective, it is common to have occasional flare-ups that can be caused by a variety of factors. When this occurs, a repeat treatment course is often prescribed. Ongoing testing is performed to ensure that other possible problems, such as prostate cancer, are not missed. There is no known relationship between prostatitis and prostate cancer.