Abstract
<jats:p>Constant or periodic chronic pelvic pain in men negatively affects quality of life and, in addition to urological pathology, may accompany conditions associated with the development of adhesions after surgical interventions on the abdominal organs. According to the literature, the prevalence of prostatitis symptoms in the male population can reach up to 14.2 %, and chronic pain can occur in 20-40 % of patients who have undergone surgery on the digestive tract. In order to evaluate the results of the study, 47 men with chronic pelvic pain who had a history of abdominal surgery were examined (of these, 24 underwent appendectomy and 23 underwent hernioplasty for inguinal hernias using synthetic mesh material), 28 of whom were treated by a urologist for chronic prostatitis/chronic pelvic pain syndrome. All male patients with chronic pelvic pain underwent comprehensive examination for chronic prostatitis and adhesive disease. The severity of symptoms and quality of life were assessed using questionnaires. Changes in the prostate gland were assessed using specific examinations (rectal examination of the prostate gland, analysis of prostate gland secretions with microbiological examination, ultrasound examination of the prostate gland). Verification of the diagnosis of adhesive disease of the abdominal cavity was performed by assessing the passage of a radiopaque barium sulfate suspension through the gastrointestinal tract (Schwartz test). It has been found that men with chronic pelvic pain do not always have urinary disorders, but this may be a manifestation of adhesions after surgical interventions on the abdominal organs and have a moderate severity of 14.5 [14.0; 17.0], thereby negatively affecting the quality of life of patients, where the median value of the quality of life score was 7.5 [6.5; 8.5]. It should be noted that most male patients with chronic pelvic pain who have undergone abdominal surgery have clinical signs such as moderate abdominal pain on palpation (60.7-84.2 %), alternating tympany with dull sound on percussion (57.1-89.5 %), and increased or decreased peristalsis on auscultation (64.3-94.7 %). Typically, intestinal peristalsis was intensified, which could have been the cause of the pain syndrome. It was found that not all men who were periodically treated by a urologist for chronic pelvic pain syndrome/chronic prostatitis had objective signs of inflammation of the prostate gland, namely, only 12 (42.6 %) had pain in the prostate gland, of which 9 had laboratory test results, namely prostate gland secretions, indicating inflammation. It should be noted that in the group of patients who did not seek help from a urologist, 26.3 % were diagnosed with signs of prostatitis. Although according to ultrasound examination of the prostate gland, some patients require additional examination, since in general, in the group of patients consulted by a urologist, half (53.6 %) and one-third (36.8 %) in the group of patients who were not examined by a urologist had a heterogeneous structure with fibrotic changes in the prostate gland, which may be the cause of chronic pelvic pain. The results of the study emphasize the need for an interdisciplinary approach in the diagnostic pathway for men with chronic pelvic pain who have undergone surgery, involving a primary care physician, surgeon, and urologist.</jats:p>