320 Male Pelvic Floor Dysfunction: The Great Masquerader

Abstract

Male pelvic floor dysfunction (PFD) can cause a variety of symptoms, often chronic pain and sexual dysfunction, leading to diminished quality of life. Our ability to successfully diagnosis and treat PFD in men is limited due to its diverse manifestations. We analyzed a cohort of male patients with PFD to better characterize the presenting symptoms. A secondary aim was to examine the effectiveness of pelvic floor physical therapy (PFPT). A retrospective review was conducted using ICD-10 codes N81.84, M62.58, and M62.89 to identify patients with PFD from 2016 to 2019. Patients were diagnosed clinically based on pain or increased tone noted on palpation of the Levator Ani muscle group. Initial visits were used to classify presenting symptoms as pain, urinary, or sexual dysfunction. At PFPT, the Colorectal-Anal Distress Inventory (CRADI-8), and Urinary Distress Inventory (UDI-6) were administered to objectively evaluate symptoms. Thirty-one male patients with PFD were identified. Surprisingly, only sixteen percent reported sexual dysfunction (Table 1), while the overwhelming majority reported urinary symptoms (93%, Table 3) and pain (87%, Table 2). Eleven patients underwent PFPT within the institution, ten of which underwent multiple treatments, allowing comparison of scores. Mean improvement on the CRADI-8 was three points and on the UDI-6 was thirteen points. Sixty percent of patients with sexual dysfunction (3/5) reported improvement with physical therapy.