Imaging of Male Chronic Pelvic Pain

Integrating Electromyography and Sonographic Imaging for Evidence-Based Physical Therapy for Chronic Pelvic Pain

Principal Investigator: Shawn Roll

Funding Source: USC Keck School of Medicine-Southern California Clinical Translational Science Institute (SC CTSI)

Project Period: 07/01/2012 – 06/30/2013

Award Number:

Total Award: $30,000

Co-Investigators: Jason Kutch

Specific Aim: To identify a set of neuromuscular biomarkers for chronic prostatitis/chronic pelvic pain syndrome patients using sonographic imaging and electromyographic recording that will enhance the current clinical phenotyping system for referral and treatment of patients with this pain syndrome.

Abstract: Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) is present in 6-12% of men and is the most frequent urological diagnosis for men younger than 50 years old. CP/CPPS significantly reduces quality of life, even below that of other prevalent chronic conditions (e.g. congestive heart failure, diabetes). CP/CPPS patients are a highly heterogeneous group, with varied pathophysiology. One identified mechanism for CP/CPPS is involuntary localized neuromuscular activity. Physical therapy has emerged as one primary treatment modality for CP/CPPS, but up to 41% of patients report little to no improvement or a worsening of symptoms after a course of physical therapy treatment. There is currently no method for stratifying CP/CPPS patients to ensure that appropriate treatments are being provided. There is an urgent need to identify patients, before treatment begins, who are likely to respond positively to physical therapy. We aim to identify a set of neuromuscular biomarkers for CP/CPPS patients using sonographic imaging (i.e. 2D & 3D, spectral analysis, and elastography) and EMG recording, and to determine the ability of neuromusuclar biomarkers to enhance current clinical phenotyping.