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Biofeedback therapy for prostatitis is one of the available alternative treatments for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). When people do biofeedback they are trained to control their bodily functions that are usually involuntary. Patients can learn the technique to control functions such as blood pressure, brainwaves, heart rate, and certain types of muscle tension, which is why biofeedback can be helpful for cases of prostatitis that involve pelvic muscle tension.
Sometimes men unknowingly tighten their pelvic muscles when stressed, and over time this can lead to inflammation, chronic tension, and pain. The pelvic floor muscles help support the bladder and control urine flow. A biofeedback therapist can use a monitoring device with special electrodes to train men how to make voluntary changes to those pelvic muscles. The therapist can help teach men to relax those pelvic floor muscles using feedback from the electrodes. The men then can practice and gradually work to achieve the same responses without needing to use the device.
Biofeedback therapy seems to work best for conditions that are associated with chronic stress, such as CP/CPPS cases that are related to pelvic tension due to chronic stress. About 50% of CP/CPPS cases are due to pelvic tension and pelvic floor disorders. Stress and psychological health are closely related to prostatitis.
Biofeedback Therapy for Prostatitis — How Does It Work?
Experts are not exactly certain how biofeedback therapy for prostatitis, or biofeedback in general, works but relaxation seems to be the key.
A research team found that most men with CP/CPPS had pathological tenderness of the pelvic floor muscles and little or no pelvic floor function. (Zermann 1999) A following study demonstrated that men with CP/CPPS have significantly more abnormal pelvic floor musculature than men with similar pain but no CP/CPPS. Because biofeedback therapy can help train men to control their muscular tension, biofeedback provides a drug-free method that can help men with managing pelvic tension and pain.
A study on biofeedback therapy for prostatitis involved 31 men diagnosed with CP/CPPS between March 2000 and March 2004. All of the men worked one-on-one with a therapist while participating in a pelvic floor biofeedback re-education program. Their progress was evaluated after the first six to eight sessions. Researchers used a rectal electromyography (EMG) biofeedback probe to measure the resting stage of the pelvic floor muscles. The probe was also helpful for instructing the men how to relax their pelvic floor muscles.
Overall, by the end of the study the men experienced a significant improvement in their symptom scores (the Chronic Prostatitis Symptom Index: NIH-CPSI). The investigators noted, “the EMG results correlated with the NIH-CPSI score appears to emphasize that the pelvic floor plays an important role in the pathophysiology of CP/CPPS.” (Cornel 2005) The long-term results from biofeedback (along with pelvic floor re-education) seem to be good.
In another study, 11 men with CP/CPPS underwent a study of biofeedback and pelvic floor re-education. Overall, 8 out of 11 patients had an improvement in their CPSI score, and 6 patients had in improvement in their pain scores.
A recent study on biofeedback therapy for prostatitis in teens with pubertal chronic prostatitis found that lengthy consolidation sessions can help in achieving long-term success. All patients underwent 12 weeks of intensive biofeedback training. The ones who received further monthly training for 26 to 36 months had significantly better long-term outcomes in terms of pain, urination symptoms, and life-impact scores than patients who received further monthly training for only 13 to 23 months. (Wang 2013)
Uses and Side Effects of Biofeedback Therapy for Prostatitis
There are three common types of biofeedback therapy commonly used:
- Electromyography (EMG), which measures muscle tension;
- Thermal biofeedback, which measures skin temperature; and
- Electroencephalography (EEG), also called neurofeedback, which measure brain wave activity.
Men who have CP/CPPS use EMG biofeedback therapy to manage their symptoms. Using EMG does not have any major side effects associated with it. People with epilepsy or at risk for seizures should talk to their doctor before looking into an EEG.
Men with CP/CPPS can use biofeedback in conjunction with other stress management techniques and stress–relieving exercises like yoga, tai chi, or even meditation. It also may be used with other natural and alternative treatments for prostatitis, and especially complementary to pelvic floor rehabilitation. Men who employ multiple different treatment options for their CP/CPPS usually achieve the best results at overall elimination of their symptoms.
References for Biofeedback Therapy for Prostatitis:
Cornel EB et al. The effect of biofeedback physical therapy in men with chronic pelvic pain syndrome type III. Eur Urol 2005; 47: 607-11
Segura JW et al. Prostatosis, prostatitis or pelvic floor tension myalgia? J Urol 1979; 122:168
Wang J et al. Consolidation therapy is necessary following successful biofeedback treatment for pubertal chronic prostatitis patients: a 3-year follow-up study. J Int Med Res 2013 Apr;4192):410-7.
Zermann DH et al. Neurological insights into the etiology of genitourinary pain in men. J Urol 1999; 161: 903