International Urology and Nephrology, 2025/11, 57(11):3521–3531. doi: 10.1007/s11255-025-04521-2, type of study: ,css,

Free full text   (https://link.springer.com/article/10.1007/s11255-025-04521-2)

Keywords:

chronic pain [324]
coccydynia [7]
cross sectional study [894]
diagnosis [412]
pelvic floor [26]
pelvic pain [72]
sacrococcygeal symphysis [1]
sacroiliac joint [76]

Abstract:

OBJECTIVE: This study examines the prevalence of abnormal palpatory findings (APFs) in the different pelvic areas among individuals with chronic pelvic pain syndrome (CPP-CPPS) and assesses correlations between APFs and clinical and psychosocial symptoms. METHODS: In this cross-sectional study, 326 participants (162 CPP-CPPS patients, 164 controls) underwent a standardized palpatory assessment of the sacroiliac, sacrococcygeal, and pelvic floor regions. The manual procedure was performed by two expert physiotherapists with a certification in osteopathic manipulation, following a consensus training. We assessed symptom severity and psychosocial variables using the NIH Chronic Prostatitis Symptom Index (NIH-CPSI), the Hospital Anxiety and Depression Scale (HADS), and the Fear Avoidance Belief Questionnaire (FABQ). Correlation analyses explored relationships between APFs, the presence of pain, and psychosocial variables. RESULTS: APFs were significantly associated with CPP/CPPS, particularly in the sacrococcygeal (r = 0.609, p < 0.01) and pelvic floor (r = 0.620, p < 0.01) regions, indicating a moderate-to-strong correlation. The multivariate analysis confirmed that sacrococcygeal APFs (OR 3.02, 95% CI 1.96-4.65, p < 0.001) and pelvic floor APFs (OR 2.99, 95% CI 1.87-4.78, p < 0.001) were independently associated with CPP/CPPS, whereas sacroiliac findings showed a weak correlation. The correlations between APFs and psychosocial issues (anxiety, depression, fear-avoidance) were weak (r = 0.25). CONCLUSIONS: Sacrococcygeal and pelvic floor APFs appear to be important clinical markers of CPP/CPPS. Their presence may help identify patients who could benefit from targeted manual therapy as part of multimodal management. Further research should evaluate the prognostic value of these findings.