University of Southern California
University of Southern California
USC Chan Division of Occupational Science and Occupational Therapy
USC Chan Division of Occupational Science and Occupational Therapy

Musculoskeletal Sonography and Occupational Performance Laboratory

Completed Research

Sonography for Male Chronic Pelvic Pain Syndrome

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. CP/CPPS has 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. 

Transperineal sonographic image of the male pelvic floor in two participants, depicting the muscles (ischiocavernosus, IC; bulbospongiousus, asterisk) surrounding the urethera (u) and bulb of the penis (p), and differences in the directionality of the central tendon (arrowhead)

Transperineal sonographic image of the male pelvic floor in two participants, depicting the muscles (ischiocavernosus, IC; bulbospongiousus, asterisk) surrounding the urethera (u) and bulb of the penis (p), and differences in the directionality of the central tendon (arrowhead)

Our team used sonography to evaluate the physical mechanisms underlying CP/CPPS. We developed and validated a scanning protocol to evaluate the muscles of the male pelvic floor using a transperineal approach. This protocol can be used to evaluate difference among individuals with and without CP/CPPS, as well as identify variations within patients with CP/CPPS. The approach may also be useful for targeting treatments to areas of hyper-contraction (e.g., trigger points) or as a biofeedback tool to train patients in both relaxation techniques and proper exercises for these muscles.

Funding

Integrating electromyography and sonographic imaging for evidence-based PT for CPPS
Southern California Clinical and Translational Science Initiative (SC-CTSI)
Clinical Pilot Award (Co-PIs: Kutch & Roll)
Total Funding: $30,000
Funding Period: 7/1/2012 – 6/30/2013

Publications

Journal Articles

Roll, S. C., Rana, M., Sigward, S. M., Yani, M. S., Kirages, D. J., & Kutch, J. J. (2015). Reliability of superficial male pelvic floor structural measurements using linear-array transperineal sonography. Ultrasound in Medicine & Biology, 41(2), 610-617. https://doi.org/10.1016/j.ultrasmedbio.2014.09.008 Show abstract

Roll, S. C., & Kutch, J. J. (2013). Transperineal sonography evaluation of muscles and vascularity in the male pelvic floor. Journal of Diagnostic Medical Sonography, 29(1), 3-10. https://doi.org/10.1177/8756479312472394 Show abstract

Conference Presentations/Proceedings

Roll, S. C., Rana, M., Sigward, S., Yani, M., Kirages, D., & Kutch, J. (2015). Cadaveric validation and in-vivo measurement reliability of a novel linear-array transperineal sonographic evaluation of male pelvic floor structures [Electronic poster presented at the 2015 AIUM Annual Convention and Preconvention Program Hosting WFUMB Congress]. Ultrasound in Medicine and Biology, 41(4, suppl), S103. https://doi.org/10.1016/j.ultrasmedbio.2014.12.426 Show abstract

Presentations

Roll, S. C., Rana, M., Sigward, S., Yani, M., Kirages, D., & Kutch J. (2015). Cadaveric validation and in-vivo measurement reliability of a novel linear-array transperineal sonographic evaluation of male pelvic floor structures. Research poster presented at the 15th World Congress of Ultrasound in Medicine and Biology, Orlando, FL.

Roll, S. C., & Kutch, J. J. (2014). Reliability of transperineal sonographic evaluation of male pelvic floor structures. Poster presented at USC Ostrow School of Dentistry Research Day, Los Angeles, CA.

Roll, S. C., & Kutch, J. J. (2013). Transperineal sonographic evaluation of the male pelvic floor. Poster presented at USC Ostrow School of Dentistry Research Day, Los Angeles, CA.

Rana, M., Roll, S. C., & Kutch, J. J. (2013). Identifying muscle hyperactivity in chronic pain. Poster presented at USC Ostrow School of Dentistry Research Day, Los Angeles, CA.