PSYCHOSOMATIC ASPECTS OF CHRONIC PELVIC PAIN SYNDROME IN MEN

Objective to determine the clinical and psychological portrait of a male patient with psychosomatic disorders in the urogenital area.
Material and methods. 34 patients aged 18 to 38 years (mean age 29±5.2), who were followed up by urologists for a long time and underwent unproductive treatment associated with chronic prostatitis (95%), chronic pelvic pain syndrome (67%), myofascial pain syndrome (36%) and overactive bladder (3%). All patients were assessed by their mental status, the state of the emotional sphere (the level of situational and personal anxiety, the level of depression), coping behavior, they also underwent sexological counseling with an assessment of the type of sexual constitution, the nature of existing sexual disorders, disorders of psychosexual development and the state of interpersonal relationships.
Results. The vast majority of patients had anxious and suspicious character traits, felt pronounced situational (over 70% of patients) and personal (65% of patients) anxiety. Over half of the men (56%) noted a depressed mood, which was of a neurotic nature. Anxious (35%), hypochondriacal (24%), obsessive-phobic and neurasthenic (12% each) prevailed among the types of attitude towards the disease. More than half of the patients (56%) had an average type of sexual constitution, and its strong type was noted in 4% of patients. All patients had various true sexual disorders: sexual failure anxiety syndrome (53%), erectile dysfunction (51%), decreased or absent sexual desire (37%), orgasm disorders (18%), and ejaculation disorders (20%). Imaginary sexual disorders were detected in 31% of patients, and in 60% of cases, sexual disorders were mixed. The majority of men (95%) had psychosexual developmental disorders and problems in interpersonal relationships.
Conclusions. A patient with a psychosomatic disorder of the urogenital sphere, as a rule, has anxious and suspicious character traits with severe situational and personal anxiety, psychosexual development disorders, various sexual disorders, and problems in family relationships. The identified features of such patients indicate the need to involve a psychotherapist-sexologist in the diagnostic and therapeutic work, which will improve the quality of care provided and comply with the principles of an interdisciplinary approach. 

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