Could Viagra cure chronic pelvic pain?

By ROGER DOBSON

Last updated at 09:58 28 February 2007

The impotence drug Viagra could help men suffering from pelvic pain. As many as one in ten men in the UK have pelvic pain syndrome, with symptoms including lower back and groin pain, and bladder problems.

A trial has been looking at the use of the drug — originally developed to help angina patients, but now widely used to treat impotence — to see if it can help to open the constricted blood vessels that may be the source of the discomfort.

• At £50 for four, Viagra goes on sale in the high street

'The idea of using Viagra for chronic pelvic pain is very interesting,' says Raj Persad, consultant urologist at Bristol Royal Infirmary and Southmead Hospital. 'It is one of a number of new uses of the drug being looked at and there may well be more.'

Pelvic pain syndrome is the most common urological problem diagnosed in men under 50, and affects up to 10per cent of men in the UK. A report from the Cleveland Clinic in America says 50 per cent of men will experience symptoms during their life.

The condition comes in two forms - acute and chronic. In the acute type, known as prostatitis, symptoms come quickly and pain is felt in the lower back and abdomen - there can be urinary problems, including difficulty passing water and erectile dysfunction.

It is associated with a bacterial infection spreading from the bladder and can be treated with antibiotics.

Chronic pelvic pain syndrome is more common. Symptoms can usually come on more slowly, but can be much more severe.

A report in the British Medical Journal described the impact of the disease on the lives of patients with the severest symptoms as comparable to that of men with heart disease.

The major problem with the chronic form is that the cause is not usually known. Most therapies are centred on easing pain - painkillers are the mainstay, but anti-depressants, anti-inflammatory drugs and beta-blockers have all been tried - and research shows they may help symptoms in some patients.

In a Washington University trial, a small number of men with chronic pelvic pain were given 50mg of Viagra a day - the dose recommended for impotence - over a three-month period.

An earlier study by other researchers, of men with erectile dysfunction problems, showed that as well as improved sexual function, they experienced a reduction in other pelvic syndrome symptoms when treated with Viagra.

The new treatment is based on the idea that one cause of pelvic pain may be constricted or narrowed blood vessels.

'Physical stress, previous pelvic surgery, radiotherapy and pelvic fractures can all cause constriction,' says Persad.

In the treatment of impotence, Viagra works by increasing blood flow to the penis. A study based on 228 men, showed that the drug can work in as little as 14 minutes. The drug and others like it have been used to treat a wide range of conditions.

Other conditions being treated with Viagra include:

PULMONARY HYPERTENSION:

Children with pulmonary arterial hypertension, which results in high blood pressure in the artery carrying blood from the heart to the lungs, are being given Viagra to open up the blood vessels.

RAYNAUD'S DISEASE:

In Raynaud's, there is an interruption of blood flow to the fingers, toes, nose or ears, when a spasm occurs in blood vessels, triggered by cold or stress.

Attacks can last hours. Patients given the drug in a German study experienced a drop in the number and length of attacks.

HEART FAILURE:

Research at Harvard University and Massachusetts General Hospital shows Viagra can improve oxygen uptake and the ability to exercise in patients with heart failure.

ENLARGED PROSTATE OR BENIGN PROSTATIC HYPERPLASIA (BPH):

As men age, the gland gets bigger and may press on the urethra, slowing the flow of urine. Studies in Germany show Viagra can relax the smooth muscles in the tissue, improving symptoms.