Table 2. Clinical Features of Functional and Chronic Anorectal and Pelvic Pain Disorders.

	Levator Ani Syndrome	Proctalgia Fugax	Interstitial Cystitis/Bladder Pain Syndrome	Chronic Prostatitis/Chronic Pelvic Pain Syndrome
Average age	30 to 60 years	Any age (rare before puberty)	45 to 60 years	Older than 50 years
Sex difference	Men<Women	Men=Women	Men<Women	Men
Pain characteristics
Quality	Vague, dull ache or pressure sensation	Cramping, gnawing, aching, or stabbing	Varying qualities of pain, pressure, or discomforta	Varying qualities of pain, pressure, or discomforta
Duration	30 minutes or longer	A few seconds to several minutes	Varying durations (from minutes to days)	Varying durations (from minutes to days)
Typical location	Rectum	Rectum	Suprapubic area	Perineum
Pain at other sites	No	No	Yes (pelvic and extragenital area)	Yes (pelvic and extragenital area)
Precipitating factors	Sitting for long periods Stress Sexual intercourse Defecation Childbirth Surgeryb	Stress Anxiety	Intake of certain foods or drinks Stress Sexual intercourse Menstrual cycle	Urination Ejaculation Stress
Associated symptoms
Urinary symptoms	No	No	Yesc	Yesc
Sexual dysfunction	No	No	Yes	Yes
Psychosocial symptoms	Possible	Possible	Yes	Yes
Physical examination
Internal pelvic tender points	Yes (puborectalisd)	No	Yes	Yes (including prostatee)
External pelvic tender points	No	No	Yes	Yes

^aAn increase in discomfort with bladder filling and relief with voiding.

^bHerniated lumbar disc, hysterectomy, or low anterior resection.

^cNo urge urinary incontinence and no response to overactive bladder treatment (eg, anticholinergics).

^dAsymmetric (left side>right side) and predictor of successful biofeedback therapy.

^eExtreme tenderness upon gentle palpation of the prostate should raise suspicion for acute bacterial prostatitis or even a prostatic abscess.