By Jill Osborne MA

male portraitWomen with pelvic pain have long sought refuge in the offices of their Ob-Gyn when struggling with pelvic pain. Of all of the medical specialties, it is the Ob-Gyn who has the most training and experience in dealing with pelvic pain and pelvic floor disorders.

Men, however, have not had such a clear cut direction for their medical services. Their typical contact is their primary care provider who, undoubtedly, will suggest that the prostate is the root the problem. After routine medications don’t work, that man may then find himself in the office of a urologist who will explore, in-depth, the role of the prostate in triggering his symptoms. When prostate medications and treatments don’t work, where is that man to go?

If that man is lucky, he would have found himself in the offices of Robert Echenberg MD (PA) or Michael Hibner MD (AZ), both obstetrician-gynecologists who have taken a special interest in treating pelvic pain disorders. Much to their credit, they and a few of their peers opened their clinic doors to include men who were suffering from pelvic pain disorders.

Inexplicably, the American Board of Obstetrics and Gynecologists have issued new rules which now forbid certified OB-GYN’s from treating men. While the board says that it was not their intention to have doctors abandon their current patients, what it clearly shows is that THEY are, in fact, abandoning both the patients AND the doctors who are at the cutting edge of a new area of medicine, the care of pelvic pain disorders.

When the decision was first announced last summer, shock and outrage swept through the pelvic pain community. Both professionals and patients were appalled that a medical society would discourage care for the suffering. The International Pelvic Pain Society, a non-profit dedicated to the study of pelvic pain, responded with a letter to the board. They wrote “Gynecologists with the appropriate skills, experience and knowledge who choose to participate in the care of men with chronic pelvic pain should not be at risk of losing their board certification, solely because they participate in the care of patients who have a real need, suffer tremendously and have limited options for treatment.”

I agree and ask the Board to reconsider. Better yet, they should develop a working group dedicated to pelvic pain research and medical care provider training. The research is dynamic and encouraging. New diagnostic methods are finding that pelvic floor dysfunction and/or nerve entrapments are often the root cause of pelvic pain disorders in women AND men. Research studies prove that physical therapy is perhaps the most effective therapy available for pelvic pain disorders. Simply put, no other medical specialists have the experience of working in the pelvis to the degree that an Ob-Gyn does.

Sadly, some have had no choice but to stop treating men completely out of fear that they will lose their certification. We ask, “where are these men to go?”.

We can only hope that a growing number of local urologists take an interest and receive the training needed to work with these pelvic pain and pelvic floor disorders. Thankfully, at this years American Urological Association 2013 Annual Meeting, two courses provided urologists more training in pelvic pain and pelvic floor assessment. As I sat in the audience, I can share that perhaps, 250 urologists attended both courses. It’s a start but it’s very VERY small start.. and until more regional and local urologists are trained, it seems quite cruel to deny Ob-Gyn’s the opportunity to treat men.

Please help us protest. Send your letters of concern to the Board! Ask that they change this rule and support the treatment of men with pelvic pain.

Contact Information:

The American Board of Obstetrics and Gynecology
2915 Vine Street
Dallas, TX 75204

Phone: (214) 871-1619
Fax: (214) 871-1943

Read more about the decision in this New York Times Article – Men With Pelvic Pain Find a Path to Treatment Blocked by a Gynecology Board – December 10, 2013