need help, do I have CPPS..

[marki]

hi to all,

My story is a bit different.
I am 33 year old male
Excuse my english which is not that good

Last Sept 2004, I started to have burning in my Bulbourethral area. It took my urologist 2 months until he decided to do a cystoscopy going thru my urethra and found that I had a stricture in my Urethra around the bulbourethral area.
Most probably when I fell on my bike while young and had my pubic bone squich my urethra most probably caused it. And thru the years the scaring was growing.
On jan 3rd 2005, He did a laser surgery in his office which wasn't too bad and cut off the stricture. I had to have a catheter and a bag hanging down my femur for a week in order for the area to heal.
After taking off the catheter I had normal urination, "by saying normal I mean that before this procedure I used to urinate for like 30 to 45 sec, because of the stricture, but the flow was strong since my bladder got used to push more and developped more muscle mass, but now 10 to 20 sec for total bladder emptying. which is excellent. I do not find myself abnormal especially when I urinate in public places where guys around me finish by 1/2 or less than my time.

But the problem was that I was still feeling the burning sensation area for more than a month after the procedure.
But later on the burning sensation moved downward toward the penis distal to the testicles. And as well a new symptom started: pressure in my rectum/anus area giving me the sensation to have a BM but did not need to.
So I went back to the Uro and made a DRE and he said it is normal. So he tough I might have interstitial cystitis or chronic prostatitis.

So he started me on Antibiotics for a month. My pain was a bit lesser but still the same pressure and burning locations which started in my anus/rectum area, and the burning in my penis

So I assumed most probably the laser procedure area has healed, but now I had maybe having CPPS.

after finishing the antibiotics I still had the same feelings of pressure in the rectum/anus & burning in the urethra.
But a few times which really scared me , I started having some numbing (numbness) in my penis distal to my testicles till almost to the tip, at first it lasted a few minutes then gone & this repeatedly for 5 or 6 times, then another time I had this numbing for more than 8 hours.
That night I had a lot of difficulty sleeping and could not take my mind of of the numbness, I was scared of loosing sensation in my penis in the future or less blood flow to the area.

When I woke up the next day the numbness has gone, but I still went the same day to my family doctor who checked my prostate again by DRE & did blood PSA exam. DRE appeared normal and the PSA was within normal range.
He explained that I might have chronic prostatitis and if the prostate is swelling slowly it might press on the nerves which pass thru it to the perineal area that extends from the rectum/anus to the tip of the penis.
The doctor started me on 2 weeks of Flomax which the 1st week did not feel much improvement on the rectal pressure and penil burning but at least the numbness did not re-occure.
Today after 4 days of finishing 2 weeks of Flomax the numbness came back and remained for almost 4 hours???

TO SUM UP since the symptomps of rectal pressure & burning and penis burning started last march, they were kinda reducing in frequency and pain scale week by week. I had even 2 to 3 days without symptoms but
unfortunately the symptoms came back but at least in one area not both at the same time most of the time. But after urination & especially if I held my pee for a hour or so before urinating I feel burning for a couple of hours or so along with my rectal pressure.
I cannot confirm though that Flomax really helped but at least the numbness was gone while on it. And it came back as I said above 4 days after I took the last pill...
And by the way the reall relief of symptoms for a few hours is doing a SITZ bath "soaking my perineal area in warm water for 5 to 10 mins"

I am sure if some of you experienced some of my symptoms. But for the the numbness I hope someone did feel that; I hope though it wasn't related to the laser surgery, but I do not think nerves pass thru the urethra???

Please need your help.
Did not buy the book yet. not sure if really have chronic prostatitis / chronic pelvic pain syndrome
waiting for your feedbacks.

thanks

MZ

[webslave]

My guess is that you have some consequences from the laser procedure. Firstly, I'd have another uro check what's going on in your urethra: was any damage caused? If that is negative, the effect of the sitz baths suggests that you may have some sport of muscular spasm of the pelvis (including trigger points) brought on by tensing too much after the operation, perhaps trying to urinate to quickly (timing yourself against other men).

[marki]

I was willing to go and do another cystoscope, but was concerned that it might cause irritation and a lot of pain again.
almost 2 month ago, the uro passed a catheter all the way to the bladder to check if the procedure area was still fully patent.
He did that because of the burning symptoms which were still there after the procedure I though the scaring of the area was causing a stricture again.
Well it was fully patent still, but I had extreme pain, either because of the friction to the lasered area or while passing thru the prostate to reach the bladder.
The extreme pain lasted for 2 days after the passing of the catheter.

I never force myself to urinated it flows normally, I am not trying to do it faster to compare myself with other men.

With all that I described besides the numbness do I have symptoms of CPPS??


MZ

[webslave]

I know of another case where post-op pain lasted a long time after the procedure. You may have chronic prostatitis / chronic pelvic pain syndrome or you may just have an upregulated neurological response and low pain threshold because of the invasive procedures. It may take quite a while for this to settle, and I'd avoid more investigations if they result in pain.

[marki]

Thanks for the advice MARK,

I will wait a while longer before going for another check-up.

The only thing bothering me is the numbness in case it occurs again.

What do you think of Flomax??? any other drug u recommend

thanks

Marc Z

[webslave]

Try to get lorazepam and perhaps a nerve drug like gabapentin from your doctor. If the alpha blocker does not help after a few weeks, no point in continuing. This is not medical advice.

[marki]

My family doctor said that the nerves to the Perineal & penis area pass thru the Prostate??? is that 100% accurate???

If yes, does chronic prostatitis if it exists cause the numbness, and occasional pressure in rectal area & burning in the penis??


Marc Z

[webslave]

Unfortunately, the penile nerves seem to run adjacent to the urethra in the area where you may have had laser surgery.



This would imply that it's possible that the laser may have damaged the nerve.

Get a second opinion.

[marki]

Mark you have extensive reference & knowledge.

But do you think if damage has occured to some nerves passing adjacent to the Urethra?
Shouldn't symptoms have appeared within hours or days post procedure.

I only felt that numbness the first time around mid May. And I did my procedure on Jan 3, 05. (that is more than 4,5 months)

Thanks Mark for keeping on replying to my concerns

Marc Z

[webslave]

Could be scar tissue forming around nerve, constricting it. Difficult to say. This is really off topic so perhaps you need to take the issue back to a DIFFERENT urologist, and maybe a neurologist.

[sto876]

I was first diagnosed with prostatitis later on I found a new urologist
who decided to do a cystoscopy and found a stricture
I had the same procedure its called Urethrotomy
after a month I felt much better but the pain started coming back after 6 months

the reason could be because the stricture can grow back

from urologyhealth.org

"Because urethral strictures can recur at any time after surgery, patients should be monitored by a urologist. After removal of the catheter, followup of the repair should be performed intermittently with physical examination and X-ray studies being performed as necessary. Sometimes, the doctor will perform urethroscopy to evaluate the repaired area. Some patients will have recurrence of stricture at the site of the prior repair. These are sometimes mild and require no intervention, but if they cause obstruction they can be treated with urethrotomy or dilation. A repeat open surgical repair may be needed for significant recurrent strictures. "


I have some of the symptoms you describe I have been taking Bextra for the pain which seems to work most of the time . I plan to go back to the Urologist to take some test. you can email me if you have any questions

[marki]

dear Sto876

thanks for Sharing,

Myself I had my urethral procedure by Laser.
I was told it would cause less complications, heal faster, and chances of recurrence is lesser than the traditional way.
And since I was still young it is recommended.
I actually researched it and the Uro was right, more chances of recurrence with the tradiotional way.

When I went for another visit because of the same symtomps for 2 month after the procedure, he said that it might re-occure in the next 7 to 10 years but not so soon.
Nowadays I feel occasional burning after urinating, but for the last couple of weeks almost nothing. And besides the area of the surgery was in the Bulbourethral area, but my burning is felt more middle penis distal to the testicles.

But Mark had a point there if scaring is kinda affecting nerves.
While doing my procedure my wife who is a nurse was present, and she researched extensively too before we did it, and the nerves complications was never brought up in any book or website. She watched the whole procedure live on the TV monitor while it was in process. The uro was careful and took his time, all that he did was to cut off scare tissue.
eventually this is what we saw on the monitor, I hope any way he did not hit tiny nerves that we did not see or cannot be seen by the naked eye.

MZ