Internal massage/Injection of Procaine/Botox:PLEASE READ

[scoobysnacks]

Hey all,

Looking for a little advice here. I have been doing my stretching, relaxation, warm baths, and internal massage.

My pain is right below the anal sphincter, or on the lower part of the anal sphincter (when I say lower I mean testicle side or 6 o clock if the tailbone area is 12). I can feel this area spasm when I try to urinate (I've put my finger there, and it actually spasms) which causes fluttering urination or stoppage of the urine, it will then releases, and allows me to go, but this refers irritation up to the urethra.

When I massage this area internally, which is probably only a 1/4 inch or 1/2 inch inside the rectum I can feel its very irritated, like wiping salt on it. If I work it for 15 mins or better (bearing down slightly to relax it) I can loosen it, and make it relax. After the massage I pee completely normal, the area relaxes and releases.

Does anyone know what this mechanism is. I know this is a muscle/or part of the sphincter involved in urination but can't figure out how this works (I also think this muscle goes into contraction upon orgasm, because orgasm releases it too for a few hours with normal peeing). I know when I pee normal, this muscle or sphincter part is relaxed and seems to move towards the testicles (which I seem to think means its releasing to allow urination). When its tight, its pulled in toward the sphincter (sphincter seems tighter too) and this results in my symptoms.

Furthermore, after internal massage if I put Prep H, extra strength, inside there, this area really relaxes and I urinate good for about 10-12 hrs.

Therefore, I'm contemplating injections of either Lidocaine into this area or Botox. This is my only problem area. I have no other areas deeper inside that hurt or ache. Just this spastic condition of this area.

Can someone shed some light on whether this may help.

Thanks

[webslave]

I'm not a great anatomist, but you may be referring to the Bulbospongiosus muscle (aka bulbocavernosus muscle) at the base of the penis.

I believe this is the area Dr Richard Berger injected with Botox. Here are the details of that clinical trial:
http://www.clinicaltrials.gov/ct/show/NCT00194623

It's interesting how the action of that muscle is described:

This muscle serves to empty the canal of the urethra, after the bladder has expelled its contents; during the greater part of the act of micturition its fibers are relaxed, and it only comes into action at the end of the process.

At the very start of my problem in 1990, the first sign of trouble was a sharp pain right at the end of urination. I've seen several other people mention that too.

[LightningTree]

Scoob, is this muscle below the prostate or are you refering to the prostate itself?

In either case, a urologist or a GP can prescribe you suppository-form hydrocortisone, which is your basic antiniflammatory. My urologist tried that with me as it sometimes works for his patients (I don't think he understood how far through muscles it had spread by then, but it was a good idea to try.)

You might be a prime candidate for such an approach. YOu could try it before you try injections.

[scoobysnacks]

Lightning,

Yep tried it. And they help for an hour or two. This is the same mechanism that the Prep H takes. Its the extra strength type that is really meant for easing of pain, it contains phenylphrine HCl and Praxomine HCl. This in conjunction with internal massage provides up to 10 hrs of relief, with mild irritation resulting in the massaged area and in the urethra.

I'm looking for a longer term fix. I'm convinced this won't get better unless this muscle can be relieved of the pain, irritation, and tightness. I know Botox is more long term, and that why I was considering talking this over with my proctologist. He is the one that identified the spasm and gave me the suppositories to begin with. My uro gave me Ativan, which helps less than the suppositories or the Prep Cream.

Now I know the problem, but don't know how to best treat it. I'm going back to the proctologist Oct 16. See what he says about these options, and then will go see uro again, too.

[LightningTree]

Ok, sounds smart. Let us know what you decide and how it goes.

[scoobysnacks]

I saw your other question.

Not referring to the prostate or a muscle really near it I dont think. This area is just right inside the rectum. I can reach it with external massage, though that isn't enough. Best relief from direct trigger point release type stuff internal to it. The prostate would be further down the rectum as I can feel it if I keep going, but no where near it, really.

[LightningTree]

I saw your other question.

Not referring to the prostate or a muscle really near it I don't think. This area is just right inside the rectum. I can reach it with external massage, though that isn't enough. Best relief from direct trigger point release type stuff internal to it. The prostate would be further down the rectum as I can feel it if I keep going, but no where near it, really.

Ahh, ok, I was just making sure I understood what you were talking about. I know exactly where you are refering to. I had trouble there for a long time. That was one of the last places to calm down.

Let us know how it goes.

[scoobysnacks]

anything special you did? With the treatments I've explained, IF, I do nothing, lay on my arse and be lazy, the muscle will calm down so that urination isn't too bad, but if I run, lift, play soccer, golf, anything I cherish doing, it gets very spastic causing the fluttering urination or even a muscle spasm right before I urinate, stopping urine flow, which will then start normal after the contraction. Very unnerving and annoying.

[webslave]

The muscle is hyper-irritable from constant contraction. You need to consciously practice relaxation, as in paradoxical relaxation.

[scoobysnacks]

easier said than done. I've been trying this for 7 mos now. Its better, but not getting better fast enough. How long should this take once youve identified the problem spot, started stretching, massage, baths, and alleviating things like lifting weights etc.

Just feel like I've taken it as far as it will go and need that extra thing to get over the hump.

Are you saying I need to give it more time?

[webslave]

You don't mention using paradoxical relaxation. Do you practise that? Be honest now ....

[scoobysnacks]

Webslave, I dont know how to do that specifically.

I have a meditative tape called The Mind Body 2.0, or something like that.

When I do this I spend 20-30 mins on my back, I start by relaxing my facial muscles and work down the body, trying to picture my body floating. I've been told when you get to that warm fuzzy feeling where you really can't "feel" your body, you are where you want to be. Its easier said that done.

Is there anymore to paradoxical than that? If so, I'm all ears.

[webslave]

That's not Paradoxical Relaxation at all. Perhaps someone else can explain.

[lookouth]

Paradoxical relaxation is a technique developed in the SP which most involves a heightened consciousness about ones pain and muscle tightness but not any attempts to directly alter it, as with traditional meditation of this sort which tells you to focus on your muscles and then focus on letting them go or relaxing them. Paradoxical, on the other hand simply asks you to focus on the specific sensations and feelings of tension and pain without trying to alter them- think of it as observing as a passive third party to the pain. Wise's theory is that this in and of itself is useful for decreasing pain and muscle tension because it teaches your body to focus on the sensations and become more aware of them, and that this is the most important step for your body to deal with them- assuming that a large part of chronic prostatitis / chronic pelvic pain syndrome muscle tension is related to the mind not being able to perceive when muscles are tensed or clenched.

This is not a full explanation of the theory but should give you an idea of how it differs from other forms of meditation that focus on relieving tension, to get a full overview you should probably buy the book AHIP if you are interested....

[scoobysnacks]

is this practiced in a meditative state or while sitting at your desk or anywhere.

I had a copy of AHIP, can't find it when I moved from my parents place a few years back.

I guess its time to re-purchase the new edition!