IC? PFD? Both? Neither?

[Hafegeo]

Hello all,

I'm new here.....in short, I'm a 34 y/o man, diagnosed in February 2007 with IC following a cystoscopy w/hydrodistention. My symptoms are frequency, with what I'd call "mild" urgency. Around mid-2004, I noticed that I had to urinate a little more frequently than I had been. I had flares in July 2005 and July 2006, and then from around Decmber 2006 on. Not coincidentally, in July 2003, I moved to my current home, where I also work. Without going into details, I walked into a very stressful situation, which has only improved somewhat in the last four years. I'm currently on Elmiron (400 mg/day) and Elavil (25 mg/day), and follow the diet to a degree.

When my uro did the cystoscopy, he found "multiple" hemorrhages, though not on the trigone. He took this as proof that I have a "classic" case of IC, as he called it. However, based upon further reading, it seems the results of a cysto/hydro are not so bulletproof, as the procedure itself can cause hemorrhaging.

Here's the odd part: since the cysto/hydro, I have had discomfort in my pelvis, almost as if the whole region is bloated. Far from being the least bit therapeutic, the procedure made things worse, in my opinion. I've had spells of urgency the likes of which I NEVER had before the cysto/hydro. In particular, my scrotum feels as if it's always swollen.

I'm starting to wonder if this is not related to the possibility of PFD, which my uro has not checked for. I mentioned the possibility two weeks ago, but he didn't seem too concerned with it. Frankly, I'm becoming more and more convinced each time that my uro is just one step behind on causes, treatments, etc.

I've started reading "A Headache in the Pelvis," which seems to make a lot of sense, since I've never had a "bladder insult" or any physical trauma to my pelvis.

Some additional details:

1. Before the cysto/hydro, I never had any sort of pain or 'discomfort' in my bladder. Since then, at times I have a 'headache in the pelvis' (no pun intended).

2. When I feel like I need to have a bowel movement, the urinary symptoms seem to vanish. Once I complete the former, the latter return.

3. I did have a UTI in 1996, which cleared up quickly with antibiotics. However, since then, I seem to suffer with a bashful bladder -- cannot use urinals -- only toilets -- in a public restroom.

Any thoughts?

[webslave]

Cystoscopy itself causes pain to a degree, so that may have tipped your fragile pelvis into borderline CPPS. Your bashful bladder shows you are the same anxious type as most of us here.

[Sleeper Service]

Hmm...

What's your frequency like? Is it daytime or nighttime or both? Do you/did you have any pain?

It could be IC but the lack of pain (at least before the distension) seems a bit odd.

[kevin]

Have you seen a pelvic floor physical therapist to look for trigger points yet? That sounds like the next step. Sounds like possible PFD.

By the way, the reaction to bowel movements has been observed pretty commonly here. I wrote about it in the following thread:

viewtopic.php?t=4584&highlight=bowel

[Hafegeo]

Thanks for the replies.

Sleeper Service,

I haven't kept track in awhile, but the most I had to urinate during the day was 26 times (that was over a year ago). I used to be able to get through the night without a visit -- now I'm up at least once, occasionally more. Never had any pain.

Kevin,

Haven't yet seen a PT. My urologist doesn't seem to keen on that, though I think I'm going to get a second opinion.

[Sleeper Service]

Ok, last question:

When you say that you 'had to go' was this the case or could you hold on? You mention 26 times in one day which is about every half hour I think.

[Hafegeo]

When it was that bad, I always felt like I had to go, although of that 26 times or so, a lot of it was dribble.