IC or CPPS?

[painman]

Hey guys, I'm having trouble figuring out whether or not I have interstitial cystitis or just chronic pelvic pain without bladder damage. Frequency and urgency do affect me from time to time and my bladder area does hurt if I have a full bladder, but it's not consistent. Sometimes I'll go months with just pain but no frequency or urgency. Other times I'll go months with it. Is there any way for me to determine if I'm simply suffering from muscle-related pain or if their is a malfunction of the bladder that is the underlying cause, which in turn is causing the pelvic tensing? I asked a doctor to scope me to see if it was IC and he said only women get IC. Wasn't a very smart uro obviously. Hoping I can figure this out without going to another uro. Thanks.

[webslave]

There is not much point in discovering whether the nerves innervating the bladder are more affected than the ones innervating the prostate and urethra. The pain and inflammation of UCPPS can occur anywhere in the lower GU tract. There are urologists who still argue that IC and chronic prostatitis / chronic pelvic pain syndrome are different diseases, but others that see it as one process. I'm on the side of one process.

For instance, I too had periods of urinary urgency and frequency during the years my chronic prostatitis / chronic pelvic pain syndrome was at its worst. Cystoscopy showed that I had some inflammation around the bladder outlet as well as in the prostatic urethra, in other words I had both IC and CPPS. Women have no significant prostate (only a Skene's gland), so they call their pelvic pain syndrome "IC", whereas we, with our large prostates, tend to call it "chronic prostatitis". In actual fact, it is all Urologic Chronic Pelvic Pain Syndrome.

If the inflammation is bladder-centred, it does not mean that there is "a malfunction of the bladder that is the underlying cause" (of course it could be the case, e.g. eosinophilic cystitis, but it is rare. ) The cause is almost always outside the bladder, as in UCPPS.

[Mike Kavo]

I like that answer that sums urological pelvic pain relationship up very well in men and women. Your Urologist should have answered in this concise and precise manner but I will stop as if I get on the Urologist bashing train I will never get off it. ;)

[davyboy]

I had an ultrasound of my bladder the other day and everything was fine. No inflammation. It is possible that your urinary woes are chronic prostatitis / chronic pelvic pain syndrome muscle related (like most of us here).

[painman]

Thank you for the clarification webslave. The only thing I'm stuck on is how simply tight muscles or muscle spasm alone could cause all these issues. If I have a muscle spasm in my pectoral muscles my heart doesn't become inflamed. If I have a muscle spasm in my abdomen my lower back my kidneys don't get inflamed. So why does muscle spasm in the pelvic muscles cause the surrounding organs to become inflamed when this doesn't occur in other areas of the body? Also, the association with other conditions like fibromyalgia, CFS, and cardiovascular disease leads me to believe that something else is definitely at play that is causing this condition or is at least involved in it. Again, if i have muscle spasm in my calves my endothelial function and arterial stiffness don't degrade like in chronic prostatitis / chronic pelvic pain syndrome (as shown in this study by Dr. Shoskes). I'm not trying to challenge anyone here, I greatly appreciate your helpful responses, but these are just a few things that have been stirring in my head. I'm curious as to why these conditions often occur with CPPS.

[webslave]

Painman, please read this page carefully.
https://ucpps.men/chronic-prostatitis-is-a-psychoneuromuscular-condition

Fibro, CFS, cardiovascular effects are co-morbid because the frequent underlying cause of UCPPS is stress. Don't underestimate what stress can do to you.

[Mike Kavo]

I am not saying you are wrong but are you 100% sure spasms in other areas of the body "never" lead to localised inflammation? I have had spasms in my jaw and back and that caused me inflammation via the stress of the spasm on the surrounding soft tissue and nerves and I used NSAIDS to help calm that. Do these other areas soft tissues support the organs in the same manner as the urological organs? I have got to say I do not know enough here to agree or disagree I just think this is a big statement with a great deal of complexity in comparison and we need to be careful we stick to facts. Certainly a very interesting point though.

Dr. S does not say that much here he simply identified this situation - look for what he does not say. Cause or symptom that is a big difference. This happens to diabetics but it is not the cause of diabetes it is a symptom of it. Management of it has no direct correlation back to diabetic control. Dr. S sure has hit something but as spasms and stress compound the area he could simply have found "another chronic prostatitis / chronic pelvic pain syndrome symptom" and one that needs further study. With Dr. S's papers you need to step back they are not for patients to read really. He is a researcher he is not suggesting clinical treatments. He is simply making breadcrumbs of "fact" for future research. BTW I am not being critical of his work on the contrary the man is a hero of mine for working so hard for us guys. I am just pragmatic in how research works.

[painman]

Thanks guys, excellent responses! It had already occured to me that stress was at play in the chronic prostatitis / chronic pelvic pain syndrome co-morbidities, guess I just needed confirmation. I do suffer from Generalized Anxiety Disorder (GAD) and social anxiety and was in college taking on a huge workload when this began so it does add up. The thing that really scares me is that I get some pretty disturbing cardiac symptoms from my anxiety despite a healthy lifestyle other than the stress, although an EKG has come up normal ( not that this necessarily rules out heart disease though).

[Mike Kavo]

I often here people speak about their chronic prostatitis / chronic pelvic pain syndrome and think oh that is me they are talking about but it is themselves. You sound like me and many other men on here in the anxiety situation you face. Most of us guys are educated and work in high stress time pushed jobs. It is for me a certain factor when I am stressed I seem to clamp down on muscles in my body starting the pain cycle up. My flare in January after years of calm was certainly caused by stress. This is why Paradoxical Relaxation is a must...it can break the cycle without medication (some meds work also like Benzos etc but that is a much more risky road).

You are evidently well educated and levering those muscles here (no pun intended lol) but it might be best to stick to what we know helps and get into that over doing your own research and keeping so many "what if's" running around your head adding to your anxiety.

Nice posts. You will get better you have the brains to get there!

[painman]

Thanks Mike, I appreciate the encouragement. What have you tried for controlling anxiety? I've heard that an audio program called Holosync is really good, but I've never used it and it's really expensive ( $179), but I think you get a ton of audio with it and apparently it works wonders for a lot of people. I'm thinking of giving it a shot.

[webslave]

I suggest the Dr. Jeffrey Thompson stuff rather than Holosync. Same effects, much cheaper.
>link dead<

[painman]

Thanks a bunch, webslave. I'll check that out