Nocturia, frequency, hydrocele, hernia (Wolfcub's case)

[Wolfcub]

Thanks. I feel the etiology has something to do with some kind of an inherited connective tissue disorder... she's also said I had a hypermobility of the joints (something that I remember I've been told before).

[Wolfcub]

BTW, it was a pretty long session, 2-hours in total... about half an hour - intake, interview, posture and mobility assessment - when she clearly noticed my flat feet.

The rest of the time she worked on muscles in my feet, along the leg, in the pelvic and abdominal areas. All was painful. She noticed my right side was much worse (and I can also felt it - was more painful) so the session was devoted to my right side. She was de-activating trigger points. There were so many trigger points and taut bands in my lower rectus abdominis and it was like a pain of 9-10/10 on VAS scale. Now this area feels so loose and normal to me, and no pain at all besides that caused by the scar left after my indirect inguinal hernia repair. But she also works on this area and it's also supposed to get better as well. Other extremely painful areas were:
- Pectineus muscle
- Adductor magnus muscle

She also worked on my Illiopsoas and many other muscles. Even muscles in chest, neck and face had a lot of trigger points. I strongly believe at this point that my penile symptoms are caused by the same kind of dysfunctions in the pelvic muscles, so when we start access them internally I expect those symptoms to be reduced and even resolved eventually.



I can say carefully my case is on the edge of becoming a success story.

[Caedar]

I can say carefully my case is on the edge of becoming a success story.

Excellent! Do you have a Theracane? It works wonders for the abdominals and adductors, in my experience.

[Wolfcub]

No, I will consider that depending on the outcomes. It was just a first session and I feel so much relieved in the pubic and abdominal areas.

At least in my case it all makes sense now:

• Standard tests find nothing: sure they don't, since the problem is in the muscles/connective tissues (biomechanical problem in gross anatomy). CT/MRI/Ultrasound don't image this stuff (only electron microscopes imaging the muscles).
• Urinary issues: sure. The pelvic muscles are so tense they create havoc on the organs found inside - The bladder and the prostate. The bladder and the prostate are themselves composed of muscles (actually the bladder is mainly a muscle. and the prostate's capsule is made of muscles which are connected to the pelvic muscles)
• Constant pressure/pain/discomfort in the tip of penis and along the urethra: sure, squeezed by the short and tense pelvic muscles and muscles attached to the pubis such as the Obturatur Internus.
• Difficulties with diaphragmatic breathing: sure, as the abdominal muscles are affected by the pelvic muscles. Now after having many trigger points and taut bands in the Rectus Abdominis released, my area is feeling amazingly loose down there and I can breath easily! This issue been COMPLETELY resolved.
• Difficult to abduct my hip to the side: sure, as having many trigger points in the Adductor Magnus muscle, which was found to be short and tense (and weak due to this). It also indicating the pelvic muscles as a whole unit are tense and short, "pushing" my lower limbs to the center of the body.

AMAZING, I FEEL ALMOST CURED, AFTER MORE THAN EIGHT YEARS OF CONSTANT SUFFERING.

[Wolfcub]

To conclude my case so far:

I had the hernia repair surgery on October 2012. Actually I had symptoms due to that hernia since 2002. It was discovered only in 2011 (!!!). It was a right indirect inguinal hernia of fat and some connective tissue protruding into the scrotum (via the inguinal canal) causing acute pain for minutes and even for a few hours at times (as the years went by it became worse).

During the surgery the surgeon also found a hydrocele in the inguinal canal containing 20cc of fluids (considered to be a moderate one), which was then removed. The hernia itself got fixed with ULTRA PROLENE mesh.

The PT thinks that at least some (if not all) of the following contributed to my muscles' dysfunction and pelvic dysfunction eventually:

1. Flat feet (she says that my posture is not correct due to this, as I tended to lean back, "sway back" a little, and also to over-pronate, internally rotating the lower leg, causing it over the years to become shorter)
2. Some degree of joint hypermobility
3. The symptomatic indirect inguinal hernia (and also the post-op pain, "post herniorrhaphy pain syndrome", and the scar). It makes the muscles in that area more tense and they tend to "defend" the area by flexing
4. Trauma: in 2005, 2-3 months before the onset of the CP/CPPS symptoms, there was a day I made a sudden movement with my right side using the hip and pelvis, hearing something inside me "tearing" and then having a VERY STRONG ACHING PAIN. I almost thought of going to the emergency room, but the pain disappeared after an hour or so.

My opinion: each case is unique. Your contributing factors may be different, but the principles are the same - something causing stress/overload on your muscles, especially pushing them to the midline of the body or/and causing them to become shorter and tense.

That's it for now, till my next update on the progress of healing. Your thoughts as always are very appreciated!

[davyboy]

If you have flat feet, you probably have a pelvic tilt (like me!) This can cause a lot of trouble.

http://www.rippednfit.com/home/correcti ... lvic-tilt/

[Wolfcub]

actually I'm not sure what it is... when standing relaxed:

posture.jpg

[webslave]

You have a slight lordosis.

[Caedar]

Yup, anterior tilt / lordosis. A lot of people who sit a lot have it. Start doing some light exercises and stretches to correct it; it might help your chronic prostatitis / chronic pelvic pain syndrome some amount.

[Wolfcub]

Thanks. I even think (and so does suspect my PT) it is some kind of a contributing factor to my CPPS/chronic myofascial pain. Another supporting evidence were my tight hip flexors, which were FULL of trigger points and taut bands among other areas.

I think a physical trauma I had a few months prior to the onset of my chronic prostatitis / chronic pelvic pain syndrome symptoms also is strongly linked to this all malady... There was a day I rotated my right side (where my hernia was) and flexed my hip and heard a "tearing" sound somewhere inside my right abdomen and an acute pain thereafter... which persisted for around an hour or so (I almost went to the E.R.)

On my next session, in a few days, I'll ask my PT also about building a personal plan for me to stretch those muscles... or whatever she suggests to correct my posture and other issues.

[webslave]

There was a day I rotated my right side (where my hernia was) and flexed my hip and heard a "tearing" sound somewhere inside my right abdomen and an acute pain thereafter

Sounds like you disrupted a post-operative adhesion. Was this after hernia surgery or before? If before, had you had any other surgery to that area?

[Wolfcub]

It was before the surgery.

~2002- symptomatic right indirect inguinal hernia
~May 2005 - that trauma
~July 2005 - Onset of chronic prostatitis / chronic pelvic pain syndrome symptoms
~October 2011 - hernia FIRST (!) officially diagnosed.
~October 2012 - fixing the hernia (was the only surgery I had in life so far)

[webslave]

In that case, the turning motion pulled the hernia through the aperture. That can be painful.

Also be aware that an inflamed hernia itself can cause adhesions.

[Wolfcub]

An update: MY PT has been working on the fascia in my scar area (post operation scar after my hernia was fixed), and I feel much less pain in that area (abdomen, pelvis, inner thigh, dorsal aspects of penis and scrotum) and have better range of motion in that area.

However my penile discomfort and aches have been remained much the same, being there nonstop, 24/7 (pressure felt along the urethra, especially at the tip of penis, sometimes also felt as a burning, stinging and as other sensations). Again, my PT checked the pelvic muscles and the prostate. She told me that in general my pelvic muscles are quite fine (I was surprised to hear that) and she couldn't find any trigger points inside (!). That's being said, she also said an odd thing to me: that my prostate's size, shape and texture feel normal (she said the my prostate was even a little bit smaller than average) but "it's hard to mobilize it" (?!). What the heck? Has she just invented a concept? She told me that my supposed injury in 2005 (just a few months before my chronic prostatitis / chronic pelvic pain syndrome symptoms started), when I rotated my right side and heard a tearing sound and had an acute pain thereafter was linked to the hernia (which was already exist and producing symptoms), and scars formed inside that area might pulled the prostate to that direction. Well no trigger points inside the pelvis, as she claims, but pressing gently on both sides of the prostate intensifies my penile discomfort (a strong sensation of pressure in the tip of penis as having to urinate and a burning sensation too), especially when the right side (the side where the indirect inguinal hernia was). In general, my right side of the body has been producing more symptoms than the left side.

So that's her hypothesis/assumption/claim/idea... What do you think? I have never heard such of thing as a scar tissue pulling an internal organ such the prostate... and making it difficult to move. What king of movements does the prostate have? It's a gland circling the urethra... so what else can it do besides of squeezing and relaxing?

[webslave]

What training does she have in intrarectal massage? I wouldn't be listening to a PT on issues like prostate health.