New member - My case

[fonk84]

Hello all,

My name is Alfonso, I am 30 and I am a Spanish national who moved to the US in September 2012. I have been reading many sources of information about CPPS and I ended up in this webpage and forum, which appears to be the most complete and helpful resource in the internet.

The first time I noticed some new and strange pain in my pelvic area was the summer of 2013, immediately after masturbating. I saw that like a warning and I decided to stop or decrease the frequency of masturbating. I started dating my current GF short later and I noticed an increasing post-ejaculatory pain week after week. I started reading and researching about my problem and I decided to visit an urologist in July 2013. That is when I have to fill in a questionnaire about urinary conditions and I then realized that for the previous years (I cannot remember when it started) I was not urinating perfectly.

After the prostate examination and some urine and prostate fluid cultures my urologist prescribed me for the first time with antibiotics (bactrim), corticosteroids (methylpred) and alpha-blockers (tamsusolin) even before having the results of the labs. In the beginning I remember he said that there were some bacteria in the prostate and that´s why after a month I repeated continued the antibiotics and alpha-blockers treatment. In September 2013, he changed Bactrim by Cipro and continued the alpha-blocker treatment, but added hydrocodone only as needed. I saw that hydrocodone was the same medication taken by House in the TV series and I soon got a little scared about it. After all, all these opioids medications are not allowed in Europe and I am not used to it. I took it very few times and I cannot remember if it helped me at all. My pain was still there and I kept visiting the urologist every month. In January 2014 I got news from the doctor. After reviewing the results of an ultrasound rectum procedure done in Christmas he told me that the cause of my pain could be the presence of ejaculatory duct obstruction. He suggested surgery (a quick and minimum risk procedure) and I had very positive reaction. I was not scared at all and I was even excited for the possibility of eliminating my pain and confirming I had not chronic prostatitis.

The surgery took place on January 15, 2013. I remember suffering some terrible episodes of urine blockage due to clot obstruction that took me to E.R twice. But at the same time, I remember I had not pain and I thought I was cured. Some weeks after everything happened I realized I was feeling a growing feeling of pain again, after having my first sexual relationships post surgery. It was confirmed in the following weeks that the transurethral resection of the ejaculatory ducts was not successful although my doctor said It was not a bad decision for the future. I want to think he is right about it.

On March I received Bactrim and Vicodin, on April I got prescriptions for Cipro and Baclofen (muscle relaxer). It was then when for the first time the doctor started talking about other potential causes of the condition (muscle tension, autoimmune disorder...) and I confirmed with him I never had a bacterial infection so I wanted to stop taking antibiotics from that moment on. We did additional ultrasound tests to confirm if my vesicle structures were enlarged, but nothing was seen. On May I tried Tramadol for the first time, altogether with Tamsulosin again (I remembered I had taken this medication long time ago because of its clear side effects on semen production). During the next months I noticed the best improvement ever, with a significant decrease on pain and very decent urinary flows. I even was able to live only taking tamsulosin and avoiding tramadol. I asked the doctor if this was going to be my life from now on, and he said I was lucky to find such an effective and easy treatment, as compared to most of the cases. I asked for another alpha blocker with no side effects and he gave me Alfusozin. He told me I shouldn't visit him again in a year, unless the pain would become very bad. He warned me about flare-ups. I forgot to take my medications with me to Spain during holidays and I took advantage of that to try to live without medications. I did very well until I came back to the US when I noticed everything worsen again and again. I restarted with the tramadol and the Alfusozin but now it is not being as effective as before, I don't know if it is because I got used to Tramadol or because Alfusozin does not work as good on me than Tamsulosin.

I started researching again and I soon saw myself identified with the muscular tension and trigger points theories. However I haven't tried anything yet. I decided to register in this forum and try to find some advice from people with very similar symptoms, that I will describe as follows:

1. Post-ejaculatory pain. This is the worst symptom I have. It is very annoying and it affects my sexual life to the point of avoiding sexual relationships sometimes. At this point (more than one year after I noted for the first time), the pain starts when I am getting an erection and it becomes terrible in the moment of ejaculating. After some seconds, it decreases but then another pain starts growing little by little and can lasts up to some hours. I need to stand up walk, jump... I cannot be relaxed or lay down.. IT is like what I have seen in the forum sometimes, a gulf ball in my anus. The best remedy I found to decrease the pain or making it to last a shorter time is to take a hot bath. I also noted that depending on the position I held when ejaculating, the pain may be higher or lower. Again, the pain is in my perineum area, somewhere inside and it may extend to the area. Recently I am even noting a little pain in my penis that I am sure is related to the same cause.

2. Chronic pain. In the beginning I did not have this, but unfortunately I have this problem more often now. It is not as bad as the post-ejaculatory pain but it is very annoying because I cannot avoid it just by not having sex. It is more frequent when sitting down and it is focused in the same area than the post-ejaculatory pain.

3. Urinary problems. I would not say these are my worst problems. I never had to wake up at night to urine several times. In my case it is just that I have to try several times before emptying my bladder. I also have some pain (I believe it is described like burning in English) just when emptying the bladder (or feeling like that). Again, this is not as bad as the previous pains but obviously also affects my quality of life.

4. Urinating and defecating simultaneously. This is something I noticed and that I haven't found anywhere in the forum. I commented this to my doctor and that's when he got alarmed and they did an ultrasound test for the first time in order to rule out the existence of any abscess (there were not any). This problem is still here and I believe I have had this for a longer time than the pelvic pain. I got used to sit down to urinate because just the action of urinating made me feel like defecating, even though I did not have anything to throw out. I realized that I have been doing this for a long period of time. I tried to face the problem by standing up and focusing in only urinating, sometimes I could make it with very strong efforts but many times I have to sit down. This problem is very inconvenient also because in public places I cannot be risky and just urinate standing up. I got better about this in my best moments taking tamsulosin, whenever my urinary flows were very decent.

In my work I spent long hours sitting down and I have had with very stressful seasons in the past. I am an auditor and I have been working as such for 6 years. I cannot avoid to blame my job as one of the reasons of my condition. I also consider myself a very anxious person, not only for bad things but for good and exciting things. I also cannot avoid to think that masturbating too much in the past was another reason of my condition. Whatever it is, I tried to improve my quality of life, by improving my diet, keep doing exercises several times a week, drinking more water than before and trying to walk more often. It is interesting to highlight the big change I suffered when I moved from Europe (where I was walking a lot on a single basis) to Houston (where I am driving for almost everything).

Nowadays I started having Saw Palmetto, quercetin (through cranberries and other vegetables) and I will try to have Cernilton or other pollen extracts. I am also considering to start doing stretching exercises on a regular basis before considering to go to a physical pelvic therapist.

This is the summary of my symptoms and my story in chronological order. I would appreciate any kind of advice from people who has suffered this problem much longer than me. It would be interesting to meet someone with very similar symptoms (mainly the post-ejaculatory and defecation problem) and to see what worked for them.

Best Regards,

[webslave]

Interesting case history, Alphonso.

1. You are correct in identifying stress and a move from walking to driving as underlying causes. Moving from country to country, with all the adaptation required, is also very stressful.
2. Excessive masturbation is also a potential trigger. Try to keep ejaculation to 2x a week.
3. Don't take antibiotics again. I'm glad your doctor finally admitted that you have no infection.
4. The operation you had was unrelated to your CPPS. Unfortunately urologists are surgeons and many of them will attempt to find a surgical cure to pain. Stay away from them from now on.
5. The inability to urinate without the urge to defecate indicates that your pelvic neuromusculature functioning is stuffed, to use a technical term
6. Saw palmetto is useless; quercetin is best taken as any accredited quercetin product or any accredited quercetin product (which also contains the cernilton) to get therapeutic doses; avoid cranberries (highly acidic).
7. Keep reading this forum. Most of your other questions are answered here.

Welcome to the forum.

[fonk84]

Thank you webslave for your reply and your advices. I will definitely take them in consideration.

I am open to try some of those supplements. It is true that there are hundreds of them in the market and I don't know where to begin with, most of the reviews clearly try to convince the reader about one specific product that is very acclaimed in other sources. Whatever, I want to believe that if ingredients are kind of similar and are truly included, then all of them should work, probably in different levels. I wouldn't mind to start with the ones recommended by this site, although I have some questions.

1. Are there cases of people feeling relief of pain taking these products or it is just good for urinary problems?
2. What should I try first, any accredited quercetin product or Quercetin?. I see that the second one is stronger and includes Cernilton. Are you aware of testimonials of people claiming benefits from one product over the other depending on the symptoms?

Maybe, as you said, these questions are already addressed in other topics. I will keep reading.

Thanks again,

[webslave]

1. Yes, pain relief is one of the best effects of products that have guaranteed amounts of quercetin (and cernilton, in the case of Quercetin). That's backed by published studies, not merely my opinion (and my experience, btw).
2. I would try Quercetin first. Many testimonials for these products are scattered throughout the forums.

[fonk84]

I just ordered any accredited quercetin product in Amazon. I did not find it in Whole Foods, where I only saw many other products (Jarrow Prostate Optimizer, Irwin Prosta Strong, Buried Treasure Prostate Complete, Himalaya Prostacare, MPX Bluebonnet Prostate Support, Gaia Prostate Health, Newchapter Prostate 5LX and Megafood Prostate Strength and Zyflamed Prostate). It is crazy what a competitive market this is. I was looking for any accredited quercetin product or any accredited quercetin product or PollenAid from Graminex, so far the products I am giving some credibility according to my research. I got tired of reading ridiculous webpages in the internet trying to convince the readers with independent reviews of comparisons (prostate Miracle and Prostate Supplements are in an open war sponsoring PRost-P10x (claims to have more mg of stuff than any other ???) and Prostate Miracle ('3,000 times stronger than Saw Palmetto") respectively.. It is so easy to find their reasoning so biased. They simply don't look serious.

Yesterday I had a strong flare-up. It was strange, I don't usually have constant pain in the perineum area for no reasons, I am more a sufferer of post-ejaculatory pain . The only thing I changed this week is the stretching activities and an increase in cranberry ingestion. I did not alarm about it since everyday is completely different and I was sure today was going to be different. It was. Today I feel much better. Also I am having more problems urinating, like if I was not taking the alpha-blocker at all. I am not sure if my body got used to alpha-blocker or it is just that Tamsulosin works for me and Alfuzosin does not.

I decided to stop taking medications progressively to see what is the real impact of any accredited quercetin product whenever I start taking it. I stopped taking Tramadol and I will stop taking Alfuzosin whenever I finish the last pills I have. Let's see.

What is the general view in the forum of an ingredient called Beta-Sitosterol?, some reviews on those webpages say that any accredited quercetin product or any accredited quercetin product (don't remember exactly which one) are not that good because they don't have this ingredient, which apparently is the last big thing. I haven't found any trial or research on this though....

[webslave]

There is no research linking Beta-Sitosterol to treatment of CP/CPPS.

[fonk84]

Hello,

It is been some days without taking any medications. My symptoms did not become worse so it is clear I made a good decision. I felt like they were making no differences at all.

While I am waiting for the arrival of Quercetin, this weekend I read a lot in the forum, paying much attention to the following threads:
viewtopic.php?f=37&t=6281 (Magic Bullet for Post Ejac Pain/Testicular Heaviness
viewtopic.php?f=34&t=627 (Avoiding post-ejaculation & muscle spam)

Since my worst symptoms were related to post-ejaculatory pain I really was interested in practicing the recommendations in previous links.

I found challenging but beneficial trying to relax my pelvic floor during ejaculation and I believe it avoided the pain to be as bad as it usually is. Later, my gf and I tried the massage in the bulbospongiosus and made a very interesting finding. I believe we found the trigger point (or one of them) of my post-ejaculatory pain. It is located on the left side (my left) of the muscle. The attached picture below shows where we believe it is. Whenever my gf touched that area after ejaculation, the pain increased dramatically to a level I never felt before. Obviously, after that the pain lasted for a long time. We tried to see if the right side was causing the same effect but it was not the case. The day after, when sitting, I was able to realize that the pain when sitting was also coming from the left side, probably meaning it is my left side the one that is more damaged.

I am wondering if it is a good idea to keep massaging that area in the future though, before or after ejaculating. I am not sure whether this is something familiar to anyone in the forum who could give me an advice.

bulbosp.jpg

[Caedar]

I too experienced ejaculatory pain concurrent with my bulbospongiosus trigger point. Massage and antihistamines (which reduced bladder symptoms, which in turn alleviated the pelvic TPs) fixed this almost completely.

[fonk84]

I updated my post to mark where exactly is the trigger point.

Thank you Caedar for your reply. It is always good news to hear that some people were able to fix this problem. Could you give a little more info about antihistamines?. I assume you are talking about medications so I would need a prescription from my urologist to get those.... I am not sure If that will be easy.

I was reading in the webpage that Vitamin C in high doses can work in the same direction to lower histamine? Also, isn't the quercetin also blocking the secretion of mast cells?.

Thanks,

[European]

I can somehow relate to your problems, struggling almost 5 years with pelvic pain, mainly in front side, shaft of the penis, base of the penis, perineum. My problems also appeared after vigorous sex/masturbation with heavy clenching of pelvic floor. Pain started as post-ejaculatory pain, but never immediate, but one day later. Initially feeling of having a "lump" behind the penis, later neuropathic burning pain. Nerve block of distal pudendus did not deliver any improvement. PT helped but did not resolve all the problems. Minor or none urinary problems.

My suspicion is that in your, my and Caedar's case, the trigger point might be deeper than in bulbocavernosus/ischiocavernous, namely somewhere in puboccocygeus area. Palpation in that area heavily echoed my current pain. Unfortunately, this muscles is difficult to work with.