Odd glans penis pain/ CPPS? (Alphalifestyle)

[Alphalifestyle]

Hi guys,

I am in the process of once and for all excluding any alternative conditions for my pelvic pain and dysfunction, because after consulting some experienced bodyworkers and osteopaths in recent month, they concluded, that my pelvic muscles and related muscles are pretty normal. The only thing that creates pain and burning sensations is if the PT puts pressure on the tissue of and around the prostate internally.

My osteopath is convinced, that my prostate is the culprit, which is in a state of inflammation.

I went to the urologist again, which could not find any bacterial or viral infection apparently and now he wants to to a cystoscopy. But I am extremely afraid of that, because my penis and my urethra feel very irritated and even a simple smear test there created so much pain. And I never had blood coming out of my bladder or anything, just this constant feeling of irritation and low level burning in the prostate and bladder region.

Anyway, my question is: Is the cystoscopy useful? Would useful information and treatment options could it reveal anyway? Is it not dangerous for someone with a irritated urethra and painful, retracted penis? I am really afraid of more damage and I would like to avoid the test, but than again I am afraid that maybe the bladder is the culprit after all....

[webslave]

A cystoscopy is very useful, and if a flexible unit it used, it's virtually painless. I had one a few weeks ago (kidney stone) without any anesthetics other than a gel in the urethra.

If you want a proper diagnosis that eliminates more exotic causes, have a cystoscopy.

[casperach]

Can't say the same. I had mine with a flex and it was literally the most painful experience of my life. Half way through I had to make a decision to finish or get put out at another time. I nearly chewed through the skin on my arm it was so bad.

That being said it was at the beginning of my worst days and the uro had no idea what was going on. He had never heard of pelvic pain or the Stanford/Wise-Anderson Protocol.

I headed up to the Cleveland Clinic and got 90% better from there.

[Alphalifestyle]

Hi,

The thing with my chronic prostatitis / chronic pelvic pain syndrome is, that there is exactly one trigger, which is ejaculation.

In 90% of the cases when I have an orgasm/ejaculation, besides the pleasurable feeling, I feel a very burning, stinging sensation inside, in the prostate/bladder area.

It feels like the muscle contractions are irritating some sore tissue/nerve and after the ejaculation I get a very burning, inflamed feeling in the anus, perineum, penis.

After ejaculation I have to urinate much more, I feel pain in my urethra during urination, my penis gets a little numb and I feel very stiff and almost a little feverish in general.

It takes like one week and I get progressively better again. After maybe 2 weeks I have only mild symptoms.

But one ejaculation and everything flames up again majorly.

I guess that what called a trigger and flare-up. But I feel like I can do NOTHING to make this flare-ups less severe or shorter.

I guess what I really want to know what EXACTLY causes this burning/inflamed feeling? What and how does ejaculation cause this flare up? I even get pain down my right leg and eye pain after ejaculation!

I don't find any trigger points, the only thing I can find, is that the tissue of my anal sphincter feels very painful and burning when I have a flare-up. Also when I press into my belly I feel burning sensations and pain.

Sex without ejaculation is ok, but as soon as I ejaculate, with a girl or without, life turns to a nightmare.

I feel like its mechanical. Like some nerve gets irritated and inflamed from the act of ejaculation and causes those symptoms in my bladder, penis, urethra and anus.

Anybody has a better understanding of the exact mechanism and tissues involved in pain symptoms during/after ejaculation? Any suggestions on how to work on this?

Its so frustrating because I dont have any triggerpoints to work on and my ONLY trigger is ejaculation. I always feel like my problem is slightly different from standard chronic prostatitis / chronic pelvic pain syndrome because I dont find triggerpoints and my anus tissue always feels so irritated and burning.

[MajorSky1]

HI Alphalifestyle,

I have some of what you have, but mine isn't as severe with ejaculation these days. A few months ago for a while I had the burning, pinching feeling around the prostate during and after ejaculation, and the pain also included the urethra, the perineum, and the anal sphincter to some degree.
I don't know what I've done since to make it less severe, unfortunately. But once in a great while I still get a stinging upon and after ejaculation, and after which urinating makes it worse.
I DO have an aching that creeps up just about after every time I urinate, and it's driving me crazy. Some times are worse than others, and it's not usually during urination, but a few minutes after that it starts to make everything hurt - like a resonating ache along the urethra tissue, radiating out into the perineum, and up close, or right against the prostate.

Someone on here mentioned that there is a hormone secreted (can't remember if it's from the nerves, or from where) in over abundance that causes destruction to the epithelial cells that line the urethra, prostate and bladder, which and allows the urine or semen to cause irritation because that lining has been compromised and the more sensitive tissue underneath where the nerves are gets inflamed, and irritated.
I think it's a hormone related to stress, but I'm not sure. I'm hoping someone else here can explain it. I've read about it before, what I've read was very general, and I'm trying to find a more detailed explanation.

Although I go through phases where I have a hard time buying into the idea that a lot of this is CAUSED by stress ( I do, but it just seems so unlikely) I do think that it is at least exacerbated by stress. You say you have muscle tension all over which means you are probably pushing your adrenal glans and stress hormone production to the max, as well as building up lactic acid in tissues. Also, tense muscles don't get enough oxygen in spots. All of that can make nerves start to scream.

I wish I had a solid, straight answer for you, because I, and many others could also use a clear answer for this problem, and related issues. You post a good question! Hopefully someone has had some success trying something, and will share it.
Hang in there, and best wishes!
Brant

[Alphalifestyle]

Hey man,

thanks for the reply. Yeah that makes sense, that's also what I thought actually. It does not feel like the pain and inflamed feeling afterwards is the result of muscle tension, but more like the tissue of the urogenital organs gets irritated, inflexible and painful. Maybe it is caused by Histamine or Prostagladine E2. Anyway what I am trying to say is, even so the muscle tension and triggerpoint part of chronic prostatitis / chronic pelvic pain syndrome makes sense too me, I feel like my pain and symptoms are more caused by some biochemical cause/inflammation.

I did almost any stretch and pelvic exercise imaginable, but I am actually really flexible already. My muscles are not really tight, and a pelvic floor therapist also told me, she could not find anything unusual going on with my pelvic floor. But still I have mostly the typical symptoms of CPPS. I feel like massage and pelvic floor stretches are not really doing anything for me. So I am really more and more depressed, because I just don't know what I can do to get better! It makes me feel so hopeless.

Actually I think this exact same thing, this "irritated genital tissue", which causes me the burning pain, also is responsible for my premature ejaculation. I have premature ejaculation that has nothing to do with psychology, even if I lie in bed alone and am totally relaxed I very quickly feel this weird mix of a pleasurable and painful sensation that causes me to ejaculate, like the involved tissue/nerve is super irritated and that somehow also triggers ejaculation super fast. I just don't know how to calm down the tissue. I can stretch the surrounding muscles, but that doesn't do anything.

[MajorSky1]

I know that hopeless feeling. Actually it has just been hitting me yesterday and today, after previously feeling a slight improvement. But yesterday, some pain flared and it's like back to this again.

Caeder recommended I try Hydroxyzine, so i did. I've been taking it for 4 days now, and it sounds like it took a week or so for him to notice any difference. It makes me very drowsy, but I'm going to continue to see if there is any improvement. If so, I'll let you know. I'm also headed out to go get some magnesium (not oxide, the other one that absorbs better), and some quercetin.

I would wager that you DO have trigger points, but they may be hard to find, or maybe they're more subtle. If you are using a therapist who goes in through the rectum, most will not go deeper than the second sphincter. There may be trigger points further up, to the left and right of the prostate. I found a couple myself, hard to reach, but after a few days of working them out with a finger, I noticed a difference. I think I have more that I haven't found yet. I often wonder if the urethra has its own tiny trigger points.

Don't lose hope. I know that's easier said than done at times. One of the reasons I joined this board is because I needed support from people who understand how horribly confounding, and what Hell this is to have and go through. I believe there is 99.9% remission, only because that .01% is merely the memory of going through all of this.

Question for you: Try this experiment. Next time you ejaculate, and the pain starts, immediately kick back and read something that will keep your interest. A good book, or an article, something that will be easy to lose yourself in. Read for at least 15 minutes or longer. After that, reassess where your pain and discomfort is compared to times before when you have not read for a while. Let me know how that goes, if you would.

[webslave]

I guess what I really want to know what EXACTLY causes this burning/inflamed feeling? What and how does ejaculation cause this flare up? Anybody has a better understanding of the exact mechanism and tissues involved in pain symptoms during/after ejaculation? Any suggestions on how to work on this?

viewtopic.php?f=34&t=627

[Caedar]

The peripheral molecular changes in chronic prostatitis / chronic pelvic pain syndrome aren't completely clear, as far as I've seen. Essentially everything related to mast cells (histamine, various inflammatory mediators) could be a culprit, which is why quercetin is one treatment tool. It's possible that momentary spasm (ejaculation) could be enough irritation to cause a cascade of mast cells, already upregulated by the chronic pain process, to degranulate. This is just conjecture, though, as there isn't a true answer yet. Under investigation!

[European]

Guys, I am in the same boat, as I wrote in another thread. Ejaculation as the most prominent trigger of pain, lasting several days (sometimes 2 weeks..) Horrible feeling. That was also the first initial trigger which started my pain - day after ejaculation I started to have pretty horrible pain in the area behind penis, in bulbospongiosus area, ischiocavernosus etc. Pretty classic case. My life altered completely.

I guess there are two possible explanations: Caeder is probable right that in our CPPS-veteran cases each ejaculation triggers cascade of inflammatory mediators in generally up-regulated muscular and neural environment.

On the other hand: MajorSky1 is also right, there might be important trigger points near prostate, according to Wise/Anderson the most stubborn trigger points are often in pubococygeus/levator ani area and these are seldom properly eradicated by PT. I think there might be the underlying reason for that exhausting post-ejaculation pain.

[MajorSky1]

Any luck finding solutions, Alpha?

During ejaculating this morning, the spasm in what seems like the spermatic cord started again. Now I will have that raw sore feeling from the epid. up into the ischiocavernous. I'm just wondering if anyone else has had success healing from this type of thing eventually.

[Alphalifestyle]

Hi, sorry, because I never got a response I push this up again.

This is still the most obvious source of my dysfunction and pain: When I insert a finger in the rectum and press to the front of the body I get a irritating, burning pain, it starts right when I enter the rectum up as far as I can reach.

I just want to understand what causes this burning pain at that location most likely, because so far neither bodyworkers, pelvic pain therapists nor my urologist could really help me or explain me why I have pain in that location.

Is it muscular pain, nervous pain, is it a inflammation of the urethea and/or bladder? I am just not really good with anatomy, but I feel like understanding what causes the pain in that location could help me to progress!

[MajorSky1]

Yes that tube is the urethra. As to exactly why it's burning, there are many different possibilities. If you've already been thoroughly tested for infection and the tests have all been negative (uti/std), then it's probably a muscle/nerve issue where small muscles along the urethra are chronically tight and inflamed. There could also be irritation from histamines released by mast cells that proliferate from inflammation and then degranulate and release the histamines causing irritation to the urethra. Better to massage next to the urethra but not right on it because that can instigate inflammation of the nerves. Ask your doctor about hydroxyzine. Make sure infection is ruled out first if you haven't, which only takes basic tests at your doctor's office. There can also be foods or instigators from the bladder or prostate that can possibly cause urethral irritation. If you follow that tube up far enough, you'll get to the prostate. It's a firm sponge type thing, and it might be just out of reach.

[Alphalifestyle]

Thx man. I was suspecting that. Well every time I touch along that line and as high as possible its this same burning pain.

My urologist tested me for bacterial via urethral smear test and Chlamydia infections via bloodtest. They were both negative He said a cystoscopy would be the next step. As many here I am pretty confident, that a habit of excessive internet pornography use and chronic masturbation was responsible for my pain. But even after giving up on this for many YEARS, the condition did not change for the better. So I think a physical trauma is more likely to blame for this.

I am very hesitant about doing the cystoscopy to be honest. I read from several people with pelvic pain and pudendal pain type problems, that they got permanent nerve pain in the urethra and strictures from that procedure. I believe that this would not happen to healthy individuals, but when your genitals are already painful and irritated, who knows? I already had pain for 2 weeks after a urethra smear test.

I just don't know what to do next, I feel like we are severely lacking knowledgeable doctors here in Europe. When I read about other people from the States, it seems like the doctors are much more aware of these problems and have innovative ideas on how to calm the nerves, nervous system, cooperate with physical therapists and pain specialists. I really don't want my condition to get any worse, but I am also afraid of doing any harm by visiting doctors who are not experienced enough to handle those problems the right way!

But yeah what I can say is that I feel burning pain in the area of the urethra for many years now without any change for the better. There must be something I can do!

What is hydroxyzine doing exactly? Does it help with urethral pain? Does it have any extreme side effects?

[MajorSky1]

Hydroxyzine is an antihistamine. So it will reduce the mast cells that break up and let out the histamines. If that is what is causing your pain, it will work. It's with a shot to try it. It worked for me last spring and lasted through the summer until I got a steroid injection in the caudal nerve and it messed up all my nerves. So now I have some mild aching in the urethra, but I think it will fade over time.

Doctors don't know everything here either, but some are better than others at being open minded and smart enough to try new things that have show results elsewhere.

Pressing on the prostate will always produce that burning feeling. That's pretty normal. It's not supposed to extend into the urethra though.

I'm not 100% sure that masturbation to porn definitely causes CPPS, but may aggravate it. Doing real edging may help cause it, and it seems like tantric definitely causes it. Ultimately with masturbation, what contributes the most is tightening of the pelvic floor and adjacent muscles, which do not need to be tensed during masturbation but often are inadvertently as part of a general tensing.

Webslave may have a line on a CPPS-literate doctor near you. Maybe ask him about it.

Good luck, hope you recover 100%!