something inside the urethra?

[bti20]

I've often heard it mentioned that chronic prostatitis / chronic pelvic pain syndrome can begin following urethral instrumentation (it's been talked about on this forum). I've always held this in mind as a potential factor in my CPPS. What is interesting is that when my chronic prostatitis / chronic pelvic pain syndrome is AT ITS BEST - when it's as good as chronic prostatitis / chronic pelvic pain syndrome can be - I don't really have any pain, only a strange 'niggle'. The only thing that I can really say about this niggle is that it feels as if there is SOMETHING INSIDE MY PENIS.

OK, it sounds paranoid.... but what if, in many chronic prostatitis / chronic pelvic pain syndrome cases, there really IS a tiny area of scar tissue inside the urethra, which is so small as to be undetectable by a cytoscopy, but which is significant enough to be relaying a signal to the nervous system that there is a foreign body in the urethra? This is surely POSSIBLE - after all, some really nasty pain syndromes can begin following minor injury to nerves or blood vessels.

Of course, it can be said that the feeling that there is something in the urethra is just a result of 'complex nerve interactions' etc etc., but this misses in my opinion something which seems (at least as far as introspection is concered) important. I'll explain....

When chronic prostatitis / chronic pelvic pain syndrome is at its most mild - say I've had a good day, and I'm in the bath relaxing - I sometimes palpate my penis to see if I can detect where that little 'niggle' is coming from. Different prods and pokes seem to provide differing sensations of intensity, but the overwhelming impression is one that I can only describe as 'determinacy'. The pain seems to have a definite POINT somwhere that is differentially exacerbated depending on where I prod (the worst spot - and I have heard this before too - seems to be just under the glans on the left hand side, although the pain isn't ON the glans, but rather seemingly underneath the skin somehere). As far as you can have a detailed spatial awareness of the inside of your penis (not very far, I'd imagine) I can feel that the niggle is located somewhere - can't really say WHERE (if that makes sense) - specific.

Now I find it hard to express what I mean here, but I'll try: I just can't imagine how wind-up, cross talk and the like can produce the sensation of a pain coming from a determinate location like this, since I would have thought that at the spinal level, any abnormality there could not be so PRECISE as to conjure up such a neat signal. The problem at the spinal level would presumably be so messy you'd think that it couldn't be narrowed down so easily as, at bottom, and invariantly, a feeling that there is something not only IN the urethra, but at a semi-precise location too.

If all this is true (and I admit, its probably the most insane rant I've yet had about CPPS) then couldn't it be that the BASELINE state for some chronic prostatitis / chronic pelvic pain syndrome sufferers is one of having a small foreign body in the urethra, and the fluctuating symptoms could be due to differences in the body's response to this invader (which would of course be affected by factors such as stress, OCD, cold etc etc).

Just a thought. Anyway, I'm seeing a penile plastic surgeon soon to discuss this with him.

[SickofCP]

Oddly enough, I know exactly what you mean. At times when I feel my best, I feel a very specific point. It's so hard to explain, but reading your post, I know what you are talking about. Maybe it is possible??

[bti20]

Thanks for the reply sick of CP. Thought you and others might find this interesting:

http://www.greenspun.com/bboard/q-and-a ... _id=005lwm

The idea of urethral scarring would seem to explain guys' pelvic muscle tension; if not due to an obstructed urinary stream then at least because the pelvic muscles would surely spasm in order to try to eject the 'foreign object'. And of course this idea would EXPLAIN the obsessiveness of chronic prostatitis / chronic pelvic pain syndrome sufferers (rather than suggest this factor is somehow CAUSITIVE): show me a guy who WOULDN'T be absolutely possessed with getting a foreign object out of his urethra! (Of course, the guys who were anxious in the first place might be even more possessed).

I once had a TINY piece of food stuck in a fold in my throat - I could see it but I couldn't get it out for the life of me. I was more or less constantly aware of it for about a week till my immune system finally zapped it. (perhaps the immune system component of chronic prostatitis / chronic pelvic pain syndrome could be explained by the foreign object theory too?). I also remember my dog had a grass seed in her paw - she was moping around for days gnawing away at it until I discovered the seed and removed it. Maybe some chronic prostatitis / chronic pelvic pain syndrome sufferers are displaying such well a known behavioural pattern: total obsession with removing a foreign object from the body.

[faceinthecrowd]

Hey bti,

I think everything you're saying makes sense. Especially the idea of being obsessed with getting rid of a foreign body.In fact that was the initial, and worse symptom of my prostatitis - I felt exactly like there was an object stuck inside my urethra, and it drove me absolutely insane. Nothing I could do would get rid of it. When that symptom finally did go away, I was able to deal with the other symptoms and live a more normal life.

[tractor316]

Yes thats probably the most annoying thing about this CP . But I have had that feeling of something stuck there before I ever had anything shoved down the end . And it still occasionaly comes back when I sit for long periods of time . I also used to try and manipulate the seemingly sore spot and would find nothing there . I truly believe it is just nerve endings at that spot and the pain starts elsewhere . But it does go away . Did yours show up after an examination or before ?

[scotsman]

I've avoided doing any urethral instrumentation work - even when my uro wanted to 'have a look' (since he didn't know anything else to suggest tbh) - as urethral scarring was in my mind a real possibility.

However, be careful about falling into the trap of having more work done to 'repair' the previous work.

For what it's worth I've not had any exploritory work and I feel as if something isn't right in the shalf/urethra of my penis. Given where the pudendal nerve goes these sorts of feelings are understandable though (viewtopic.php?t=912).

Richard.

[webslave]

I just can't imagine how wind-up, cross talk and the like can produce the sensation of a pain coming from a determinate location like this, since I would have thought that at the spinal level, any abnormality there could not be so PRECISE as to conjure up such a neat signal.

Whoa! There is nothing intuitive about the way the nervous system works, old chap! I hurt my spine lifting a sofa recently, yet I have a sharp lingering pain on the outer edge of my buttock! I can neatly palpate the painful area, yet I know that the pain is coming directly from a spinal nerve pinch. Re-read the post on how nerves interact:
viewtopic.php?t=353

And remember what David Wise said about pain at the end of the penis coming from the anterior levator ani?