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

[Wolfcub]

I'm starting to think my symptoms are more itch-related than pain-related. Do your chronic symptoms make you want more to touch the affected area (in my case - especially the urethral area) or to more to retract?

I think it's all related, since recent scientific evidence have been showing significant higher chemicals and enzymes in CPPS patients compared to control groups that indicate overactivity and/or immune dysfunction involving the mast cells. That could also explain partially why some ppl with chronic prostatitis / chronic pelvic pain syndrome (and ppl with interstitial cystitis too) can get relieved with antihistamines. Histamines are one of the chemicals released by triggered mast cells which irritate nerve cells and elicits irritating sensations, usually described as "itch" more than "pain".

I think it can also explain why most ppl (according to latest research, >50% in ppl with chronic prostatitis / chronic pelvic pain syndrome compared to just 7% in control groups) with chronic prostatitis / chronic pelvic pain syndrome have muscle tenderness. In my case, when my chronic condition started back in 2005, in the first few days there were mainly irritating symptoms in the urethra/perineal/genital area - which have been going constant till nowadays and felt most of the time like slight burning/pressure/"wetness"/slight itch. Only a week or so after it had started abdominal aches began too, and a few weeks later on I discovered all over large parts in my torso (abdomen and chest area) muscles tenderness. Only later on I found out this phenomenon is called "trigger points" or "myofascial pain syndrome"/"chronic myofascial pain". My hypothesis is that it is caused by some physical stress built up in the muscloskeletal muscles related to the chronic irritating symptoms.

Actually the general explanation is quite simple: In general, Pain evokes a withdrawal reflex, which leads to retraction and therefore a reaction trying to protect an endangered part of the body. On the contrary, itch creates a scratch reflex, which draws one to the affected area. I think that having symptoms in the area of the pelvic region turning on some withdrawal reflexes down there (as also explained by Wise and Anderson - "The protective guarding response" that tend to tense up pelvic and/or abdominal muscles). When this behaviour become chronic and/or too strong it may cause the building of trigger points in the muscles. Coupled with sensations such as itch, I hypothesize it affects somehow the CNS and also intensifying the muscle tenderness and making it chronic - because those two types of reflexes are kind of doing the opposite things - which might lead to additional stress (not physical only) on the system.

That can also explain why I got significant relief in symptoms only this year following a few sessions of myofascial release- in which a lot of trigger points have been found - especially in my abdominal area. My abdominal aches (which were chronic and felt similar to the urethral/penile symptoms most of the time - pressure/burning-like/itch) have almost completely gone but my urethral/penis symptoms remained the same. This is possible is the muscles tenderness is complication of the disorder (as I generally suggested in the former paragraph).

I shall provide the scientific sources later on, but I'd be more interested to hear what you think or can share on that matter/hypothesis.

[Wolfcub]

A few of my main sources: (I have full-text access to them but the first one)

Chronic pain and genetic link of chronic prostatitis / chronic pelvic pain syndrome with other conditions
http://www.sciencedaily.com/releases/20 ... 133216.htm

CPPS and Anxiety/OCD possible link (genetic?)
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3654910/

CPPS and muscle tenderness (trigger points and so on, as I see as common complications of CPPS)
http://pubmed.ncbi.nlm.nih.gov/18082223

Chronic inflammation and mast cell overactivity (Tryptase-β and carboxypeptidase A3 as potential future biomarkers to diagnose/treat CPPS)
http://pubmed.ncbi.nlm.nih.gov/24726923

A review of mast cell tryptase
http://onlinelibrary.wiley.com/doi/10.1 ... 3757.x/pdf

[kkoma037]

Wow... Finally someone to prove me I'm not going crazy.
I, too, get the itchy feeling in the urethra almost constantly throughout the day. Pain and other symptoms come and go, but this itchy feeling that makes my toes and fingers cringe almost never goes away.