Urination

[bti20]

Just wondering if anybody has experienced this, and what it could mean.

I have noticed that the LESS pain I am in, the weaker my urinary stream is. For instance, sometimes I wake up in the morning and I don't have much, if any, pain in my groin, as well as a (rare) relaxed feeling in the pelvic muscles - but my urinary stream is weak and the amount of pressure being applied my my muscles doesn't seem equal to the force of the stream. It is like the pressure builds up too far back in my groin; like the muscles at the back have to get involved to help the ones nearer the front! I also get this sensation if I have been sitting down relaxing for a long time - say driving for hours.

What usually happens after one of these weakened urinations is that a feeling of tension/clamping builds up in my groin slowly afterwards, and then it just stays there. It is like I go from fairly relaxed, to a sort of baseline 'prostatitis feeling' in the muscles. Once that feeling is there I know I can't do things like go running, or touch my genitals, without getting an exacerbation of those baseline prostatitis symtoms. I physically CANNOT achieve a urination when my muscles feel relaxed like that without getting the creeping prostatitis feeling afterwards.

The obvious explanation to me is that there is something about the process of urination which makes me go from having relaxed pelvic muscles to tight, clamped muscles. There would have to be either (i) some feature of my pelvic muscles whereby any time I employ them for urination they cannot help going clamped and tight afterwards; or (ii) some OTHER feature about urination which means that pelvic muscles which started off relaxed beforehand go tight afterwards.

Well, alternative (i) could result from some kind of nerual 'wind-up' process which meant that any sort of stressor on the system would cause an excessive reaction in the pelvic muscles. I am familiar with all that - I like to think of it as another variant of the "it's all in your head" claims: your head just gets a bit bigger - running down your back through your spine as well. I can't argue against this sort of claim but to say that I just don't like it: it seems to be based on studies in rats and also seems to be a bit nihilistic. Not to mention neglectful. It's like the urologists are saying, "well I'm not going to investigate the possibility that there is something IN your pelvis which is causing your pelvic pain; instead I'll just inform you that your spine/brain is actually contriving to represent your pelvis as painful despite the fact that you can't do anything about it and despite ther fact that there is actually nothing wrong with you". This has a ring of desparation about it; not to mention insult (you are a rat).

Furthermore, there is another reason to think that 'wind-up' needn't be the only possible explanation for my tension after urinating. The day before chronic prostatitis / chronic pelvic pain syndrome began I had two excruciatingly painful urethral swabs at a GUM clinic. I went to urinate straight afterwards and that wierd urinary feeling had started already: I could feel that the stream wasn't quite responding to the amount of pressure that was building up in my pelvic muscles. So, I wonder whether I maybe have a STRICTURE somewhere inside my penis as a result of these swabs (an example of option (ii)). After all, I have read that urethral 'instrumentation' can cause strictures. (I am guessing that a gung-ho nurse rooting around in your penis for about thirty seconds with what looks like a pipe cleaner, while you squirm around violently on a bench, constitutes 'instrumentation').

The only problem with this notion is that apparently, a stricture is only present if there is a diminished urinary stream. And I had a uroflow test and the results were normal. But I wanted to say to thge urologist: you should have given me that test this morning when I woke up feeling fine, tried to urinate, squeezed really hard to try to improve a splitting, spluttering stream, and then felt a painful, clamping sensation for hours afterwards as a result. I get the feeling that the only reason I can urinate throughout the day with any success is that my muscles have tightened up to compensate for their ineptitude at the start of the day.

Does anybody relate to this feeling of relaxation before, tension after, urinating? And has anybody had any investigations into the possibility of there being a stricture at the heart of their CPPS? Does anybody know if strictures can be present despite normal urinary flow? (even though the level of muscle tension needed to propel the urine out does not feel 'normal').

[latte]

You describe what I experience most mornings and, by the way, I had a cystoscopy last year and no stricture was present. When I get up or just lie in bed when I wake up I feel really good, very relaxed. When I go to pee for the first time I feel fine with no pain until about thirty seconds after I am done I feel an ache start in the perineum and I know that now I will feel this ache to varying degrees for the rest of the day. I pray sometimes that some morning this will not happen but for the last two years it almost always does. I just had a ten day vacation and it was better and on some day hardly noticeable so I think it has to do was stress and tension and wind up but I don't really know. It certainly is not all in my head.

[bti20]

Thanks for that information. I find my chronic prostatitis / chronic pelvic pain syndrome improves on vacation too. It's annoying though to HAVE to relax all the time just to mask CPPS. (Maybe I should take up skateboarding/dope smoking). But just because chronic prostatitis / chronic pelvic pain syndrome is masked by relaxation doesn't mean it is caused by lack of relaxation: a roof stops you getting wet, but that doesn't mean the lack of a roof causes rain.