One or two updates. I was recently browsing on this forum when I discovered a thread where a few people reported a sort of itching/burning sensation around the base of the glans, frenulum or in the urethra, which seemed to be acting like a micturition signal from the penis, as opposed to the bladder itself. It's annoying but I can't seem to find this thread again for the life of me, but that was the gist of it anyway.
For me, this is currently my last and by far the most stubborn symptom. It is pinching or burning sensation around the frenulum on the left hand side which causes me to squeeze my pelvic muslces as if to urinate without actually urinating. The burning sensation gets stronger and stronger the more I touch the fenular area, but I wouldn't call it a 'pain': my pelvic pain arises as a result of the muscle tension caused by reacting to this pinching sensation by squeezing.
Well today I discovered this article
http://www.jurology.com/pt/re/juro/full ... -00034.htm
and was amazed to find that the area of the penis where I feel my pain is subserved by the perineal nerve, NOT the dorsal nerve of the penis. I had always thought that the dorsal nerve must be responsible for the pinching problem, but here in the article it suggests that this is not the case. So I started to doing some searches on the 'perineal' nerve....
I found that this nerve "travels alongside the ischiocavernous and bulbospongiosus muscles, and before reaching the latter, nerve branches course into the bulbospongiosus muscle" (see http://www.scielo.br/pdf/ibju/v30n3/v30n3a20.pdf ).
This made a lot of sense to me, since these muscles play a role in erection and ejaculation. I have always maintained that chronic prostatitis / chronic pelvic pain syndrome should be thought of as an 'overuse' problem; a permamant state of feeling as if one has had too much sexual activity. The feeling I have right now in my penis is just like a feeling I would get before chronic prostatitis / chronic pelvic pain syndrome broke out if I had too many ejaculations in a short space of time. Perhaps this has something to do with fatigue in the muscles which subserve ercetile and ejaculatory functions? And perhaps the hard-to-define sense of urinary obstruction I am experienceing now has something to do with the sense of finding it hard to urinate immediately after sexual activity that EVERY guy can relate to?
I am sure there is something in all this, which made me particularly interested to find this thread on this forum -
viewtopic.php?p=355
- specifically the part about Dr Berger doing Botox injections into the bulbospongiousus muscle. Does anybody (.....Webslave
...?) know if these tests have been completed and the results published, and if so, what were the results? Or alternatively, does anybody know whether the bulbospongiosus muscle (spasm) can be treated with PT? I remember my PT having a crack at this, but it was a bit improvised for both of us and I can't say it helped.
I can't specify details but I have a feeling that this muscle (bulbospongiosus) and maybe the isciocavernous, could draw together all of the elements that I have always intuitively felt were integral to a proper explanation of CPPS:
- the feeling of overuse: something to do with these muscles.
- the pinching burning sensation in the urethra/frenulum: caused by dysfunction of the perineal nerve which courses through these muscles, and specifically serves the frenulum and corpus spongiosum of the penis.
- painful blood vessels: something to do with inadequate blood flow flow pelvis caused by the muscle dysfunction.
I wonder what people think of all this. Most importantly, I want to know about Berger's study though......... (and any others like it.....?)
Thank you
