Urethra pain/ache - Tip pain

[mhuda90]

Hello, I just want to give you guys a summary of my condition and if there's anything anyone can do to help.

1. November 2012 - Urinary frequency, split stream, slow stream, retention, no pain. Out of nowhere I had these symptoms and went to the doctor who prescribed me doxycycline. Took it for a week and felt sorta better. Blood test and urine test came back fine. Had two additional urinalysis which came back fine too. Also, noticed my penis was hard when not erect, like it was sorta tight. Penis veins were bulging and visible.
2. December 2012- Still some frequency and split stream. Pain comes along the journey. A lot of times when I sat down or moved quickly I would get a shooting pain right up the penis or a shock like pain in the urethra. Scary as hell. Went thru the whole anxiety thing trying to see if it's an STD. BTW I haven't had ANY and I mean ANY sexual contact a year and a half before symptoms started. And that contact was merely a BJ. Before that I haven't had any contact for months either. Started to notice varicocele on my left testicle as well.
3. January 2013 - Pain still here, frequency gone. Pain when moving quickly or swiftly also when sitting down. Still on a STD scare but my anxiety starts to settle down as I know I haven't had any contact for a while. No pain while urinating, or ejaculating, no pus discharge, no burning itching rash or typical STD symptoms. I had discharge of clear fluid twice, once after a bowel movement and once after straining hard to urinate. Realized my muscles are pretty rough and tight. Started researching PNE and then eventually CPPS.
4. February- 2013- Pain starts to decrease and is only triggered by sitting on hard surfaces while shaking my legs or rocking them side to side. Began learning about CPPS more, trying to reverse Kegel, Forgot to mention I used to Regular Kegel without relaxing so I think that's how I got this to begin with. Became more aware of my pelvic muscles and stuff. Ordered Headache in the Pelvis, began reading and feeling a lot better. Incorporated some squatting, stretching and reverse kegels. Switched up the diet to High magnesium, less crappy foods and caffeine. Ordered a bottle of any accredited quercetin product and started taking it here and there not religiously. Stopped sitting so damn much out of the fear of the shooting pain in the urethra. Overall have been improving greatly with all honesty, no frequency anymore, varicocele reduced greatly only notice once ot twice a week, penis is no longer tight and veins are a lot less visible, Pain still lingers and aches once in a blue.
5. March 2013- Best month so far, I keep reverse kegeling and stretching. I squat a lot and do light exercises, and lift weights that don't affect the usage of the pelvic floor. I try to relax the pelvic floor as much as possible. I'm back to taking the Quercetin which I intend on finishing becuz I think it won't do any harm. I have been applying a heat pad to my pelvic area and abdominals. I felt a lot of muscle knots which I work on here and there with my fingers. I also have a knotted massage vibrator which I sometimes sit on to force my weight on the knot.

In conclusion, I am convinced that this is muscular in nature. I used to Kegel hard without relaxing and Kegel a lot while masturbating. I might have messed something up down there. I look at the triggerpoint documents in the pelvic floor and found out that the levator ani, rectus abdominis, obrutrator internus, and piriformis muscle are responsible for anything related to the urethra in terms of pain and the tip. I just have a few flare ups here and there but so far in the month of March I've only had one lasting 2 days.

CAN ANYONE PLEASE TELL ME WHAT CAN GET RID OF THE URETHRAL SPASM or shooting pain. I mean I'm in better condition than many of you here and I'm sorry if I seem impatient but sometimes when you're at 80-90% you're so eager to get to the 100% mark!

[webslave]

You're doing pretty well. Ideally you'd be getting some internal trigger point treatment too, but with a mild case, it's not essential.

I think you can expect complete symptom resolution within months if you keep up the protocol you're following. Add in breathing (see book about it in the Amazon link in my signature) and relaxation CDs. These aspects are more important than most people think!

As far as kegels while masturbating, see The Importance of Relaxing During Ejaculation

[mhuda90]

Thanks for the reply man. I find muscle knots but they don't replicate pain. I find this odd. Plus everytime I get a mild flare its because I leaned forward while sitting or I move my legs opening and closing them. Any tips?

[webslave]

The "knots" you are finding may or may not be trigger points. You may be looking in the wrong place. A vibrator will not reach the correct places.

Leaning forward compresses the prostate area, and opening/closing legs tenses some of the dysfunctional pelvic floor, so that's why you're flaring.

Best thing is to proceed as advised, short of visiting the Wise-Anderson Protocol clinic.

[mhuda90]

Reverse kegels, what are your thoughts?

[webslave]

There is no place for reverse Kegels in this patient group. Contracting and releasing muscles in the pelvic floor is an exercise designed to strengthen muscle. But it also fires up the nerve plexus in the zone, so exacerbating the existing pelvic myoneuropathy.

It's useful to review Dr Wise's words on Kegels:

Q: Dr Wise, can men do Kegel exercises to help them if they cannot travel to Sebastopol for your Program? If not, can you suggest any other exercises they can do?

A: In general, I do not believe that doing Kegel exercises is a good idea for men with chronic pelvic pain syndrome/abacterial prostatitis. The only conditions that I believe Kegel exercises are useful for (and I believe they should be monitored with an EMG home unit) is for problems of incontinence and for women who have vulvar vestibulitis.

When I was symptomatic I did Kegel exercises for an hour a day for a year. I think they were not helpful for myself. And in general, if anything, I think they are not innocuous and can sometimes exacerbate symptoms and sometimes cause flareups. I will explain why.

Let me say at the outset that this is my view and I am not representing anyone else. What I am writing you here is based on both my own experience of having chronic pelvic pain syndrome for 22 years and having been symptom free for many years now, my experience in seeing many hundreds of men with CPPS/category IIIa prostatitis at Stanford and having done many EMG evaluations in which I watched the microvolt readings of men doing Kegel exercises as part of our diagnostic evaluation. Most men who have chronic pelvic pain syndrome that is abacterial tend to have chronically shortened muscles in the pelvic floor due to chronically focused tension there. Their hypertonic pelvic muscles are close, near or above a threshold that produces pain and dysfunction when crossed. Furthermore, men with these syndromes tend to have a sluggish relaxation response and recovery after they try to relax the pelvic muscles once they have done the tension part of the Kegel exercise. If these shortened and chronically tensed muscles are not rehabilitated, all that the Kegel exercise does is expose the pelvic muscles to unnecessary contraction and the tendency toward sluggish recovery from the contraction. I have seen men have an exacerbation of symptoms doing this. Furthermore I see no therapeutic value in it.

Keep in mind that Arnold Kegel was a gynecologist who taught women to do Kegel exercises to strengthen the pelvic floor. It is my understanding from reading Kegel's work that there was no intention to use Kegel exercise to relax tense pelvic muscles.

In my view the therapeutic goal in dealing with chronic pelvic pain syndromes is to rehabilitate the chronically contracted muscles of the pelvic floor and modify the habit of chronically focusing tension there.

The protocol we have developed is intended to make patients self reliant and not dependent on the doctor. When possible we train the willing spouse to do the internal triggerpoint/myofascial release. The method of profoundly relaxing the pelvic floor is basically an inside job and something that can be done at home after some necessary consultations. In the home stretching program, we give patients the specifically designed stretches as part of their home program.

While I would be the first to offer exercises that men who have not seen us could do to help them, the truth is that I think it is not helpful to do so. No exercises, in my experience are useful if the pelvic floor musculature is in what you could call a kind of contracture. We have presented papers at professional meetings and have published articles on our work to promote what we are doing so that doctors in other places can offer our protocol. Unfortunately, there have been few doctors interested. Our new book, A Headache in the Pelvis: A New Perspective and Treatment of Chronic Pelvic Pain Syndromes will hopefully communicate our method to other health professionals.

What I believe is that watering down our approach and communicating half measures to patients will do more harm than good in that patients will do the half measures in the form of exercises we might suggest, which will fail to impact the symptoms and then the patients will give up on pursuing the whole measures.

Nobody wants to help people with pelvic pain and dysfunction more than I do. I was one of the wretched of the earth for many years. I am clear that our method are only useful if done fully and earnestly, and even then it isn't easy. Wish I had a more satisfactory answer for you.

Sincerely,
David Wise, Ph.D.

[mhuda90]

I know kegels are bad but reverse kegels drop the pelvic floor, they relax the muscles. I'm talking about just doing reverses only.

[webslave]

If you read up on Reverse Kegels, you'll see there is a contraction component too.

Without the contraction component, it becomes similar to Paradoxical Relaxation, so yes, that's good.

[mhuda90]

I see becuz when you release its just naturally gonna return to contraction or because you must contract in order to release...sorry I'm annoying u

[webslave]

No, contraction is an active process in Reverse Kegels. For example, from one site:

In order to do a reverse Kegel, start by gently contracting your pelvic floor to feel what tightening the muscles feels like.

From another site:

Focus on your penile muscles, and start to contract the muscles located at the front of the penis.

etc

[mhuda90]

Hey, I've had a prostate exam done and when the doc inserted his finger I felt tremendous pressure in my penis and urethra. When I try it myself in the shower I can't get that feeling. I generally have short fingers so I think I'm either not reaching it or not not pressing correctly. When I press against my navel I get a small amount of pressure so I think the prostate is somewhere behind the navel but its probably hard as hell to get at. Any idea where the usual trigger point is located inside the levator?

[webslave]

Usual trigger points are just to the left and right of the prostate. You need a wand.

[mhuda90]

Pressure in urethra when farting....symptom?

[webslave]

Others may wish to comment on that. Some people say the passage of stool affects symptoms.

[mhuda90]

After the shooting pain and electrical shock pains have started to subside, I'm getting these like nerve signals or irritations that shoot or like sting the urethra, head, or shaft. Its not painful and is slightly noticeable. This plus the overall feeling of tightness, occasional varicocele and occasional hard flaccid is the only symptoms I have. Can anyone help? From what I understand now is that the brain can send false nerve pain signals which are barely painful but rather annoying. Just like a a signal feeling. Idk I'm sorry its hard to explain.