Need advice

Male pelvic pain, prostatitis, IC
noquitter
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Need advice

Post by noquitter »

This forum is a godsend, since there is not much information out there about this. At the same time this is weird, since just reading the posts, it seems CPPS is more common than publicly acknowledged.

My current situation is that after 6 months of being in this CPPS hell, I am slowly working my way out of it, but I am still not fully well, so I would appreciate your advice as to if my symptoms are common to pelvic myoneuropathy or something else is going on.

History:

1. It all started after a stressful couple of weeks where I was tense and wasn't sleeping very well for some other reasons, and then suddenly, after masturbation, I developed a pain in the urethra (about where the glans meet the rest of penis) that wouldn't subside no matter what. At the worst, it was a bad burning feeling, like something was clamping me at that site, and it was 24x7 and totally unrelated to urination. Urination was not painful at all, as a matter of fact have never had burning pain while urinating, but my urine flow slowed significantly.

2. Pain was so bad, I couldn't even touch the underside of my penis. It felt like it was broken, but there was no external sign of inflammation, redness nor anything.

3. No discharge - ever, EPS - Clean, Urethral swab - Clean, Several Urinalysis - clean. No external signs, not even redness on the meatus. Uroflow test - not very good, with Qmax at 14 , Qave at 7 and significant residue. At that point, Dr suggests Cytoscopy to rule out things. Cystoscopy - completely clean - he says as normal as it gets. At that point Dr. suggests nerve related...

4. I went like this for a couple of weeks, and got rid of this by taking (by pure chance) valium 10mg and getting a good night sleep. The symptom subsided a lot, and I was on the right path. No masturbation, no sex for 10 days, and I was symptom free. Started taking B vitamins, de-stressing and getting some rest and urine flow came back. But after having sex for a couple of straight days / or masturbation, it would flare right back. :(

5. Then recently I discovered this forum and site.

Where I am at now:

1. Taking Vit C, Multivitamin with Complex B, Omega 3 and Quercetin.
2. Have cut out caffeine, and any stimulants (which gives me more anxiety), and still have one or two beers which do not seem to affect me one way or another.
3. Read A HEADACHE IN THE PELVIS and started to avoid the clenching of the pelvic muscles that I would inadvertently do when tense. Also trying to relax more, although not easy all the time.
4. I think I am 90% pain free. Will get sometimes a tightness feeling in the site, but don't feel pain per say lately (Think any accredited quercetin product has helped on this).
5. Urine flow is back to normal or better, most of the time. Sometimes I can pee three feet away from the toilet with good strength, sometimes, if I have been tense, not so great.
6. Lingering symptom is that at ejaculation, sometimes I still get a strange feeling at the site in the urethra. Sometimes like a spasm (like it can't decide what to do or the ejaculation spasms are out of sync), sometimes like a sore feeling on the ejaculation movement and sometimes like if the semen was passing through a tight place or something was gripping the urethra tightly. It is odd to describe for sure, but it is not something I used to have. When I get this feeling, 2 out of 3 times I know that I will have a flare, and it's time to take a break from sex or reach for the valium.
7. Obviously this has led me to cut down severely on my sex life to about once every three to five days, unless I got a flare, and then it's 10 days with no activity whatsoever.

Couple of questions:

1. Does this sound familiar? Specially odd to me is the discomfort at the urethra at ejaculation and would like to know if this is something that others have experienced and how can that be explained from a muscle problem perspective.
2. How do you know when you are completely cured and can go back to your regular sex life (which was daily masturbation or sex with wife). I sure miss that! it has me quite a bit depressed and it is affecting my family life...
3. How long can you go on Quercetin? I have read three months, six months and indefinitely on some other posts.

Thanks guys.
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webslave
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Re: Need advice

Post by webslave »

  1. Yes, and it's explained here. But you should get a cystoscopy to make sure there is no stricture (EDIT: sorry, I see you said you had one]
  2. Daily sex is a big ask for pelvic nerves that are prone to dysfunction. Once or twice a week is normal.
  3. Indefinitely, but take shorts breaks of a week every month or so (makes it work better, for some reason).
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noquitter
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Re: Need advice

Post by noquitter »

Yes, at the start, the two doctors I went to were inclining towards a stricture, and I was sold on this idea until they did a Urethrography and Cystoscopy, where both ruled it out. Can they miss something like this?

Later on from researching strictures, I found out that a) they rarely if ever cause pain b) their flow restriction is pretty much constant. It's not like you have a firehose one day and the next day you lose pressure only to have a firehose the following week... It's more like a permanent blockage. Also how would a stricture be helped by valium?

Dr's never mentioned CPPS, and it was just when I stumbled on this site, that things started to make sense. Still, as one of my Doctors told me, it's all very weird.
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webslave
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Re: Need advice

Post by webslave »

You don't have a stricture. Forget about it.

Lots of family doctors and GPs know nothing about CPPS.
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noquitter
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Re: Need advice

Post by noquitter »

Well, it seems like my last symptom is the discomfort, weird feeling at ejaculation. Sometimes it happens, sometimes it doesn't. The pain that came afterwards seems like it's gone since I started the any accredited quercetin product and started the conscious effort not to clench the pelvic muscles. (I give most of the credit to the Quercetin).

Why still the discomfort / sore feeling at the ejaculation contractions? Is this still a sore muscle at the contractions that refers the discomfort to the urethra? a nerve problem also reflected at the urethra?

How do the resolution of CPPS symptoms usually progresses for other members? Is this the last symptom to get rid of? I just want to make sure I am making progress on this. I will do whatever it takes to get this fixed once and for all.
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Re: Need advice

Post by webslave »

When dealing with nerves, progress is slow. I would continue on your path, and expect it to take months to go away, and even perhaps return now and then as life progresses, because once you have established the neural pathways for that pain, it can come back when provoked.
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Re: Need advice

Post by davyboy »

webslave wrote:When dealing with nerves, progress is slow. I would continue on your path, and expect it to take months to go away, and even perhaps return now and then as life progresses, because once you have established the neural pathways for that pain, it can come back when provoked.
Interesting. I was unaware of this.
Age: 27 | Onset Age: 26| Symptoms: Occasional penis discomfort (mild), primary pain is perineum - feels like I'm sitting on a golf ball, pressure in penis, almost like a stick is in my urethra, difficulty sitting for long periods of time, urinary frequency (some), incontinence (dribbling), right testicle pain (almost gone!), hip pain, stiff hips, lower back pain. Some abdomen pain. Just general discomfort in the area, post sex discomfort. | Helped By: External and Internal PT. Hot bathes. Supplements (mag, omega 3, vitamin b and D, prosta Q). Relaxing. Breathing exercises. Anti inflammatory diet. Stretches. Yoga | Worsened By: Stress. Core exercises, too much exercise, too little exercise, strenuous exercise. Sitting. Too much Sex | Other comments: Feeling better, but still not 100% I'd say I'm 75%
noquitter
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Re: Need advice

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I had continued getting better, feeling excellent at times and I almost thought that had beat this thing, but now lingering symptom is a constant burning feeling at the tip (unrelated to voiding) that comes on towards the end of the day. It is not so much pain as uncomfortable. I do believe it's referred pain, as I can't pinpoint exactly the discomfort site. I go to sleep and next day I am good to go... Weird...

In your experience are there any cues on whether the problem is prostate or pelvic muscles related? That would obviously help in directing the treatment. I was never treated with antibiotics because my first and only EPS was negative...

As I mentioned previously, valium helps which would point towards pelvic muscles, but then any accredited quercetin product also helps which would point towards prostate related?

Let me have your ideas.

I am very frustrated... :cry:
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Re: Need advice

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Re: Need advice

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Well, what I was trying to get at is if I should try out the Antibiotic route. I never tried antibiotics, since the first thing they tested for was the EPS and it was clean. BUT, I have read that on bacterial prostatitis you could do this test several times and get some clean results...

What would be the first antibiotics to try? My understanding is that I shouldn't use Quinolones since they dont mix well with Quercetin. Any other antibiotic that works well while taking quercetin?

I hate taking antibiotics just for the sake of it, but I think the risks of not taking them (if I do have a slight infection) vs taking them without an infection supports the former.

The weird thing is why would Valium help if it was indeed a bacterial component. But none of this syndrome makes much sense...
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Re: Need advice

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If no bacteria can be isolated, then it is not an infection, and taking antibiotics is highly inadvisable.
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Re: Need advice

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Are you suggesting to get a new Prostate massage / EPS before starting antibiotics? My doubt is regarding the conclusiveness of just one EPS at the start of this ordeal. Any other things that might point out if this is bacterial in origin?

If it's bacterial in origin and I don't treat it, will it also go away or I risk serious damage?
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Re: Need advice

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Re: Need advice

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Thanks Webslave. Great response and reference. My symptoms look nothing like the ones described by the chronic bacterial prostatitis sufferer. If I had to play doctor, I would also agree, that this does not sound like an infection at all. Just wanted to keep an open mind and discard any remaining options, specially if they could prove harmful.

Yesterday I went out with a couple of friends, had a couple of scotchs and had a great time. Alcohol seems to have no effect whatsoever on my symptoms. No worsening, no burning on peeing, no nothing. Sometimes, I am actually even more relaxed, which helps...

What muscles are the ones involved in the ejaculation contractions of the urethra? The pain at ejaculation seems to be like a strong contraction or spasm at the urethra (corpus spongiosum). That seems to be my last remaining symptom...

Any medications that I could try for this besides valium? Elavil for a time perhaps?

Thanks for bearing with a frustated me.
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Re: Need advice

Post by webslave »

Main muscle involved in ejaculation is the bulbospongiosus.

Yes, Elavil has helped many men. Worth a try. Start slowly with it, use a pill cutter.
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