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Old 06-07-2012, 01:36 PM   #1
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Prostatitis or Pudendal Nerve Entrapment?

I'm a health married male of 53yrs old. In mid-March I felt what I thought was a urinary tract infection (UTI). Some discomfort amplified when sitting but relieved when standing. Went to primary care doc, urinalysis was clean; no bacteria. Given sulfa due to symptoms believed to be prostatitis but changed to Cipro due to going to Florida for 1 week and sulfa makes you suspectible to sun burn. Did 2wks of Cipro, and went to Urologist because I still wasn't feeling great. Aches in groin but UTI symptoms where subsiding. Urologist did urinalysis and blood count; both normal. Digital rectal exam; normal. Prescribed doxcyclene for 2wks. UTI symptoms gone, but 4 wks of antibiotics started to notice anal/perineum pain.
Back to urologist for cystography, results; all looks normal in urethra and bladder. Urethra passing by bladder not showing significant signs of narrowing to support enlarge prostate.
.
After coming off antibiotics start noticing when seated I have discomfort in anal area and most southern part of perineum where it joins anal area.
.
Upon morning wake have very little to no discomfort. As day passes and I'm sitting the discomfort begins and gets worse. Standing helps. Modified workstation (in spend many hrs at PC due to job) so I can stand. Started using donut seat.
.
My early May (2012) I was really anxious and stressed about the whole issue.
More blood testing of cbc auto diff, segmentation(inflammation), comp metabolic panel; all good results. Doc even checked for autoimmune system with HIV test (although I do not have any risky behavior to proke HIV contraction), HIV test; negative. Other STD tests all negative, again as I suspected with good cause.
.
Went to PT who did thorough history and exam. She cited other men with similar issues and searched for trigger points in the pelvic floor/hip area.
Only found a right upper groin area with sensitivity. She did the most thorough digital exam to date looking for trigger points, including hitting on my
prostate, but none of it bothered me.
.
Last evening I was again pretty sore but found after doing my hip flexor and groining stretches the discomfort is greatly relieved. This is not the first time I noticed this correlation.
.
With all these various test coming back negative or good results, no sign of bacteria, PT can't find trigger point , I continue my search.
.
On 6/11 I have an appt with Chief of Gastrointestinal and Colorectal Surgery for and examination to determine if anything in the rectal cavity can be foun
beside my known relatively small hemorriods.
.
Another avenue I am learning of Pudenal neuralgia after learning of Interestly two credible articles on Pudenal Nerve Entrapment. The similarities in non-bacteria chronic prostatis and Pudenal Nerve Entrapment are staggering. At least to my situation. Unfortunately there is not a lot of info or research to
diagnose PN


What amazed me is the my symptoms definitely get worse when sitting for prolong time and as the day goes by. My skin the anal and groin area gets very sensitive to touch (have to pull my underwear away from it at time to get relief). Even the elastic around the legs from underwear begins to bother me. Another contributor is tight muscles and tendons in the groin area
causing undue pressure on the pudendal nerve. (My hips, legs are very tight, hence PT's required 2x/day stretching).


I'm not convinced I have prostatitis but not denying it could be either. It's just that diagnosis of non-bacterial chronic prostatitis is based on symptoms, which I have a real issue with accepting
as being 100% accurate without some type of proof. Like show me the my prostate is enlarged? or what it is about my prostate that's causing the issue.


Any input would be appreciated.

Last edited by Administrator; 06-07-2012 at 04:53 PM.

 
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Old 05-19-2013, 03:25 PM   #2
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Re: Prostatitis or Pudendal Nerve Entrapment?

Oh my word. Your story is almost completely identical to mine. Every bit of it from the early prostatitis stuff to the physical therapist - all of it! I have recently been under the assumption that my issue is pudendal related (according to my neuro and pelvic PT), but recently I have been wondering if it is something else like my earlier prostatitis diagnosis.

I know that you posted this last year, but if you happen to read this, please let me know if you ever figured out what your problem is - I am absolutely sure that we have the same problem.

Thanks.
Wally

 
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Old 05-20-2013, 06:09 AM   #3
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Re: Prostatitis or Pudendal Nerve Entrapment?

Its has been an interesting past 10-11 months for me. After my initial post I began performing lower to mid-body stretching excerises provided by my PT.
Almost always would feel relief following the stretches. I learned some folks channel stress in the groining area which promotes tightening of those muscles.Taking a look at my overall life situation, my job promoted two things; many hours sitting at a workstation (like 10-15hrs/day at times) and much stress in the work I am involved with. So, I started to address the stress part through professsional counseling and started taking low dosage of prozac and klonopin (anxiety/anti-depressive meds). After 3 months of regular stretching in the eveings and sometimes mornings my symptoms greatly reduced. In addition, I was not taking anti-anxiety meds which no doubt help deal with the stress. I also tried to walk each day. One thing I observed about myself is this; if a situation arised that makes me cringe (like I hate the sight of someone being stabbed in the movies) I notice a physical reaction most notable in the perineum area. A momentary real tightening of the area. Anyway, by October my symptoms where gone or extremely mild,if at all. I backed off on the stretching (which I should continue w/because I am by nature not very flexible person, physically) because I got lazy. Also the work situation relaxed a bit, or was it the meds, either way work was more tolerable and I was not work quite as many long days in a row. By last December, my symptoms where gone. I was not stretching, walking most days and work was tolerable.

That said, it's now ~1 yr later and I'm coming off the prozac & klonopin, but work has gotten very busy (again!) and I notice some mild symptoms reoccurring. Nothing to warrant a doctor visit, but I my situation I am feeling pretty confident I have a relational situation; sitting long hrs + stress and tension equate to symptoms. As it is very interesting in my observations as to when the symptom flare, always around work situation. I can work 8 hours in my yard performing very laborious activity and be completely symptom free. But after a couple or three days of long sittings at work with stressful situations at hand, bam!, symptoms arise. I need to get back to stretching and more exercise while hoping I dont have to revert to back to the prozac/klonopin meds. Every medical testing I've had (and it was a boat load last year) all resulted in negative findings. Only the PT was able to insight my symptoms by pressing in certain areas of the cervical wall, but it wasn't near the prostate. Four different doctors (physician, urologist, gastroenterologist) all sighted no prostate enlargement detected. My PSA test (for what its worth) was 0.9, same value from 5 yrs ago. So, at this time I am of the mind-set my condition is being invoked by stress induced
situations coupled with long periods of sitting provoking tightening of the
perineum and anal areas which cause somewhat of a sustained soreness or
irritation.

 
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Old 05-21-2013, 09:30 AM   #4
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Re: Prostatitis or Pudendal Nerve Entrapment?

Hi, your original doctor prescribed antibiotics when your tests came back negative for bacteria.........why? You probably have an inflammation of the prostate in which case take lots of prostate suppliments, go easy on ejaculation and avoid coffee and alcohol.

 
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Old 05-21-2013, 03:40 PM   #5
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Re: Prostatitis or Pudendal Nerve Entrapment?

Thanks for the update Doug! Interestingly your story has continued to be similar to mine. I had been receiving trigger point therapy. It helped some. But just recently my PT set me up with some core stretches - pelvic tilt, bridges, crunches, other similar ones all while maintaining the ab muscles tightened. I immediately felt better after the training session. I have done them today for the second day and they definitely help. I am very high strung, and over the last couple months of paying attention to my pelvic tension I have learned that my pelvic floor is frequently tensed up. I have learned to relax it, but only while I am not distracted. I watched my son's buzzer beater basketball game this weekend and I was very sore afterwards because of all the tension directed to my pelvic area.

I am so happy that you got through this. It gives me hope that I will be able to do the same. I am sure to keep up with my stretches now.

Just curious, what stretches worked for you?

 
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Old 05-30-2013, 03:30 PM   #6
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Re: Prostatitis or Pudendal Nerve Entrapment?

Hi Doug,

I have been to numerous doctors and all over the internet looking for the cause of my sitting pain. I have seen several stories that are similar to mine, but none were so much exactly like your story (except i haven't gotten better yet). I am four months after the first initial pain was misdiagnosed as prostatitis, and I have reached the point where my PT has got me doing exercises to help with pelvic floor issues. I had a great first week, but then had a terrible time this week. The PT had me doing a lot of abdominal exercises - pelvic tilt, pelvic bridges, crunches, obliques, single leg 6" killers. The pelvic bridges seem to cause me more pain than help.

Would you mind listing specifically what exercises worked for you. I recognize that you might not have the same problem, but your situation is so similar to mine that it could be really useful information. Thanks for any info that you can provide.

Walt

 
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Old 05-30-2013, 03:31 PM   #7
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Re: Prostatitis or Pudendal Nerve Entrapment?

Hi Doug,

I have been to numerous doctors and all over the internet looking for the cause of my sitting pain. I have seen several stories that are similar to mine, but none were so much exactly like your story (except i haven't gotten better yet). I am four months after the first initial pain was misdiagnosed as prostatitis, and I have reached the point where my PT has got me doing exercises to help with pelvic floor issues. I had a great first week, but then had a terrible time this week. The PT had me doing a lot of abdominal exercises - pelvic tilt, pelvic bridges, crunches, obliques, single leg 6" killers. The pelvic bridges seem to cause me more pain than help.

Would you mind listing specifically what exercises worked for you. I recognize that you might not have the same problem, but your situation is so similar to mine that it could be really useful information. Thanks for any info that you can provide.

Walt

 
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Old 06-02-2013, 07:18 AM   #8
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Re: Prostatitis or Pudendal Nerve Entrapment?

Doug,

Can you give a more detailed description of what stretches you used to get better. I know that not everyone is the same, but your case is so similar to mine that it might be really useful information to discuss with my PT. It would really help me out.

Thanks,
Walt

 
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Old 08-18-2013, 09:33 PM   #9
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steamingcold HB User
Re: Prostatitis or Pudendal Nerve Entrapment?

I have a very similar story comparable to what I have read in this thread so far.

My symptoms started after sexual intercourse 2 years ago with a sting feeling on the urethra I thought it was a UTI as well. No bacteria was ever found so the Urologists claimed it was non bacterial prostatitis and started to pump me full of antibiotics ( makes me sick thinking about it )

Eventually 3 weeks later, I started having discomfort and fullness in the perineum. Urination frequency , etc . Eventually after time passed my symptoms started to improve ( who knows what helped ) and I was left with much more manageable problems which is what I have now. My current symptoms are very minor fullness in the perineum and mild irritation in the rectal/anal area. I also had anal fissures develop when this all started, however those have been healed for over a year.

My 4th urologist finally turned me on to the idea I probably pelvic floor or nerve problems and referrred to me to a specialist in the area. The pelvic floor specialist diagnosed me with some form of pudendal neuralgia, pelvic floor problems, muscle spasms, etc. I have had a nerve block , been to physical therapy, but have never been able to fully get rid of these problems. Its just there and doesnt want to go away. Luckily my symptoms are manageable and dont interfere too much with real life, but it would be nice to get rid of

Anyway, just thought I would share my story for others. Good luck

 
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