I’m going to lay out a scenario for you…
You’re at home having a little ~ alone time ~.
It’s been a long day and you need to release some stress, so you get the vibe right, grab the lube and a towel, and start going at it. Things are feeling great, the erection is strong, and it’s finally time to release…
However, rather than the normal feeling of a toe-curling firework-like orgasm, you feel an intense fiery-hot-poker-type pain in your taint at the base of your penis that forces you into the fetal position.Your entire perineum feels tight and painful to touch, and it doesn’t matter how much you massage it, apply a heat pack to it, or what kind of stretches that you do, the pain just won’t seem to go away.
Does this sound familiar?
We’re going to continue down this hypothetical scenario.
Over the course of the next day or two, the pain kind of lingers. It comes and goes. Gets worse with random things like sitting or having a bowel movement, and it constantly feels like you’re sitting on a golf ball.
This episode of pain obviously scares you and has you worried. So you contact your doctor’s office and make an appointment to get in as soon as possible. You go in to see your physician, tell them the whole story, and they run all the tests – ultrasounds, CT scans, urine cultures, blood and hormone panels – all of it. You leave the clinic and they said they’ll call you when they have the results to decide the next steps.
A few more days go by, your stress and anxiety increasing every day. They finally call you with the results, and to both you and your doctors surprise they all come back negative.
Your MD tells you “everything is fine” and writes you a prescription for antibiotics, EVEN THOUGH they told you everything was negative and they didn’t find any kind of infection. So you go home, start your course of antibiotics, and try to live your life. However, now you’re worried that the same 10 out of 10, knife-like pain you felt last time is going to happen again, so you wait to be intimate with yourself, or any other partner for that matter, until you finish your course of antibiotics.
A couple weeks later, that day finally comes, and even though there’s no real noticeable difference in your pain, you decide to give it a go anyway and try to drain the pipes.
…then it happens again.
Once more, your orgasmic experience causes your mild dull ache to turn into a full blown charlie horse right at the base of your penis that spreads all the way down into the rectum. You’re very obviously frustrated and likely worried, so you immediately call to make another appointment with your physician.
Again, the pain subsides after a couple days, although still present. You get in to see your physician again, they run a bunch of tests again, and again everything comes back negative; so they refer you to a urologist for further testing.
You’re not able to get into the urologist for a couple weeks, and all the while you’ve become celebate with yourself and every other human for fear of making things worse. You finally get in with a urologist who also runs the same tests, and then some; tests like a prostate exam, a bladder scan, or a kidney function test.
And again, they all come back negative for any underlying cause.
So now, it’s the urologist telling you everything is “fine”, but diagnoses you with Prostatitis, and writes you a prescription for an antibiotic and maybe even a round of high dose steroids. EVEN THOUGH they just said, “everything is fine”.
A few weeks pass, and you finish the course of antibiotics AND the steroids. Weirdly enough though, your symptoms have started to go away, albeit slowly, but they’re becoming less and less. So you being curious, start to… self explore… cautiously, anxiously, nervously. Things are feeling OK, erection is firm, strokes are feeling good, and there’s no noticeable pain. Then the big finale happens…
And boom… literally. It feels like a bomb went off in your pelvis and every single muscle from your penis to your anus has seized into a spasm. Again you’re in the fetal position with 10 out of 10 pain with no understanding as to why.
Does any of this sound familiar to you?
If it does, you’re likely frustrated, anxious, stressed, and feeling helpless. This is an all-to-common experience that I hear from my male pelvic health patients, and unfortunately it happens over and over again.
There are 4 categories of prostatitis:
- Asymptomatic inflammatory prostatitis
- Acute bacterial prostatitis
- Chronic bacterial prostatitis
- Chronic prostatitis or chronic pelvic pain syndrome
Asymptomatic inflammatory prostatitis typically does not have symptoms, and typically does not cause complications and does not need treatment.
Acute and chronic bacterial prostatitis happen when bacteria travel from the urethra into the prostate and symptoms occur suddenly and go away quickly, or they can develop slowly and last a long time.
Chronic prostatitis (CP) or Chronic Pelvic Pain Syndrome (CPPS) is thought to be caused by a microorganism, though not a bacterial infection. This type of prostatitis may be related to chemicals in the urine, the immune system’s response to a previous UTI, or nerve damage in the pelvic area by the pelvic floor musculature.
CP or CPPS is most common in men younger than 50, affects 15% of the U.S. male population, and accounts for almost 2 million visits to healthcare providers in the United States each year.
The main symptoms of CP/CPPS can include pain or discomfort lasting 3 or more months in one of more of the following areas.
- Between the scrotum and anus
- The central lower abdomen
- The penis
- The scrotum
- The lower back
Pain during or after ejaculation is another common symptom and patients may also have pain spread out around the pelvic area in more than one area at the same time. Other symptoms may include:
- Pain in the urethra during or after urination
- Pain in the penis during or after urination
- Urinary frequency – more than 8 times in a day
- Urinary urgency
- A weak or hesitant urine stream
CP/CPPS is a very complex and often misunderstood diagnosis in the medical community. Treatment often consists of antibiotics, NSAIDs, muscle relaxers, steroids, or neuromodulators. However, more alternative conservative treatments such as physical therapy have been proven to be very successful in treating CP/CPPS, as well as mental health therapy for the psychological stress typically associated with the condition.
If you are having any of these symptoms or are feeling you don’t know who to consult for your symptoms, first schedule a visit with your PCP or urologist to rule out any underlying bacterial infection. However, it could also be hugely beneficial to seek out the help from a pelvic physical therapist to help manage your symptoms. To schedule a virtual consultation with the therapists at Flex PT ATL, please call 404.445.8784 or email firstname.lastname@example.org.
National Institute of Diabetes and Digestive and Kidney Diseases. (2014, July). Prostatitis: Inflammation of the Prostate. https://www.niddk.nih.gov/health-information/urologic-diseases/prostate-problems/prostatitis-inflammation-prostate