Acute pain in urethra, currently waiting for answers, any ideas?

[jamesnh87]

Hi all,
      I'm less seeking out answers here (although any thoughts are certainly welcome!) and more posting this in case other people have this issue, with the hope that what I ultimately figure out about it could be useful.

For about three weeks, I've had an acute pain in my urethra, about 3/4" from the tip of my penis. This has resulted burning pain after urination. When it first occurred, the spot was tender and painful from the outside (this was after masturbating, so I think I irritated it). Now, when I apply pressure, it feels like my urethra is scratched or there's some small object there. Hard to explain accurately.

I've been to a few doctors and have had an initial appointment with a urology.

There's no bacteria in my urine (multiple dip tests and urinalysis have been done). My HSV (herpes) status is unknown but a week of Valtrex had no effect on the symptoms, so it seems unlikely that could be the cause. I'm negative for gonorrhoea and chlamydia. I've been through a course of azithromycin.

The pain hasn't gotten any worse or better. I've avoided putting any pressure on that part of my penis through masturbation and am waiting for a cytoscopy in a few weeks.

I have a few thoughts on what this could be, but frankly, I'm not a doctor, so who knows. I'm wondering if it might be an issue known as a 'lacuna magna', which is an issue sometimes found in the glans portion of the urethra. The pain is right around that spot. There's not much online about that issue, and everything I've found seems to point towards it being an issue earlier on in life.

My other thoughts are that it's some sort of lesion, wart, cyst, etc. - something that has developed on the urethral wall and is being irritated every time I urinate. Strangely, the pain from this developed more after I've urinated, rather than while I urinate.

I have no symptoms of HPV, but I'm wondering if it might be related to that somehow. Oddly enough, I did have a skin tag right at my urethral opening when I was younger (before I was sexually active, so HPV wouldn't make sense there), and I wonder if it's related in some way to that.

[jamesnh87]

And another update (because I realize when people get better, they tend not to post followups).

It's over a year later and the pain has pretty much disappeared. It only reappears briefly when I think about it, and it goes away just as quickly when I shift my thinking away from it. I'm cured and my life is back to normal.

[jamesnh87]

PLEASE READ! (If you've read my past two posts). I can't seem to edit my former posts. Anyway, again, for whatever it's worth, I wanted to say that physical therapy ended up not working in the long run. The pain returned after two weeks. I was fairly downbeat, and then came across something called TMS, a.k.a. Mind-Body syndrome. If you google it, you can find some great resources and forums on the topic.

Long story short, in my case, it was a psychosomatic/somatiform illness. I think a lot of non-bacterial chronic prostatitis is like this, and I'm not the only one to have had success treating it. There are quite a few of us out there.

My pain is now 70-90% better than it was, and has been for the three weeks I've known about TMS and have been treating it as such. It keeps improving - apart from periods of stress - and I continue working at reducing the pain. I feel like I have my life back now and the worry is gone.

If you're worryingly doing internet research for hours a day, you might come across this post. I used to be that person, and unknowingly, I was ramping up the psychological causes of my pain. It was real, intense, chronic pain. I ended up in the ER at one point. Your brain can do amazing things.

You might think I'm crazy, but at least keep this possible cause of your pain at the back of your mind. If you've tried all else, had all the proper tests to rule out physical causes, consider that it might be psychogenic in origin. I always found it odd that prostatitis got worse with stress.

In any case, best of luck.

[jamesnh87]

And another update (because I realize when people get better, they tend not to post followups).

It's over a year later and the pain has pretty much disappeared. It only reappears briefly when I think about it, and it goes away just as quickly when I shift my thinking away from it. I'm cured and my life is back to normal.

[jamesnh87]

So for whatever it's worth, I figured out what's the matter with me. Hope someone searching through here who has the same issues finds this useful.

My urologist diagnosed me with prostatitis. She said the acute pain was referred pain, and my prostate was tender upon a digital rectal exam. I went on two courses of antibiotics (doxycycline and bactrin), but neither helped. I took a bacterial test of my prostate secretions, but it came back contaminated, so I'm not sure if it's the bacterial strain or the non-bacterial strain.

That being said, 90-95% of people who have this don't test positive for bacteria, so it's likely mine would be negative if it wasn't for the contamination. People with negative tests get lumped into the category of having 'chronic non-bacterial prostatitis' and are often put on long courses of antibiotics, with little if any success.

I've read some of the recent scientific review papers on antibiotics for chronic non-bacterial prostatitis, and their effectiveness is about the same as placebo. In fact, it's now being called 'chronic pelvic pain syndrome'.

My urologist was covering all the bases, thankfully, and sent me to a physical therapist who specializes in pelvic floor pain. I've been doing some pelvic floor drop exercises which have cut the urethral pain by more than half in just a week.

The pelvic floor drop exercises immediately helped correct my issues with frequent voiding and urinary hesitation/intermittent flow.

Turns out, my hip bones are twisted, and so my pelvic floor muscles, which span my hip bones, are being stretched (as is my bladder, prostate, urethra, etc. - hence the pain). I'm now doing some stretches to untwist my hips and should be symptom free in a few months. I'm already seeing relief just after the first day.

So, if you're having some of the same symptoms and get told by your doctor you have prostatitis, I'd recommend trying to track down a physical therapist who specializes in pelvic floor issues. It's really worth it. Don't let the horror stories of people living with chronic non-bacterial prostatitis scare you. I'm convinced that - in most cases - this issue is completely muscular and can be fixed through physical therapy.

If you can't do that, then I'd recommend at least trying some pelvic floor drop exercises (google that exact phrase). That'll help you release some of the tension in your pelvic floor muscles.

Good luck and hope this is useful to someone. The past two months have been extremely difficult for me, trying to figure out what this is, and I hope I can help at least help someone else facing this issue. It doesn't seem like the medical profession has yet got the memo on 'chronic non-bacterial prostatitis', but hopefully they will soon.