Pain when sitting

[mike53]

I am 52 year old male and my problems started with urinray retention - which eventually I had a neural stimulator implanted in April 09 which resolved that issue. Soon after the implant I started having issues with buring pain between my testes and rectum, especially when sitting (it gets a little better standing or as I sleep). It was diagnosed as prostatits and antibiotics eventually provides relief for about a month. Then I had to take 2 long trips involving many hours in cars, planes and trains and the pain came back worse. Since them I have had 2 operations in which first my small urethra was enlarged, and then I had turp 2 1/2 weeks ago (during which there was some cust on the penis from the tools he had to use to make them fit down the urethra). Since the turp I have had pain in both the original area and in my penis. My urologist said that the turp will relieve the pain after about 4-6 weeks of healing - although since I have to drive to work every day and then sit for most of an 8 hour day I wonder if this will delay my healing - I do sit on a "donut". Does my urologists work and prognosis sound like they would be correct?

[Stephen Liroff, MD]

You bring up several issues. I’ll try to isolate them in my answer. First, your healing should not be influenced by your sitting or standing. Second, pain is not usually a part of transurethral surgeries of the prostate. The enlargement of your urethra to allow passage of the instruments may result in pain at the site where the urethra was incised if this was done at the opening of the penis. My experience with incising the urethra further in is that there is little to no pain except while the catheter is in place.
In reviewing the literature, I cannot find any reference to pain in the areas that you mentioned related to the placement of a nerve stimulator, but I wonder how you would feel if the stimulator were turned off for a period.
Beyond that, I would suggest that you be evaluated from a neurological standpoint and if nothing is found, consult a urologist who deals with pelvic pain syndromes. A urologists who specialize in treating interstitial cystitis would be appropriate.
Good luck !
S.A.Liroff, M.D.

[mike53]

Doctor:

First, my urologist already did a cytoscopy to check for IC and I do not have it.

I went to a neurologist and it was his determination that my stimulator is causing my pain. He has had me turn it down to the minimum level it still works at, and he has me taking lyrica to see if it helps the pain.  Hopefully I will see an improvement in the coming weeks.

Thank you.