I was born with spina bifida, L4 lipomeningocele. Had surgery to correct it which left me with muscle weakness below the knees, complete urinary incontinence and chronic constipation. I used diapers to deal with my incontinence and daily laxatives in the form of malt extract. At various times I tried multiple overactive bladder medication to try and help with my incontinence which did not bring the desired effect and the side effects where unacceptable. Severe constipation mostly and at the age of around 6, Ditropan gave me terrible constipation and a painful erection that would not go away, it was believed to be because of the constipation. As far as my incontinence goes I never catheterized but I used to get somewhat frequent urinary tract infections, once or twice a year. At age 25 I had an artificial urinary sphincter implanted for my incontinence. It was successful and I have not used a diaper for a year. The surgery had no complications, other than a urinary tract infection less than a month after the surgery which was treated with antibiotics. Since after the surgery I have been having some symptoms that I had mostly been ignoring but seem to be getting worse. The first one is that is that I do not remember the last time I woke up with an erection. I believe that it was a frequent occurrence right before the surgery but I cannot be sure. Also now I seem to be having severe premature ejaculation. Before the surgery I was able to watch porn with light stimulation of my penis and it would stay very hard/full for the duration for a long time before I absolutely felt like I needed to ejaculate. I could feel when I was approaching the point of no return and could pause without ejaculating. Now it seems that I get the feeling I need to ejaculate as I am getting erect and sometimes ejaculate as soon as my erection reaches its peak. Also I seem to be having a lower sex drive and weaker erections (especially when laying down). My ejaculation volume has also diminished to about 20% of what it used to be, even if my urinary sphincter is in the open position. Now recently I have been having a relatively new symptom. At various points during the day, I get strong dull pains on the tip of my penis, the base of my bladder, heaviness in my rectum and pain on both my big toes all at the same time, most of the time accompanied by an uncomfortable erection. These symptoms don't happen when I get erect but rather I get erect when the symptoms are present. The pain is worse when lying down or sitting, (worse when lying down that sitting) and on the days when I have these symptoms, my premature ejaculation is at its worst and I am able to orgasm/ejaculate multiple times, albeit every time prematurely. I have had these symptoms before, including the big toe pain when I was a teen a few times but haven't had any of that for years up until recently. Warm baths seem to take the pain away and relax me and some days are better than others. If I am diligent with my intake of water and fiber, it seems that these symptoms are not as pronounced. I believe the big toe pain that accompanies the rest of my symptoms comes from some sort of referred pain from my prostate. The reason why I say this, is because there is an implantable device called InterStim that helps with overactive bladder by sending electrical pulses to your spinal cord around the L4 level and one way the surgeons know that the electrode is placed in the correct place is when the large toes flick when a strong electrical pulse is given. Therefore I believe to be a connection of the pain I am feeling with the nerves in the area. Also it seems that my erections, ejaculation volume and prostate pain is better when I am not severely constipated. I believe that my symptoms are related to a combination of chronic constipation, possible prostatitis stemming from a prior urinary tract infection and possible benign prostate hyperplasia. I will not be able to contact my urologist for a little while and I was hoping if I could get some advice about my problems.