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What can be done for burning prostate/rectal area


I'm a 64 year-old white male.

I had a vasectomy 25 years ago, resulting in a pea-sized lump on my right chord.

I have had a broken tailbone and fractured pelvis.

I have had some penal and prostate burning and pain after ejaculation for the past 10-15 years.

About a year ago I started having more penal and prostate pain and a slower urine flow. Last summer I started taking an alpha blocker, Terazosin 2mg once a day. I take no other medications except for some vitamin and mineral supplements.

Last fall I had a severe prostate attack and almost a full urine blockage. Prostitutes? Prior to this flare-up, I had driven about 16,000 miles in a period of three months. Now, sitting more than ten minutes irritates my prostate and rectal area. I usually have to urinate two to four times a night. Often the flow rate is slow, uncomfortable, and slow to start. Sometimes I take two Advil before going to bed to relieve some of the discomfort.

Two cystoscopies showed everything normal. Several digital rectal exams showed a normal prostate. No detectable urinary tract infections. Normal urine every office visit. A year ago I had a colonoscopy with no significant findings.

Since then I have had various levels of burning in the prostate and rectal area.

My PSAs before these problems showed up were 1 to 2, inching up to 4. My PSA was 33 during my severe prostate attack. My last two PSAs were 6, two months ago, and 4 last week. Both were taken while I had some prostate and rectal area irritation, so they could also be misleading.

About two months ago the lump on my right testicle increased in size to about 3/4 inch and became more painful. On May 2, it will be removed (Epididymectomy). Maybe this lump has been affecting my prostate?

I consume a significant amount of fiber, but still have hard stools more often than not. My liquid consumption is mostly water and skimmed milk and no caffeine. I try to consume about one gallon of liquid each day. I am regular with at least one bowel movement per day. In recent months I have often gotten the urge for a bowel movement three or more times a day, generally passing only a few hard lumps. This certainly can't be helping my prostate and rectal situation, and I need to investigtate a stool softener.

More facts: I've worked in an office environment nearly 40 years, which obviously hasn't been good for my prostate. I have been riding a bicycle for many years, and have had problems with pain in my tailbone area, but I don't recall any prostate discomfort until last summer. Last summer/fall after my prostate had been acting up, I rode about 100 miles until I could no longer stand the prostate/tailbone pain.

Here's my issue. Back in 2004 at a Postgraduate course, "Male Pelvic Pain", Dr. Jeanette Potts, Cleveland Clinic Foundation, gave a presentation whose title started with, "If Your Only Tool is a Hammer, Everything Looks Like a Nail:..." It seems to me that a hammer may be the only tool many urologists have. I'm wondering if I may have some nerve problems that could be causing referred pain. I cannot lie on my back on a soft or hard flat surface for more than a few minutes before my prostate and rectal area begin to burn almost unbearably. I have to lie on my side. Why would lying on my back cause such burning in my prostate and rectal area? The same is true when I sit. Standing in one place for periods of time generally causes pain in my right kidney area and also the prostate and rectal area. For a number of years, riding my bicycle also caused pain in my right kidney area, which always went away a week or two after not riding. In the past 20 years, I have strained my back three or four times while lifting something, each time making it difficult to move around without some pain for several weeks. Other than that I generally have had no significant back discomfort, other than when I stand in one place for a significant amount of time, such as right now as I type this standing at my desk. I also jogged for about twenty years until around 50 years of age, and I may have had some sciatic nerve problems.

Last summer/fall I also walked about 250 miles in the mountains, and when the weather is good I regularly walk two to six miles several times a week. While I'm walking and for hours after, my prostate and rectal burning often become barely noticeable, and while walking, the discomfort will usually become apparent only as my bladder begins to fill up. When I'm outside working in the yard, etc. the discomfort also seems to be less. Perhaps increased blood flow is helping?

The rest of my story is that I'm not overweight, but I'm probably in average to below average physical shape. I have low muscle mass and various joint pains that seem to come and go. I'm sensitive to many chemicals, but have no allergies. I'm sensitive to heat and cold. I tend to be hypersensitive and nervous, and I absolutely need no caffeine to stay awake. Even when my prostate keeps me awake much of the night, I generally will not be sleepy the next day, but I may start to feel fatigued in the afternoon.

If my urologist cannot find anything wrong with my prostate, and if the symptoms don't start to improve after recovering from my Epididymectomy, I may need to suggest that he look for a new tool to replace his hammer. Any suggestions for what that tool might look like would be deeply appreciated.

Thank you.
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