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>hi Dee, >i have been doing a lot of research on this pain and i >sent this same email to an online doctor. here is his >response: >"I do believe the most common cause of your complaints >is an inflammation of the prostate gland, so called >prostatitis.  There are very few other conditions that >can cause this.  Symptoms that might occur with >prostatitis include frequency of urination, slowing of >the urinary stream, burning with voiding or >ejaculation, burning in the penile tip unrelated to >voiding, urethral discharge, sexual dysfunction (such >as difficulty with erection), aching in the penis, >testicles, and discomfort in the lower abdomen, low >back, groin, rectum or perineum (the area between the >scrotum and rectum – between the “wind and the rain”) >and constipation. The passage of blood at the >initiation or termination of urination or in the semen >can also be noted.  semen.   During sexual arousal the >prostate gland & seminal vesicles manufactures fluid >that account for the majority of the semen. The >seminal vesicles are paired structures located behind >the prostate gland that are also sensitive to sexual >excitement.  Sperm from the testicles (which account >for only 1-2 % of the semen) travel up a series of >tubes (epididymis and vas deferens) on each side to >join the seminal vesicles forming the paired >ejaculatory ducts.  These structures empty into the >prostatic portion of the urethra.  At the time of >ejaculation, fluid is discharged from the prostate >gland and ejaculatory ducts into the urethra (urinary >canal) forming the semen.  The average semen volume is >2-6 cc.  With the inception of ejaculation, the >bladder neck closes and the semen is forced forward >out the urethra by contraction of the pelvic muscles. > It is not uncommon for inflammation and/or infection >to spread in a retrograde manner into the vas and >epididymis.  Even without such spread, prostatic >discomfort is often referred into the testicle.  Too >frequent or too infrequent ejaculation, sexual arousal >without ejaculation, withdraw at the time of >ejaculation, aggressive bike or horse back riding, and >excessive spicy foods, alcohol, and caffeine in the >diet can predispose you to this.  Sitting for long >periods of time, especially in an automotive vehicle, >can put undo pressure on the prostate and aggravate >the condition.  For the latter, it is best not to sit >more than 2-3 hours at a time.  Stop the vehicle >periodically, take a short walk and go to the bathroom >to urinate.  A thick pad or piece of sponge rubber on >your seat will also help to cushion the prostate.  One >should avoid any of the above that apply.  Eliminating >all of these factors that apply to you are just as >important, if not more so, than taking medication! > Ejaculation beyond the tolerance of the prostate to >fill and empty may also cause discomfort.  Likewise if >one does so infrequently, fluid still builds up from >thoughts, dreams, fantasies, etc. and has to be >released periodically to decompress the gland and >relieve the symptoms.  For most men, ejaculation in >moderation, perhaps 1-2 times a week, is reasonable. > A daily warm bath for 10-15 minutes 1-2 times daily >also lessens the discomfort.  Attention to sexual >activity and warm bathes should be utilized regardless >of the type of prostatitis and whether or not >medications are prescribed. > >There are several types of prostatitis.  Sometimes >prostatitis can be due to an infection of the gland >with bacteria.  Typically, pus cells and bacteria are >found in the prostatic fluid. The infection usually >requires an initial 4 week course of an appropriate >antibiotic (the commonest prescribed are the >fluoroquinolones, but tetracyclines, sulfas and other >agents can also work).   > >Abacterial prostatitis has several varieties. In one, >the prostatic fluid demonstrates pus cells but no >bacteria.  In the other, there are neither pus cells >nor bacteria in the fluid, just the symptoms.  In all >types of prostatitis, the urinalysis generally is >normal unless the infection spreads into the bladder. > Abacterial prostatitis is an elusive entity that has >been called by a variety of names including >nonbacterial prostatitis, prostadynia, pelvic >congestion syndrome and most recently pelvic >myoneuropathy.  The latter name was coined by Dr. >David Wise of Stanford.  He believes that this may >represent up to 95% of all cases of prostatitis.  This >variant may be an expression of interstitial cystitis >and possibly is due to autoimmune or neurogenic >factors. Dr. Wise suggests that  the primary cause of >the symptoms involves pelvic muscle spasm, nerve >trigger points and some degree of anxiety (either the >cause or result of the symptoms).  His therapy >involves the use of anti-depressents (we have used >Elavil for years in refractory patients), relaxation >techniques, trigger point physiotherapy, and >biofeedback.  Some others recommend Yoga & meditation >as being useful.  Although he may well prove to be >correct,  I generally recommend an initial course of >antibacterial therapy for patients who clinically have >symptomatic prostatitis of any variety.  The majority >of patients (even those with nonbacterial prostatitis) >seem to respond favorably.  It has been know for >decades that many patients with the abacterial variety >of prostatitis do well with antibiotics but the reason >has been vague.  Some theorized that they may harbor >bacteria in the tissues of the prostate that are not >being picked up in cultures (possibly walled off loci >of infection).  For more information on Dr. Wise's >studies check out: ><a rel=nofollow target=_blank >href="http://www.pelvicpainhelp.com/">http://www.pelvic >painhelp.com/</a> >In my experience, symptoms usually responds to the >general measures mentioned in the initial paragraph. > Medications that sometimes help include the >over-the-counter natural supplement saw palmetto 320 >mgm daily and alpha-blockers (such as Flomax, Hytrin, >Cardura & Uroxatral).  The latter require a >prescription from you physician if he thinks it is >indicated.  Prostatitis may also be classified as >acute (severe), subacute (mild), or asymptomatic.  It >may also occur as a single episode, be recurrent or >chronic.   > >In cases refractory to treatment, there is another >condition that can produce similar symptoms. This >disorder is ejaculatory duct obstruction. Usually the >  doctor will find the seminal vesicles to be very >swollen on rectal examination. The patient will notice >either absence or a markedly diminished semen volume. >The diagnosis is made by doing a transrectal >ultrasound of the prostate and seminal vesicles. > >Therefore, if symptoms persist, consultation with a >urologist should be scheduled.  In cases with >recurrent prostatitis or hematuria, it often is >necessary to study the urinary tract more completely. > Predisposing factors to prostatitis such as a >urethral stricture (narrowing) and other disorders can >then be evaluated. If your symptoms persist in spite >of proper therapy and you have not previously had a >cystoscopy, this should be performed. A man should >learn to listen to his body.  Good luck." > > > > >>Chris, My husband is having the same problem. We are >>desperate to find help!! I feel for you and my >>husband. Please let us know if you found out >>anything>Hello I am a 38 year old male. For the last 3 >>months I >>>have had sharp needle-like pains in my penis. I have >>>been to 5 different urologists and taken test for >>>clamidia and stick tests for all bacteria and sexual >>>diseases and also a spermorgram, and everything has >>>comeback negative. >>>1. I have no trouble or pain urinating and the pain >is >>>not increased by it. No increased frequency or >>>urgency. Completely normal there. >>>2. no discharge/no blood in urine or semen. Lymph >>>nodes are normal. >>>3. I dont have back pains or any swelling of the >>>prostate (doctors checked twice with DRI) >>>4.sexual function are normal >>>5. the rim of the head of the penis is very sensitve >>>and more red than I remember it being. it hurts when >I >>>walk because the tip is so sensitive. >>>6. I have been on 4 different antibiotics, at first >>>they worked and the pains decreased while I took them >>>but then came back full force when the treatment >>>finished. now they dont even work. >>>7. I have had what i thought was a yeast infection >3-4 >>>times in the last 3 years. Docs say there is no >>>infection now but symptoms are exactly the same. >>>8. I'm pretty sure the pain is in my urethra. Feels >>>like needles on the inside and doctor said it was a >>>bit red in there. >>>9. This all started 5 days after having unprotected >>>sex with a woman and rather hard oral sex from her. >>>She got checked and found only a minor yeast >>>infection. But i have been cleared of all sexual >>>diseases with the tests. >>> >>>I have pain all day and night. >>>...the pain is real and driving me mad. >>>any idea what i should do next? >>> >>>Any help would be appreciated. I am in real pain. >>> thank you, >>> Chris

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