Chronic discomfort in penis and abdomen
Posted: Wed Dec 12, 2012 6:07 pm
My story in short:
1.Was born as a premature baby, but was not diagnosed with any related medical conditions that time.
2.Age: 16-17 years old. One day I suddenly saw and felt a mass in my right testicle. I talked about it with my mother. She told me we would go to a doctor to check this in case it didn't go away. That mass felt soft, liquid-like and not solid, and disappeared after a day or two, so I guessed it was an hydrocele.
3.Age: 16-19 years old. That mass continued to appear from time to time, and additional symptoms began to appear such as a feeling of pressure and even light pain in the area of my right testicle (bot not always, and especially when the mass became bigger or deeper in the scrotum),
4.Age: 19 years old. During the Spring/Summer period It's started, what I call "a constant sensation to urinate". In the beginning I basically thought it was due to some kind of stress and/or drinking a lot of fluids (I was a student that time, and the weather where I live is quite hot during the summer). But limiting my fluid intake didn't help. As the days were passing by, I started to notice this sensation became more strong and more frequent. In summer it already became very annoying interfering with my activities and sleep. After going to the bathroom, the sensation disappeared but came back after 20-30 minutes or so. In the end of that Summer, the sensation became constant in nature, as disappearing only for a few minutes after urinating. Additional symptom was a constant 24/7 (ALL THE TIME) annoying sensaton in the tip of penis. it feels like there's something "trapped" in there.
5.Age: 19-25 years old. My sleep became poor. During that period I went to see many urologists. They gave me a lot of tests, among them: urine and blood tests, urine culture, ultrasound imagings of the upper urinary tract (kidneys, ureters and bladder+prostate), physical tests. They couldn't find anything unusual. Some of them told me the "it is all in your head" thing, others were clueless/seemed to be indifferent. There was a GP who gave me an alpha-blocker drug to try to ease my symptoms. I took it for week or two but appeared to do nothing but dryness in my mouth and a little bit of urinary retention. I started to accept my condition and try to live with it. It was not only the sensation to urinate that bothered me: the more I try to hold my urine the more feelings of pressure and pain build in my pelvic area, radiating to the stomach and even close to the chest. This is a very annoying and unpleasant feeling, waking me up when I sleep every 1-2 hours.
6.Age: 26 years old to present. Due to another medical condition unrelated to this one, I tried to give it "another try" and went to see a new urologist. In addition to the constant sensation to urinate, the nagging feelng in the tip of the penis and the nocturia, I also mentioned to him I usually felt a mass close to my right testicle accompanied by aches from time to time. He gave me a suspicious look and told me I might have an hernia. He checked the area physically and told me he suspected I had an hernia through my inguinal canal, not of intestinal loop but some peritoneal content. He referred me to a general surgeon. The surgeon checked my and told me I had an indirect inguinal hernia of reducible omentum which was protruding to my scrotum through the deep inguinal ring. He advised me to to have an operation to fix it. I asked him whether it could cause my aches in the pelvic and abdominal area, and he said it could. I asked him if it could also cause that sensation in my penis, and he said he didn't think so.
7.I saw another general surgeon thereafter who thought much the same: symptoms in the pelvic area - yes, in the genitals - not conclusive.
8.I still had follow up appointments with that last urologist, He wanted to check my urine stream, so I had a uroflowmetry test. The results were: average flow of 13 ml/s and max of 18 ml/s (bladder filled with 520 ml) and somewhat flat curve of the flowing pattern and residual urine of 80ml (in other ultrasound tests the residual urine after urinating was 0-40 ml and actually zero most of the times, so it wasn't considered to be significant). The velocity sounded a little bit low for me, so I asked him if those results were normal to my age. He told me they appear to be normal but quite low, so because of this and because of my chronic symptoms he suspected I had a urethral stricture or a problem with my prostate or bladder. He gave me a DRE and told me my prostate was just fine. He referred me to have an urethrocystoscopy done under a general anesthesia. I did it last summer and the again, nothing unusual was found. That last urologist decided to end the consultation with me. He didn't want me to take drugs because he thought it might not help as it didn't in the past and due to my young age. I asked him if there were additional tests that can be dome such as a urodynamic testing. He was strongly against any further testing, especially invasive ones, and the general impression I got from him was to try to live with it and that's all. I didn't mention the words CPPS/IC to him. Yet he recommended me to treat the hernia and told me it was not related to my frequent sensation to urinate and my nocturia.
9.present: I had an operation to fix my inguinal hernia two months ago. The surgeon also detected an hydrocele, what I suspected I had almost a decade ago already. He said I had an hydrocele of 20 ml, which was considered to be medium, that was "communicating" with my peritoneum through the anatomical defect. So he did a right inguinal hernioplasty with a mesh and hydrocelectomy at the same operation (open inguinal approach).
10. The chronic symptoms stayed much the same (constant sensation to urinate, constant sensation in the tip of penis and dull aches in abdomen). The acute ones (the scrotal ones) disappeared right after the operation, but for the first few week I had some neuological symptoms in thearea of the genitofemural nerve. Fortunaltey it disappeared last month but return in the last few days (however very mild). I guess there's some kind of re-modeling of tissue where the mesh was planted and sutured.
In short:
Age: 26| Onset Age: 19| Symptoms: Urinary frequency, Urinary urgency, constant 24/7 sensation in the penis (in the tip mainly - burning/pressure/discomfort/"wetness"), Nocturia, discomfort and pressure in the pelvic region radiating to the abdomen and becoming severe as time passes since last urination, Stream velocity is somewhat slow and prolonged with an average velocity of ~13cc/min (and max 18cc/min) found in flowmetry test when bladder is filled with 500cc (I always feel like I need to press my abdomen to urinate)| Helped By: Mental distraction, Sexual arousment (having erection)| Worsened By: Focusing on it, being in stressful events/activities| Other comments: Liquid intake and nutrition don't appear to affect symptoms. Sexual activity is fine, sometimes the symptoms seem to be worsened a bit after ejaculation. Age 25-26: Diagnosed with indirect inguinal hernia and medium hydrocele at the same side. After operation many of the acute symptoms (scrotal ones) disappeared, but the chronic urinary and pelvic symptoms (penile and abdominal ones) remained much the same.
1.Was born as a premature baby, but was not diagnosed with any related medical conditions that time.
2.Age: 16-17 years old. One day I suddenly saw and felt a mass in my right testicle. I talked about it with my mother. She told me we would go to a doctor to check this in case it didn't go away. That mass felt soft, liquid-like and not solid, and disappeared after a day or two, so I guessed it was an hydrocele.
3.Age: 16-19 years old. That mass continued to appear from time to time, and additional symptoms began to appear such as a feeling of pressure and even light pain in the area of my right testicle (bot not always, and especially when the mass became bigger or deeper in the scrotum),
4.Age: 19 years old. During the Spring/Summer period It's started, what I call "a constant sensation to urinate". In the beginning I basically thought it was due to some kind of stress and/or drinking a lot of fluids (I was a student that time, and the weather where I live is quite hot during the summer). But limiting my fluid intake didn't help. As the days were passing by, I started to notice this sensation became more strong and more frequent. In summer it already became very annoying interfering with my activities and sleep. After going to the bathroom, the sensation disappeared but came back after 20-30 minutes or so. In the end of that Summer, the sensation became constant in nature, as disappearing only for a few minutes after urinating. Additional symptom was a constant 24/7 (ALL THE TIME) annoying sensaton in the tip of penis. it feels like there's something "trapped" in there.
5.Age: 19-25 years old. My sleep became poor. During that period I went to see many urologists. They gave me a lot of tests, among them: urine and blood tests, urine culture, ultrasound imagings of the upper urinary tract (kidneys, ureters and bladder+prostate), physical tests. They couldn't find anything unusual. Some of them told me the "it is all in your head" thing, others were clueless/seemed to be indifferent. There was a GP who gave me an alpha-blocker drug to try to ease my symptoms. I took it for week or two but appeared to do nothing but dryness in my mouth and a little bit of urinary retention. I started to accept my condition and try to live with it. It was not only the sensation to urinate that bothered me: the more I try to hold my urine the more feelings of pressure and pain build in my pelvic area, radiating to the stomach and even close to the chest. This is a very annoying and unpleasant feeling, waking me up when I sleep every 1-2 hours.
6.Age: 26 years old to present. Due to another medical condition unrelated to this one, I tried to give it "another try" and went to see a new urologist. In addition to the constant sensation to urinate, the nagging feelng in the tip of the penis and the nocturia, I also mentioned to him I usually felt a mass close to my right testicle accompanied by aches from time to time. He gave me a suspicious look and told me I might have an hernia. He checked the area physically and told me he suspected I had an hernia through my inguinal canal, not of intestinal loop but some peritoneal content. He referred me to a general surgeon. The surgeon checked my and told me I had an indirect inguinal hernia of reducible omentum which was protruding to my scrotum through the deep inguinal ring. He advised me to to have an operation to fix it. I asked him whether it could cause my aches in the pelvic and abdominal area, and he said it could. I asked him if it could also cause that sensation in my penis, and he said he didn't think so.
7.I saw another general surgeon thereafter who thought much the same: symptoms in the pelvic area - yes, in the genitals - not conclusive.
8.I still had follow up appointments with that last urologist, He wanted to check my urine stream, so I had a uroflowmetry test. The results were: average flow of 13 ml/s and max of 18 ml/s (bladder filled with 520 ml) and somewhat flat curve of the flowing pattern and residual urine of 80ml (in other ultrasound tests the residual urine after urinating was 0-40 ml and actually zero most of the times, so it wasn't considered to be significant). The velocity sounded a little bit low for me, so I asked him if those results were normal to my age. He told me they appear to be normal but quite low, so because of this and because of my chronic symptoms he suspected I had a urethral stricture or a problem with my prostate or bladder. He gave me a DRE and told me my prostate was just fine. He referred me to have an urethrocystoscopy done under a general anesthesia. I did it last summer and the again, nothing unusual was found. That last urologist decided to end the consultation with me. He didn't want me to take drugs because he thought it might not help as it didn't in the past and due to my young age. I asked him if there were additional tests that can be dome such as a urodynamic testing. He was strongly against any further testing, especially invasive ones, and the general impression I got from him was to try to live with it and that's all. I didn't mention the words CPPS/IC to him. Yet he recommended me to treat the hernia and told me it was not related to my frequent sensation to urinate and my nocturia.
9.present: I had an operation to fix my inguinal hernia two months ago. The surgeon also detected an hydrocele, what I suspected I had almost a decade ago already. He said I had an hydrocele of 20 ml, which was considered to be medium, that was "communicating" with my peritoneum through the anatomical defect. So he did a right inguinal hernioplasty with a mesh and hydrocelectomy at the same operation (open inguinal approach).
10. The chronic symptoms stayed much the same (constant sensation to urinate, constant sensation in the tip of penis and dull aches in abdomen). The acute ones (the scrotal ones) disappeared right after the operation, but for the first few week I had some neuological symptoms in thearea of the genitofemural nerve. Fortunaltey it disappeared last month but return in the last few days (however very mild). I guess there's some kind of re-modeling of tissue where the mesh was planted and sutured.
In short:
Age: 26| Onset Age: 19| Symptoms: Urinary frequency, Urinary urgency, constant 24/7 sensation in the penis (in the tip mainly - burning/pressure/discomfort/"wetness"), Nocturia, discomfort and pressure in the pelvic region radiating to the abdomen and becoming severe as time passes since last urination, Stream velocity is somewhat slow and prolonged with an average velocity of ~13cc/min (and max 18cc/min) found in flowmetry test when bladder is filled with 500cc (I always feel like I need to press my abdomen to urinate)| Helped By: Mental distraction, Sexual arousment (having erection)| Worsened By: Focusing on it, being in stressful events/activities| Other comments: Liquid intake and nutrition don't appear to affect symptoms. Sexual activity is fine, sometimes the symptoms seem to be worsened a bit after ejaculation. Age 25-26: Diagnosed with indirect inguinal hernia and medium hydrocele at the same side. After operation many of the acute symptoms (scrotal ones) disappeared, but the chronic urinary and pelvic symptoms (penile and abdominal ones) remained much the same.
) but I would explore the physio side first perhaps or at least in conjunction with, as this can give you a better handle on what is going on before a Dr visit, unless you find a dr. on the list who is near you of course.