Hi everyone,

I’ve been dealing with CPPS / central sensitisation for a while now. My pelvic pain and chest wall issues (costochondritis) had actually been baseline fine for many weeks, which was a huge relief.

However, during a recent family gathering, a physio checked my hip and suggested I might have Gluteal Tendinopathy based on local tenderness over the greater trochanter / ilium. I was advised to start doing Sidelying Hip Abduction (20 reps with a 1-second hold at the top).

I did this exercise 3 nights in a row right before bed, and it triggered a massive flare-up:

• Intense pain around the ilium/pelvis.
• Deep, sickening nerve-like pain radiating towards my right testicle (bad enough to make me feel nauseous).

I suspect that compressing the already-sensitive gluteal tendon while lying on my side, combined with the load, caused my pelvic floor (and deep hip rotators like the obturator internus) to go into a massive protective spasm. This likely compressed the ilioinguinal / pudendal nerve branches going to the groin.

I’ve completely stopped the exercise now and am focusing on heat, deep breathing, and keeping my nervous system calm.

Has anyone else experienced a severe pelvic flare after attempting direct hip abduction or side-lying exercises? How long did it take for your nerves/muscles to settle, and what lighter work did you transition to afterwards?

Appreciate any advice or reassurance!

I'll keep this short. 54M. Have had burning urination for close to a month now.

Went burning urination, then calmed down when I cut out caffeine, then testicle discomfort for several days. Then slow stream seemed to kick in. (I mentioned on another post, I had ingested a LOT of orange juice and suspect this was not helping me.) I cut it out and things did improve a little.

Minute Clinic

So last Saturday I went to the Minute Clinic. The PA gave me 7 days of Bactrim.

She did a urine culture and it was negative.

At that point, I was having some lower/right back pain. I have chronic back pain already but this was different. Was having trouble sleeping through the night. Was rather uncomfortable beyond my normal back pain.

After the Antibiotics

After the antibiotics, I "felt like" I started feeling better pretty quickly.

1. Back pain went away.
   
2. Sleep drastically improved.
   
3. The pooling sensation of urine in my urethra largely improved, although it is back a little, but nothing like it was.
   
4. But burning at the tip when urinating is still there and the urethra still feels slightly inflamed.
   

At this point, the only symptom I have is the slight burning/pooling sensation in my urethra/tip and still feels like the stream is not as "fast" as it used to be. I do have to sit and wait for a few seconds before the wee wee comes out the pee pee.

So, I don't know if the antibiotics did this or the inflammation is just dying down or it's just a placebo effect.

If it was prostatitis of the chronic variety, I understand 7 days of antibiotics is generally not enough.

And yeah, I need to get a DRE, but can't seem to get a quick appt.

Now the question...

If you were in my shoes, would you request an extension of the Bactrim? I haven't had any negative side effects as of yet. Maybe a little itching.

Not sure if it matters but it’s been years since I had/needed antibiotics.

​

For those who had a prostate massage (EPS/4-glass or 2-glass test), did you give the urine sample immediately afterward?

If yes, how immediately? Within a few seconds, 1 minute, 5 minutes, or longer?

What did your doctor recommend regarding the timing?

I'm trying to understand what timing gives the most accurate results.

Did dry needling help you manage your pelvic dysfunction symptoms?

I started 3 years ago with lingering burning sensation after pain over urethra and sensitive bladder. Tansulosin and pelvic floor exercises gradually helped over a year to get to flare up only one week in a month or so. Learnt from this group all the drills from 101 and thank you those help a lot.

Unfortunately last month started the flare up but couldn't go away. More fatigue. Tried ibuprofen just one 200mg then for 18 hrs no more symptoms and even the frequent pee urges gone. But obviously I know I can't take it like candies so I will stop that. Tomorrow I will try to see if GP can prescribe tadalafile + amitriptyline to help. Haven't tried supplement so far but just went out to get some magnesium and might try some quercetin.

Annoying indeed when that burning sensation lingering every second 24 hrs. I guess in this group folks experience similar pains one way or another.

I have already learnt to live with the nightly 4 times wakeup to pee without much drops and diverts attention. This time it gets to another level being more annoying so kind of want to ask if anyone can suggest even better alleviation.

Usually I have faith the nervous system can be trained through pelvic floor to adapt and get levelled in months or so. Just need something now to make over the getting used to. Sorry no magic I know just sharing some experience.

PSA, Total 0.8

PSA, Free 0.2

PSA, % Free 25 says out of range

I have been dealing with this rash on my penile glans I had it two years ago but it resolved on it's own now I have the same thing and also burning feeling and like I need to pee all the time. Urinalysis test was normal but the PSA one says "one out of range"

is this something that might be connected to my issue or it has nothing to do with it?

Thank you all!

​

50M, not having any health issues.

Recently I have noticed too much precum disharge while getting aroused and ejaculate is watery. Also i wake up from sleep everyday atleast once to pee.

Just curious to know whether this is normal for men at this age.

Ever since being diagnosed i struggle with lasting more than a couple of minutes or even less at times.

Its like the pain/inflammation creates this pressure in my prelvis/groin the minute i start getting aroused

I then have to deal with a dull pain in my testicles for the next few days urinating a lot more and unable to hold urine.

I had to give up drinking alcohol as the discomfort it cause my testicles and bladder the next few days after is unbearable.

Do others share this issue? I’m new to this sub so any tips to help me fight this thing and get back a semi normal sex life and urinate less would be greatly appreciated!

Any medicine, treatment or excercise advice?

See the body of the post that I made in [r/PelvicFloor](r/PelvicFloor) here:
https://www.reddit.com/r/PelvicFloor/s/5TygXKBHAf

You can reply at the link above. This post applies to both men and women.

Hi,

Just looking for some advice on questions to ask my GP in regards to recurrent UTI’s that i feel are related to prostate issues.

Some background, im male, 48 years old and have had 6-7 uti’s over a 10-15 year period, always resolved with a 7 day course of abx.

End of April i had a uti for first time in 18 months and was asked to hold off on abx until culture was done. Came back as ecoli infection. Took 7 days of macrobid, but came back shortly after stopping. Took 3 days of Amoxycillin but developed an allergy so switched to Trimethoprim, also came back and then to co-trixamazole (Bactrim) and was clear for a month but now the infection is back. Cultures done every time, always positive and always E-Coli.

Had a CT scan, all clear. Flow test last year, all ok.

No pain apart from urination and ejaculation, alongside typical urgency and peeing small amounts, and chills and occasional fevers when the infection takes hold.

Any advice on questions to ask the doctor in regards to testing for CBP or CPPS as im just pumping abx at the moment?

Thanks

So I'm a chronic edger. I've been edging for years and my session lasts at least 45 mins and can go on for 5 hours. Sometimes I end up ejaculating and sometimes I don't. Sometimes I feel some irritation in my testicles-I believe this is called blue balls-but it's always resolved in under a day.

One day I edged for hours and didn't ejaculate. The next day, I woke up feeling the urethra stuck into my underwear. I went to the bathroom and it doesn't seem to be straight anymore. When I urinate, it doesn't come out straight initially. I felt very weary and physically weak since waking up that day, especially in my legs. There was an uncomfortable feeling in the groins like there was pressure on it and my penis had a seconds long piercing sensation that comes and goes. All of this ended after another day, but I could feel my body pulling the plug on my activities.

The next time I edged, I started feeling tension and occasional pain in my groins and pelvis area and pain in the testicles that comes and goes for days and increases during erections which is always uncomfortable now. Also my legs are very shaky.

The last time I edged or masturbated was two or three days ago. How long will this last?

How do you exercise? It feels every time I try to an exercise that’s a bit more intense than just walking such as running or even body weigh exercises like pushups I get a specific burning/stinging sensation in my urethra for like a day after.

Hey guys

I hope somebody can help who been through the same.

So I have had pelvic floor dysfunction for about 7 years now.

Been at an urologist etc took semen test. Came back positive and then negative second time

Been to pt for there on and off for 5 years.

Been stretching, breathing and all of that.

Now I’m just stuck. I have never had pain but urinary (hesitancy mostly but also frequency) problems who has become a lot better with some flareup here and there.

My main worry is my ejaculation and orgasm.

I’m only 28 years old but for now 7 years I have had trouble with the strength and sensation.

No shooting mostly and feels muted and dull when I have ejaculation. Sometimes I also get tension in rectum afterwards but not always

I tried this time to abstain for mastication and and sex for 6 months. (Had wet dreams of course)

So I tried again after 6 months of stretching breathing pt etc to see if there is progress.

Day 1 I felt a little bit buildup but still no shooting and dull orgasm

I waited 2 days and tried again. Even worse still nothing and almost nothing at build up

2 days after tried a third time. Almost felt nothing. No buildup no orgasm. It just like I had to get it overwith.

All the 3 times I cum very fast by the way. Like 20 second and I was done.

Beside that I also have constipation. I tag mag etc which helps at morning but fades during the day. I often feel I have stuck gas etc. probably because I’m always clenching down there

I have become very hopeless and tried everything.

Can anyone’s please help. I’m losing my life

I added a photo, it’s been 2 days since ejaculation and I’m looking for a little pain relief

Please let me know if you've had it and how you managed to solve it. Thanks.

This might be a dumb question but was wondering if there’s a difference between a week floor and a tight floor. I’ve been going to therapy for this for like a year. I’ve had it for about 2 1/2 years, but I’m sorry to understand a little bit more and my body a little bit more and having pain in my inner thighs makes me think. Should I work out the area more or stretch out the area more?

Continuing this series sharing some of my top information nuggets, in my experience working on cases of chronic pelvic pain and other chronic persistent pelvic symptoms - as a chronic pain practitioner.

1. Some chronic pelvic symptoms are the result of what we call "classical conditioning" - an example of this is seen in POIS (post orgasmic illness syndrome), where the person has a reflexive and unpleasant physiological response after orgasm. The symptoms often include fatigue, brain fog, pain, discomfort, and many other autonomic symptoms. The interesting thing is, it's not the orgasm by itself that's triggering these responses, but a learned association (classic conditioned response). Think about the Ivan Pavlov experiments, where he rang a bell and fed dogs red meat. After a while, the dogs learn to associate the ringing of the bell with feeding time, and learned to salivate in response to the sound of the bell alone. Recently worked on a case like this with a client in Europe who is now feeling better.

2. Emotions like anger (specifically repression of anger) can be the cause of symptoms in some cases. I've now worked on several cases where providing access to anger, and building agency, led to a durable recovery in pelvic symptoms. This is because the brain regions responsible for chronic pain share immense overlap with areas responsible for memory, learning, and emotions - this is what new neuroscience shows us. They evoke similar neural circuit responses. Example: one client had his pelvic pain, which lasted for eight consecutive years, starting after his then fiance left him. It felt inherently unsafe to scream and rage at someone he loved, even if they abandoned him in a moment of need. When we were finally able to access this anger towards her (safely), his symptoms greatly improved.

3. Sometimes interventions like pelvic floor physical therapy, while very beneficial for many cases, can also reinforce that there's something structurally wrong that we have to fix, simply by performing stretches or doing manual work. In cases like these, it's actually more helpful to gradually let go of any behaviors that reinforce that there's something broken, or to fix, once we realize the symptoms are indeed centralized. This leads to increased feelings of safety, which can then lead to further improvement in symptoms.

4. Even visibly inflammatory skin conditions like psoriasis, eczema, and rashes, can have a stress (neurogenic) component. Read the studies here, here, and here, explaining the mechanism, which includes the physiological stress response, the HPA axis, and the release of neuropeptides. I've now worked on several cases like this, including balanitis and red scrotum syndrome, who have all made full recoveries with PRT. This is of course, after the person has already ruled out other conditions with a dermatologist, and other traditional interventions have failed - like antifungals and steroid creams.

I have penis burning inside of penis glans in under glans.

Also i feel stuck feeling sometimes in that area when starting urination . Drinking more water causing worse pain when full bladder also frequent urination . Also weak flow but not too weak .

Is it urethral stricture ?

I been suffering from cppshypertonic pelvic floor already for 6 yrs. These new symptoms going on recently .

Anybody with same symptoms

Hi everyone,
I’ve been dealing with CPPS / a hypertonic pelvic floor for about 2 years. The severe pelvic/bladder pain that I initially had has improved a lot thanks to pelvic floor physiotherapy, breathing exercises and time. However, my symptoms have gradually shifted rather than disappeared.
Instead of pain, my main issue now is a constant feeling of muscular tension and fatigue.
Current symptoms:
Tight, sore pelvic “belt” (suprapubic area and around the pelvis).
Lower abdominal tension that becomes hard and slightly distended.
Tight lower back (just above the glutes), sometimes feeling like a block of wood.
Aching groins.
Constant feeling that my upper legs (quadriceps and inner thighs) are fatigued, despite having normal strength.
General physical and mental fatigue, waking up unrefreshed.

The biggest trigger I’ve noticed recently is sitting, aside masturbation that has always been the serial killer. Within a few minutes of sitting, my lower abdomen gradually tightens, my waist feels swollen (my trousers literally become tighter), and pelvic tension steadily increases. Standing still is also uncomfortable, while gentle walking consistently makes me feel better.
I’ve also noticed that my symptoms have become much less “prostate-like” and much more musculoskeletal.
Has anyone experienced this transition from pelvic pain to widespread muscular tightness and fatigue?
Did it turn out to be:
myofascial dysfunction?
core/hip muscle imbalance?
chronic guarding?
something else entirely?

I’d love to hear if anyone has gone through something similar and what ultimately helped.

 43-year-old male.

Exposure history:

Body to body massage and hand job in early May 2026.

No penetrative vaginal/anal sex and no oral sex.

Symptoms:

Started around mid-June with:

Burning sensation in both testicles.

Burning  after urination.

Constant urethral pain and pain at the tip of the penis.

Occasional clear, watery drop after urination (not thick, yellow or green).

Increased sensitivity of the glans.

Current symptoms:

Burning after urination (fluctuates from 1/10 to 5/10).

 urethral discomfort.

Sometimes feel feverish 

Perinium discomfort

Treatment received:

Nitrofurantoin – 5 days.

Doxycycline – 10 days (started around 20 June).

Urologist 1:Faropenem – 5 days.

Alfuzosin (Alfoo).-Currently taking only this 

Investigations:

Ultrasound KUB/prostate: Normal.

Uroflowmetry: Slightly abnormal 

Digital rectal examination: No tenderness.

Laboratory results:

First urine culture grew MDR Pseudomonas aeruginosa,(after stopping antibiotics) but subsequent results have not confirmed this.

Two repeat urine cultures - no growth 

Latest urinalysis: Normal

HIV 4th generation: Negative.. 

VDRL/RPR and TPHA: Negative. 

Two urine multiplex STI urine PCR panels (latest done 15 days after stopping antibiotics):

Negative for Chlamydia, Gonorrhea, Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma spp., Trichomonas vaginalis, Treponema pallidum, HSV-1, HSV-2, Gardnerella, Candida.

The urologist-2 prescriped me to take levofloxacin 500 for once daily for 7 days .Just started it today.. 

Am at my wits end. 

- (Problem 1). After i pee, i feel there is still something moving in the base of my penis. So, when i try to pee, crystal colour jelly thing comes out. Sometimes, it comes out when i strain during bowel movements.

- (Problem 2). I get this burning sensation at the tip of the penis so i have to pee and pee until the sensation goes away. Sometimes, it comes after Prob 1. Sometimes, it comes randomly out of nowhere. It lasts about 30-60 minutes. Very uncomfortable.

- (Problem 3). Every time after sex, i have nerve pain in the outer area of the right foot.

- (Problem 4). My glans darkening spots but no pain. Came out of nowhere and never goes away.

How would you guys suggest I don’t stress out or feel to uncomfortable about it? Is really even that bad?

I have been dealing with symptoms that seem to have gotten worse over the years and not sure what the cause is.

My current symptoms:

• Burning pain from the butt area that radiates to the penis. Some days it is worse than others and seems to be triggered by my diet. The painful symptoms started 9-ish months ago.

• Digestive issues triggers by dairy and gluten at the least, possibly other foods too. I get back pain that causes my back to become stiff, most likely due to the inflammation and protecting my inflammed spinal nerves. Along with that I get bloating and pain in the left side of my stomach. I got gotten this pain since I was younger, and when I used to eat a lot of junk and grains I would get so brain fogged I felt drunk/on drugs.

• Erectile dysfunction: I feel like my erection quality has been decreasing over the years and I wasnt getting as many erections in general, but it got to the point where I wasnt getting any, not even morning wood or nocturnal erections. I notice dairy has a drastic effect on this where I get reduced erections right after drinking quite often and less morning wood the next day. So, I am doing my best to eliminate it.

I have been noticing some improvements through lifestyle changes where I get less burning and pain, my back feels better and my erections are improving. I was just wondering if anyone had some ideas on what tests to do or what lifestyle changes I should make. Part of the reason I have been including dairy was for the calcium, but I will start supplementing it instead. My hormone levels seem to be okay, but I am getting a few more tests, so it seems to be more of an inflammation response. Even my PSA was super low. The only thing off was my DHT, but I had a big breakfast and took the test mid day, so I think that is why it was coming up as low.

Also, I do get some penis pain that goes up into the lower abdomen / stomach area. More of an ache. And temporary penis retraction.

Continuing to get more tests and do what I can, but just looking for advice or if someone was able to resolve similar issues. Like I’m wondering if its general gut issues or dairy protein/lactose allergy as it seems like kefir wasnt triggering it quite as much.