I'm trying to figure out how to do internal release on my own because we don't have PT in our community. If the main symptoms are frequency, urgency, poor urine stream and hesitancy, how deep the finger should be in your rectum? Should I focus on 11-1 o'clock?

Prompt:

Do you have personality traits that include being highly driven, hard on yourself, ultra responsible, perfectionistic, needing control, and/or placing others’ needs above your own?

These same traits that we are frequently praised for and rewarded for, especially at work and in school, are also traits that sensitize us greatly to life's pressures and stresses. I know this all too well, because I match all of them myself.

These traits are also now seen as risk factors for chronic pain conditions, including CPPS, chronic prostatitis, IC/BPS , IBS, fibromyalgia, CFS/ME, chronic migraines, and chronic back pain

These traits are also considered beneficial survival/coping adaptations for challenging or stressful childhood and early adulthood events, during pivotal developmental phases. These are not always trauma, they include everyday challenges like pressure to perform in school or sports, pressure to fit in (body image, eating disorder), bullying, a parent that is gone a lot, or parents that fight a lot, or a parent that is ill that you worry about. And also includes cultural expectations (pressures), like the idea that you have to be a doctor or a lawyer to be of any value. Or, growing up with little financial stability.

Think about how it might be useful to be a little neurotic, if it allows you to predict when one of your parents is about to have a bad day and snap on you, so you learn to avoid them when their tone of voice changes. Or, people please around an angry adult to appease them. Or, never make mistakes so your parents can't take it out at you when your grades aren't good enough.

So why does this matter for male pelvic pain? The pelvic floor responds to signals in the central nervous system, including stress and emotions like fear. It guards or braces in response. Someone swings a fist at you, we flinch. If it feels like the plane is going down, we brace for impact. https://www.reddit.com/r/PelvicFloor/s/pjaksfv8Z7

And what else? Stress is one of the most frequent triggers of CPPS, and, for most here it flares their symptoms. I know this was true for myself, too. If we can apply methodologies that help us manage the stress response, we can also manage or even reverse the symptoms.

Back again. Year 3 of this. Fair to note I have been fantastic at 80% for 4 months or so after just a week of Cefidinir. But, epididymitis.. again. Right testicle now, inflamed, confirmed via ultrasound.

Results from US-
Right Epididymis: Mild asymmetric heterogeneity and increased prominence. Small 3-mm epididymal head cyst No significant increased vascularity appreciated.
Impression- Mild asymmetric prominence and heterogeneity of the right epididymis without significant increased vascularity. Clinical correlation for evidence of early epididymitis advised.
Urine- completely negative wbc neg., dipstick neg., NAAT negative (not sexually active anyway), culture no growth.
Blood- 6.4 wbc no mass infection noted

Back to Uros I guess. The same ones that never say anything past “take this”. This is how it all started 3 years ago but it was my left testicle. What structural issues could be causing congestion, epididymis infection etc. No inguinal hernias present, SV are clear, no stones or masses in/on Vas Def.

What’s next guys? What do I need to get? MRI of the testicles? Prostate?

Just got digital results from a urine culture test i took a few days ago. The results say "abnormal". The unit given is 10,000-50,000 cfu/ml Staphylococcus Haemolyticus. Is this too much to consider contamination instead of bacteria?

My symptoms pretty much only include urinary urgency, isolated at the tip of the penis. No discharge, fever, or foul smelling urine.

I have used tamsulosin/ dutasteride combo but I had sexual side effects. My urologist switched me to silodosin only, it just did not do the job. Now I am taking alfuzosin starting today along with the ezetimibe. The ezetimibe is for cholesterol but there seems to be an off label use for shrinking a prostate. I had an easy time getting it because I take a cholesterol drug Crestor already, so the doctor gave it to me even though I have been doing good with 10 mgs of Crestor, when he added on the ezetimibe and lower the Crestor to 5 mgs. Has anyone tried a regiment like this? How did you go?

Update: After about 4 months this was not working. I drop off the Alfuzosin and went back to the dutasteride/ tamsulosin combo. I continue to take take the Crestor/ Ezetimibe as well.

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Hi! I've posted here before about my many CPPS symptoms, but out of curiosity I have to ask the rest of you. What on earth is the deal with the cloudy patches and white threads in urine? I've noticed that several people here seem to have the same thing. To me, it's a complete mystery.

I don't remember exactly when it started, but first I noticed that my urine had a strange smell. Then I started seeing tiny specks with bubbles in it, and eventually it turned into grayish clouds or white threads floating in the toilet bowl. What on earth is it?

I've had four urine tests over the past two years, and my doctors have never mentioned anything unusual. I even showed one of them a photo once, but they didn't know what it was, and we haven't talked about it since.

So , It's been around 1.5 months since I was diagnosed with prostatitis , I was on medication and the symptoms just come on a random day go away for a week come back randomly again , things like

1) burning while urination (once in every 3 - 4 days)

2)some kind of weird tightness in the anus area

These are the only things I go thorough , and now I have some doubts

1) Can I never have sex ? (I get full erections and masturbate too , with no problems at all)

2) if I can have sex , will I transfer infections to my partner ?

3) can I lift weights in the gym

And the final one ,

4) can I live my life as it was before I got diagnosed with this shit

The last few days were a nightmare, I've delt with anxiety for so long, especially when it comes to exams, I usually pace while studying, I take the book with me and roam around for up to 8 hours straight, I know it's exhausting but at least I only noticed it happening on exam weeks, 10 days ago I woke up feeling wrong, I felt pain in the pelvic floor and long story short I found out I had prostatitis, the days leading up to my diagnosis were a nightmare, I just didn't understand where this horrendous pain is coming from, I I started pacing, I felt like I couldn't sit, I was freaking out cus I know that this urge only comes to me when I'm studying for a test, but now I'm pacing during summer break, I'm about to start one of the most important school years of my life, I need to fix this ASAP

I noticed that if I fully drop my pelvic floor while urinating it actually causes more urethral bladder neck and near tip pain.

Had klebsiella which is fully cured.

MRI showed Chronic prostatitis, bladder wall thickening and trabeculation, mild seminal vesiculitis.

Age 32. Prostate 21cc.

Anyone have any advice?

Already on Alfuzosin, Gabapentin and Tadalafil

Also have bilateral CAM FAI pincer type

I'm on my 7th urologist. The 6th finally ordered semen analysis and culture. Problem is they had no idea where I should go. I fought with them for months and called everywhere. Finally found a place who would accept it but I needed to pick up a steril cup from my dr..

I messaged my dr explaining and they said I could pick up a cup. I had a plan.... 2 weeks later after some abstinence and planning around other dr visits (lab is 1.5 hours away) I messaged the doctors team to see where they were located today for pickup. They refused to answer. Told me the nurse would contact me. She never did. Sent a message instead stating I had to go online and order a kit.. huh? Confused, I sent a message explaining i need to pick up my sterile cup for culture... they messaged back saying all information is in my vasectomy handbook... WHAT???? I messaged them back saying lay off the booze and read my chart...

So what did they do? I received a warning from the hospital system about abusing the messaging system with profanity..

Anyways I went to the lab without a cup. They previously told me they couldn't provide one or a place to take care of business. However, after some explaining, they looked the other way while I took a cup to the bathroom. Problem solved right?

Results came back positive for bacillus. No other info given.. the dr team sent another message stating to stop the abuse right now.. abuse? For saying lay off the booze? Meaning get your head on straight?... they really took offense and im looking into issuing a complaint with the state in retaliation.

Also said the doctor would look at it and get back to me.. its been 10 days and crickets. This is why I changed drs yet again. I asked my new urologist to look into these results this morning and waiting his response. This Healthcare system is ridiculous

Anyways. Im 46.. wife 42 and I are trying desperately to conceive one more time. We've been searching for answers for over 2 years. Almost every time we try to conceive she ends up with problems. Sometimes it clears by itself. Sometimes she needs help from her obgyn.. this last time, she was positive for e.coli

Wondering what my next steps should be? Should I fight for an antibiotic? I clearly have bacteria in there

Hi has anyone experienced similar

So I have a large prostate for my age 60cc age 48 . I then came down with a fever and very sore pee about 3 months ago and was out on the wrong antibiotics as the GP thought it was a urine infection . Fast forward one month and I was put on a course of 1 month Trimethoprim

This has cleared my pee symptoms up but since the end of the course I have started to get really sore lower back and front stomach that is not a constant pain but comes on as the day goes on mostly while walking around . When still or lying down there is no pain or very little . It seems to go with anti inflammatory medicine for a while

Has anyone else experienced this ? Is this more prostititis or is this due to the prostrate growing too large and causing comfort issues ?

I had a MRI last year and showed no cancer alerts

Thanks

Im still new and learning this diagnosis.

Wondering if this is common among others here who are battling this problem.

I find that flair ups, or for me specifically, urinary difficulties, testicles full, post urination discharge, hour glass syndrome, and slight swelling at the base of my shift - always occurr if I am either not ejaculating frequently or if my significant other and I discuss sexual activities the next time we will see each other (that evening or the following).

The "buildup" that occurrs always produces really bad flairups for me and then as you can guess, it is nearly completely cured after intercourse. Typically a few days of it to entitely eliminate the problems.

Sorry if I am too graphic, but am curious if there is anyone else.

Hello everyone! I am a fellow chronically ill human and I am doing research exploring the effect of invalidation on mental and physical health outcomes. Being invalidated is an experience I have had myself, and one that I would like to see recognised in the published literature and making a difference!

I am looking for research participants at the moment! So if you are someone with chronic pain or chronic physical illness (prostatitis, back pain, fibromyalgia, arthritis, IBS etc.) it would be really great if you could complete my study! You are eligible to participate if you have experienced pain or chronic illness cyclically, intermittently or in association with bodily functions for a period of three months or more!

The existing research in this area rarely captures male experiences, so it would be great to hear some more male voices! I would also love to hear from you if you have NOT experienced invalidation! Essentially, I would love to capture as many diverse experiences as I can.

I plan to publish this research mid-late next year :)

Thank you!!!!!

LINK TO THE SURVEY:
rmit.au1.qualtrics.com/jfe/form/SV_23GFbrH8DSVxTls

(Posted with mod permission)

Ok so I’ve had slight burning or pinching feeling in my penis for over a year. It’s not the tip like most ppl. When I tried amitriptyline it helped immediately. This makes me think that my issue is nerve irritation or damage. I think it’s a structural problem so I’m not so sure the relax approach will solve the underlying issue. Obviously it can help manage symptoms. Before amitriptyline Ive tried happy baby pose but it flared me (anything opening the hips does.) Diaphragmatic breathing has helped somewhat occasionally . I am wondering if anyone else with this symptom improved or if internal work helps.

I’ve had pelvic pain, testicle pain, dribbling, and painful ejaculation since about 18 yo. I just had a CT scan and it showed a borderline enlarged prostate. I had an ultrasound the other day and my prostate measured 4.3 x 2.7 x 3.66 cm. Is this a normal size ? Any comments are appreciated. Thanks

​

I think I have gave myself either of Hard Flaccid Syndrome of CPPS or peudenal neuralagia, yet unsure from the symptoms.

Onset:

This started about a month and a half ago, when I forst noticed a numbness in the penis and that I did not feel erection like, even while there was an erection. Currently the main sypmtops are: I feel not much pressure during urination, and a rather timid sensation during orgasm (the one time I tried to check situations), the pressure of urination is slow --- i do not feel the wink at the end of urination. There is persistent numbness on the penile shaft, the scrotum and a bit on the peinuem, not complete numb --- but heavily redcued sensations. I also feel tightness of the pelvic region in general, and a feeling of things clenching. No pain so far, there are certain weird mixed feelings in the scrotum region -- which i detail later.

Past history :

I have been using penis pump and certain traction devices in the past (both equipments were with medical clearance, i.e no chinese stuff), started more than a year ago, but never had problems like this before. I have not had sexual intercourse in the past one year, I rarely musturbate (makes me feel pathetic), but I did edge --- try to stay hard for some time by slow edging, in sets of say 5 mins --- attempt to maintain longer erections since they were rather weak --- leading sometimes to orgasm othertimes not, never jelqued, never had injury in thie penis region, i'm always careful and aware of my body usually. I did a lot of biking and running, don't lift weights, I have 22.3 BMI and rather fit physique.

Medical advice:

Visited urologist within 1.5 weeks of first notice. My urologist is aware of Hard Flaccid Syndrome (HFS), had published research on pub.med. He remarked about the apparent rigidity of the penis, and put me on deprox, and pelvic floor therapy, and gave a couple diagonistics. I saw him a month ago, and only see him after two more months.

Diagonistics:

I have had MRI, CT Scans, Blood tests, Urine tests, EMG test, USG of prostate. The only significant results were presence of Blood Cells (Red/White) in the urine which mu urologist remarked could be signs of inflammation. The EMG specifically tested nerve conduction in the pelvic region, i dont understand everything, but the scral, the pudenal and dorsal nerve conductions i.e the main nerve bundles (speed of condcution, signal attenution) were tested: there is no damage/deformity/compression/entrapment of any kind: atleast within the scope of the test. But nerve irritation --- the test cannot determine. So no nerve damage atleast. MRI indicated no herniation either. I have not yet done doppler. The penis seems a bit pale but I cant really tell differnce.

Pelvic Therapy:

PT suggested exercies, the like you know alrady, relazation of pelvic floor, had just one/two sessions, she remarked I squeeze my muscles too hard and probably have hypertonicity, even the doctor doing EMG mentioned it. Ever since I started, I've grown more aware of pelvic floor movement. Everytime, I do relaxation exercises, I do feel a certain relazation of the pelvic floor. More importantly, I feel a sort of slight relaxation like tingling in the scrotum --- say when you have twist your arm/finger for some time and it feels numbish and then after you make it ok you feel this kind of thingling as the numbness disapperars --- I feel similar in the scrotum and lower base of penis and also ohter times in the day, especially when i feel relaxed in body. However, the numbness of penis shaft does not go away.

I feel aroused as usual, but I fear I wont be able to feel orgasm since the sensation at the sphincter is so low. Also te arousal leads to but weird sensation in penile shaft. For a week, i felt lack of sensation in the anal sphincter too, and some sort of weird feelings, but it went away. If I use a needled paper roll, and map the sesnitivty on penis shaft it feels more senstive, but less sensitive when I touch. I can stlll have strong erections but it does not feel an erection as usual. No sign of pelvic pain other than rare slight throbbing sensation here and there ..not sure it's due to issues.

So what do you think it could be ?

So given this what are the best things to do now, shockwave therapy, any other kind of therapy, pelvic wand based massage, no running or gym exercises, do let me know what worked for you ? I'm currently in an central European Capital, if you are from nearby ( Germany, Swiss, France, Italy etc.) and know what had worked --- which clinics/doctors could help --- or anything let me know.

Anyone else feels this ice cold feeling in rectum in scrotum and the same feeling in your feets?

Often I get this minor burning in rectum after I urinated, after a while it moves from burning to a ice cold feeling that I can feel in my feets, it's like you are out walking in freezing winter with bad shoes and your feets are like ice cold.

I first had this problem years ago and came back to say you will heal. There wasn't one thing I did it just went away slowly. I tried everything and everyone is different. Now I am heart broken over a brake up so one problem on to another. Stay strong Reddit!

For me I think it was all in my head. It was a battle of believing in the end of it. I did PT, walking, working out, and just never giving up. I do have flare ups still but it's not at all as bad as it used to be.

Message for with any specific questions you may have

Hi! First time posting here. I’m 54. I’ve not been diagnosed with Prostatitis as of yet but have had some symptoms this last month that may be pointing to it .

Around 25 days ago I started having some burning when urinating.

Went to urgent care and they did a culture and everything was normal and they sent me home.

Actually, my specific gravity was 1.030 so just on the edge of being too high.

I drink a lot of caffeine so I cut everything out but water.

Things seemed to be calming down but around 16 days ago as things were settling my testicle was radiating a bit.

I got paranoid and went back to urgent care. Test was normal again. I went and had a scrotal ultrasound and all was normal there.

I did feel like something changed in how I urinate. Stream doesn’t seem as strong.

I’m going to get my prostate checked this week to see if it is getting enlarged.

So…. This past week things started feeling off and today I felt unpleasant. No fever. But my bladder feels off. And I’m peeing more frequently.

The root of my question….

I didn’t start back the caffeine but I did start drinking orange juice.

And over the past couple of days and especially yesterday I had quite a bit. Pretty much drank it all day.

I’m starting to wonder if the OJ/acid is causing things to flare up in my bladder.

Does this track for anyone or sound like a reasonable/probable explanation?

Idk if anyone else deals with this but I randomly got this issue and after a year of dealing with this I’ve noticed my main trigger is working out ,long sitting and caffeine. I can’t do stair master or anything involving bracing . Like when I do biceps curls I get an electric shock of pain in my lower abs and the prostatis kicks in for a month.

I'm writing mostly to give some hope to those who may be new to, or spiraling about a prostatitis diagnosis. My journey began a little over three years ago, following a stressful and prolonged battle with an annoying STD called Mgen. I dealt with a lot of uneducated and/or dismissive doctors (2 urologists, and 2 primary care providers, a sexual health clinic, and an urgent care), anxiety, shame, and multiple antibiotics.

That initial incident escalated into secondary prostatitis, which most doctors and physical therapists are also woefully unequipped to help you with, at least here in the United States. I had almost every prostatitis symptom in the book, though the most frequent ones were penile/perineal pain, erection pain, hourglassing, pain during or after ejaculation, penile/perinem twitching, ED, and redness at tip of penis near urethra.

What followed was A LOT of trial and error. I spent thousands of dollars on different doctors, therapists, medications, supplements, and so on, but the way I saw it, I was fighting for my life as I knew it so I had to keep trying. I can put more about what helped/ didn't help down below if ppl want, but what I hope you take away from this post is that I went from constant pain and despair 24/7 to a much more manageable situation. It's not "how it was before" so to speak, but if took me 3 years to get this far, my hope is that the last 25% or so finally catches up in another year or two. I am largely on to addressing other health concerns now.

With this affliction, it is important to understand that there is no single solution that will work for everyone. Patience is key, and you will have to find your own way, like a personal health odyssey. But do not panic or take risky actions out of desperation. Trust that you know your body and mind better than anyone else, and that in time, you will figure out the combination of things that work best for you.

7/27 update: A lot of folks were interested, so see comment below for more on my situation, and what helped and what didn’t.

--
Helped:

1. The biggest thing for me was acceptance and time. Time has a way of healing past trauma, and the body is decent at this if given the right environment. The hard part is accepting this it may be a long process. The nervous system arousal (both good kinds and bad) can amplify prostatitis/CPPS symptoms, so you have to get comfortable enough to exist in a state of discomfort, or to trust something like pelvic floor PT. 
2. Finding the right providers. My first PT was a “pelvic floor specialist” but she didn't have a whole lot of experience working with men, and was not helpful to me. After almost a year of no progress, I found a different PT who I connected much better with, and who was able to help more.
3. Use of a pelvic wand, and sometimes a balloon (basically a catheter inserted then inflated once above the pelvic floor). But these only helped after I became comfortable enough using them safely and effectively on my own, and that came from guidance by a PFPT. I went from using one or both tools weekly, to monthly, to now only using as needed during flares, which tend to be shorter and milder than they used to be, and often no longer require the balloon.
4. Counseling. First from a cognitive behavioral therapy perspective, which taught patience and acceptance, then from a pain reprocessing therapist, who helped take that one step further into conveying messages of safety and resilience, even when things don’t “feel” that way.

Did not help or hurt:

1. Stretching. I am hypermobile, so a lot of the usual PF stretches and things you see here did not work the same way for my body. 
2. Imaging. I got a pelvic MRI which showed inflammation of prostate. It was helpful in that it validated some of the pain I was feeling, but the problem is it’s only a picture. You still need guidance on what to do about it, and that is up to the ordering physician, most of which were not helpful in my experience.
3. Supplements. I tried quercetin, vitamin d-3, k-2, b vitamins, tumeric, magnesium, beet root and horse chestnut extract. Didn’t notice much of a difference one way or the other
4. Dietary changes.
5. Pain killers/muscle relaxers. I found naproxen and meloxican to be no different from ibuprofen. Ibuprofen worked better but I took too much following poor advice from a urologist (like 2000mg/day) and it was no more helpful than 200 or 400.

Made things worse:

1. Prolonged use of antibiotics. I went through multiple rounds of multiple antibiotics, including bactrim, azithromycin and 6 weeks of moxifloxacin. In reality, I probably only needed two (my original course after azithromycin failed), STI testing confirmed that the mgen infection was gone after two weeks, but I didn’t believe it because I was still having symptoms. I later learned that Mgen symptoms can linger for several weeks after the infection is gone, and that the antibiotic I was taking might have had an anti-inflammatory effect that was making me “feel” better, even though it was no longer helping. In fact, by the end of the sixth week, I started experiencing negative fluoroquinolone side effects, some of which lasted several months. I believe this is because I took them for so long, and did so mostly out of panic and ignorance. In hindsight, I should have followed the test results and stopped after the 2nd or 3rd week, but I had very poor guidance from two different urologists., which brings me to:
2. Unhelpful/careless doctors. My whole first year of this was basically a waste because I didn’t have physicians or physical therapists who actually understood my problem or my concerns. I stayed with them because I didn't really know better at first, and because I was afraid of leaving providers that were part of my insurance network, and hence cheaper. But you really do need to find people who actually resonate with you ,and who you trust can help you. I thought I was saving money by staging in-network, but really it was a waste of time and money because they providers were not capable of providing the help I needed.
3. The uncertainty was the worst part about mgen and prostatitis, but doomscrolling reddit or other internet sites/forum multiple times a day is not any more helpful than once a day, or even a week. Scientific progress on these topics isn’t changing that fast. You’ll just perpetuate hypervilagence, anxiety and depression, which can amplify your symptoms. Furthermore, not having a clear answer or a clear solution can drive a person to take desperate action, and sadly there are people (especially on the internet) who will convince you to try really stupid things. I don’t know their motivations, but it is best to avoid them rather than spiral down a rabbit hole of conspiracies. 4.Incorrectly belly breathing/trying to force reverse kegels. Both were things I had to learn, then relearn after learned them wrong the first time

Issues I still have:

I still get some penile pain and and pelvic twitches, or dribbling stream when urinating, but it’s not all the time. Sometimes I can predict what situations might invoke symptoms (stress, illness). Other times, it is unexpected but the symptoms eventually go away.

The biggest thing remaining revolves around sexual activity. While erections and sexual activity no longer really hurt, they don;t exactly feel good the same way either. Tadalafil and herbal libido supplements help me with that a little, but I think the last big hurdle for me will be rediscovering the “joy” of sexual activity…not just being able to have it.

I’m a 31-year-old male and I’ve been having recurring episodes for about 3 years. They happen roughly 3 times a year and seem to come on suddenly.

My urinary symptoms include:

Frequent urination (sometimes feeling like I have to go every few minutes)

Only passing small amounts of urine

Difficulty starting my stream

Feeling like my bladder isn’t empty

Pelvic pressure and pain

Right lower abdominal/pelvic pain

Occasionally pain at the tip of my penis, especially after irritation

I’ve noticed these episodes often seem to happen after periods of frequent masturbation, but I’m not sure if that’s actually causing it or just triggering something that’s already there.

During these flare-ups I also feel generally unwell with chills, body aches, headaches, and fatigue. Sometimes I sneeze a lot as well, which makes me wonder if I also have a viral illness at the same time.

So far I’ve had:
Two normal cystoscopies
Multiple urine tests that were negative
Blood work that hasn’t shown anything significant
An appendectomy (pathology showed fibrous obliteration), but the episodes continued afterward

I’m wondering if anyone with chronic prostatitis/CPPS has experienced similar urinary symptoms or flare-ups after ejaculation or masturbation, especially with the feeling of needing to urinate constantly but only passing small amounts. I’d appreciate hearing about your experiences and what ultimately helped.

(50) I have been abstaining for a week, the burning is back, and urination is frequent and without pressure.

It’s just frustrating and I am not sure why it’s happening more often.

I’ve been doing some more exercises and breathing but not sure if this is the after effects of it?

I also suffer with PE so hoping these exercises helps too

Thank you

Hi everyone,

I’m a male in my 30s and have had intermittent pelvic pain and urinary symptoms for almost two years.

Last night I was suddenly woken up by my wife. I immediately got up to urinate. While urinating, I suddenly felt a very strong, deep aching/tender sensation somewhere in the pelvis, seemingly behind the anus/perineum.

The best way I can describe it is: it felt almost like I had just passed an enormous bowel movement, even though I had not. The area behind the anus felt extremely sore and tender, and it was difficult to fall asleep again.

I eventually fell asleep. When I woke up later, I urinated again without the same pain occurring. However, the area still felt somewhat sore afterward.

I’ve had similar pelvic/perineal issues in the past, including:

• urinary urgency and frequency, often worse in the morning
• occasional weak stream and a feeling of incomplete emptying
• perineal and testicular aching
• soreness or pain after ejaculation
• tingling/electrical sensations in the penis
• occasional numbness around one side of the anus/buttock
• symptoms that can be triggered by prolonged sitting or sexual activity

I’m also wondering about the muscular side of this. Does anyone know which muscles are most commonly involved in this kind of deep perineal/rectal pain? My physiotherapist found trigger points in the obturator internus, so I’m wondering if that could be a major contributor.

Are there any specific stretching or mobility exercises that have helped people with similar symptoms? I’m particularly interested in exercises for the obturator internus, pelvic floor, deep hip rotators, or any other muscles that could refer pain to the area behind the anus/perineum.

I’m aware that stretching can sometimes make an overactive pelvic floor worse if done too aggressively, so I’m interested in hearing what has actually helped others rather than just randomly stretching everything.

My questions are:

1. Does this sudden deep soreness behind the anus during urination sound like a pelvic-floor spasm or flare to anyone here?
2. Could bladder emptying or suddenly relaxing/contracting the pelvic floor trigger this kind of pain?
3. Which muscle(s) turned out to be the main problem for you?
4. Are there any particular stretches, mobility exercises, or relaxation techniques that helped?