Male, Year 8 of constant urinary urgency seeking advice
Hello! I'll be as precise and to the point as possible in order to respect your time and kindness in reading this.
Onset:
8 years ago I had an exquisitely painful hemorrhoid removed. 24hrs after the procedure I developed a strong urge to void. That same urge hasn't left me since.
DX:
A half-hearted CPPS DX. No agent/cause has ever been found. According to PT my pelvic floor is not tight. My prostate has never been found to be enflamed or even painful via DRR assessment.
Symptoms:
・'Cross-your-legs'-level of constant urgency even with an empty bladder.
・Initially this urgency would randomly disappear during increasingly shorter intervals during years 1-3, but I no longer experience any periods of prolonged relief.
・Urgency is more intense in the colder months. (heating pads, hot baths, etc. have not alleviated this)
・Urgency is slightly less intense in warmer months.
・When enduring a cold with a fever, I *may* experience temporary relief.
・TMI territry: I randomly tend to have a leaky bum for an unknown reason. Despite wiping clean, sometimes after walking around for 15-30min, things get 'itchy'. If chaffing occurs my urgency seems to increase. (possible irritation at site of hemorrhoid removal?)
No urethral pain.
No pain when sitting.
No sexual dysfunction/pain.
No recognizable nerve/disc issues.
I do not suffer from significant stress/pressure. I lead an (otherwise) comfortable and happy life.
Urgency discomfort is 'bearable' if I'm seated but when I walk, the urgency can be felt with each step and or turn of my body.
Treatments:
Over 40 variety of prescribed meds. Everything from heavy-duty pain meds to Eastern meds. None have managed to produce any results.
Early on I was prescribed a litany of abx, they didn't change anything.
I worked with multiple PTs and I leave each of them scratching their heads.
I've had unremarkable but noticeable response to efforts to try and control how I interpret the discomfort. While I can usually pull the discomfort back from an extreme level if I focus extraordinarily hard on telling myself that the pain is just an incorrect signal, even performing these types of mental gymnastics leave me with an extremely high level of urgency discomfort that is unpleasant.
I'm compelled to believe that either a pelvic muscle or nerve was perturbed during the hemorrhoid removal which has left me with this constant discomfort. Are there any nerve specialists who might be able to resolve this issue? I've been told by different individuals that I can't possibly have PN, while others tell me it totally sounds like a case.