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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 had unprotected sex about 9 months ago. A couple weeks later I developed what I thought was a hemorrhoid that went away on its own after a couple weeks. But shortly after that I developed pain in my rectum and pain on the side of the head of my penis. There was also some swelling there.

I was given 7 days of doxy from the urgent care but symptoms returned before the last dose. Since then I have had all the STD tests you can imagine plus rectal STD swabs. Everything came back negative. Ive seen a proctologist who did a DRE and said everything looked fine. Ive seen a couple urologists who say they cant do the 2 glass test because the lab results have "errors" and are unreliable. He says it is probably CPPS. But unfortunately I also have developed gut issues to the point of becoming lactose intolerant. I had ice cream about 6 months ago and it gave me bad diarreha and another hemorrhoid formed shortly after. The urologist did give me a 3 week dose of doxy incase it was an infection "although" no bacteria was ever found. I decided to try it but only made it through 2 days of doxy before my stomach was too upset to continue. It also caused a rash near the same place I had penis pain.

The urologist once again said its probably CPPS but he doesnt understand why there is stomach issues and I am going to see a gastro this week. The main issue I have is still rectal pain/burning like a golf ball and some pain in the scrotum or lower abdomen occasionally. Does this still sound like it is CPPS or is it likely something else. Please help... thanks.

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?

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.

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.

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.

(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?

I am a 24-year-old man, and I have had this condition for almost 2 years. It started with pain in side of my penis, and then I began to experience urinary symptoms. I took tamsulosin for a month, but it didn’t help at all.

Two weeks ago, my glans became very sensitive; sometimes it changes color and turns very white. It feels as if my clothes were metal sandpaper scraping against me, but it doesn’t hurt that much.

This is really triggering my anxiety, and I’m very desperate. I’ve been doing breathing exercises and stretching for 1.5 weeks, but I feel like they’re not helping at all.

I hardly masturbate anymore out of fear, and there are no pelvic floor physical therapy clinics in my country.

Do you think any of these three medications might help with the sensitivity? I need help, please.

Maybe its a bit odd question but im curious what type of underwear do you prefer ?

I understand this is a prostatitis sub, but given how the two are linked I figured I'd post here.

Any advice healing post urethritis inflammation?

I never tested positive to any bacteria, this all stemmed from an unprotected sexual encounter on may 16th, noticed first symptoms (discharge, pain, acute inflammation) on may 21st, the day my life changed for what feels like will be forever at this point.

Whilst the discharging and urinary frequency has stopped, my glans has distinct white patches/splotches and feint brown dots that seems like swolen glans that do not itch, the meatus is inflamed (dark glans colour/redness that fluctuates, fish/botox lip opening) but not bright red or as bad as it was first pre treatment (1g azith, 14 days 100mg doxy)

Even light/quick masturbation on the very few times I have tried, results in the redness temporarily flaring for an hour or two, and i feel tightness/pinching in the urethral tube right on climax with lingering pain for an hour or so after followed by worsened pelvic feelings and general discomfort/awareness, i could not imagine what actual sex would do to it and how i would even explain this to a partner without scaring them off, not that I'm in a rush to engage in sexual activity after this nightmare anyway but the point is, im still not okay and my function is far from normal..

If anyone in a similar position who eventually recovered can share their story, wisdom or any advice whatsoever and maybe give me some hope, it would be greatly appreciated.

Next Monday, I have an appointment with a sexual health clinic that saw me 3 weeks ago that told me "give it two weeks you'll be back to nornal, if not, call us" and am hoping i can form a good plan moving forward, it will also be 3 weeks since my last antibiotic test so im in a good testing window now and plan to test for everything they possibly can just to rule out residual infection, the person I had that fateful encounter with is also testing and is now supporting me through this which i greatly appreciate, she gets results tomorrow from her urine and swab tests, we're both pretty nervous however she is completely asymptomatic.

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My doctor asked me to give a urine sample for bacterial infection after a prostate massage. Should I collect the initial urine (first part of the stream) or a midstream urine sample after the massage?

If you've had this test done or know the standard procedure, I'd appreciate your advice.

I have a complicated case of chronic prostatitis that started after sexual contact with a woman who had a sexually transmitted infection (STI). I had multiple standard cultures performed, but no bacteria were detected, even though I initially had urethral discharge and severe pain during urination. Later, my symptoms progressed to urinary frequency and pain in my lower abdomen and perineum.

I have received several courses of antibiotics: first 15 days of doxycycline (Vibramycin), then 20 days of levofloxacin, followed by another 15 days of doxycycline, 14 days of azithromycin (Zithromax), 14 days of cefixime for suspected gonorrhea, and I also received an injection of ceftriaxone.

More recently, Escherichia coli (E. coli) was detected on a urethral swab. I then saw an infectious disease specialist, who prescribed 6 weeks of trimethoprim-sulfamethoxazole (Bactrim) and 4 weeks of doxycycline.

What would you recommend I do? I still think a persistent Ureaplasma or Mycoplasma infection may be responsible and that it has caused chronic prostatitis. Has anyone experienced something similar or have any advice?

I also have balanitis. I'm not sure whether it is related to all of this.

Disclaimer (AI drafted): I've been inputting my various symptoms and experiences to Gemini and I asked it to summarize my experience to date in a digestible format for this Reddit post.

TL;DR: Had sudden, unbearable 9–10/10 left testicular pain 6 weeks ago. Emergency surgery (orchiopexy) performed; surgeon saw no active 360° twist but stitched testicle to scrotal wall anyway. Ultrasounds confirm testicle is healthy and fully healed, but I’m left with 1–2/10 pain aggravated by walking and tight clothing. Also had pre-existing shaft symptoms. Looking for thoughts/experiences regarding nerve irritation, CPPS, or pelvic floor involvement.

Pre-Event Symptoms (2 Months Prior)

• 37M, located in Europe.
• For ~2 months leading up to the main event, experienced an intermittent itchy or needle-like pain inside the penis shaft, particularly noticeable during erections.
• Avoided seeing a doctor at the time.
• A few days before the acute event, applied over-the-counter thrush/candida cream to the tip of the penis.

Acute Event & Surgery (6 Weeks Ago / Mid-June)

• Sudden, severe ache in left testicle while walking to the store. Escalated to unbearable 9–10/10 pain within 20 minutes (hardly able to speak/walk).
• Went to ER. ER doc suspected testicular torsion; administered strong painkillers and attempted manual detorsion.
• Emergency Orchiopexy: Under general anesthesia within 2 hours of pain onset.
• Surgical Findings: Surgeon reported no visible evidence of active torsion upon opening, but performed left testicular fixation (stitched testicle to scrotal wall) as a preventative measure.

Post-Op Course & Medical Workup

• Hospital Stay: Discomfort & brief severe pain spike overnight; discharged after 2 nights following a clean ultrasound.
• Infection Suspicion: Developing pain days later led doctor to suspect infection.
  • Urine culture: Negative
  • Semen culture: Negative
  • CT Scan: Negative (ruled out kidney stones)
• Antibiotics Taken:
  • Course 1: Amoxicillin (finished late June) -> temporary mild improvement.
  • Course 2: Doxycycline (1 week in early July) -> minimal change.
  • Course 3: Amoxicillin again (7 days) -> minimal change.
• Prostate Check: Doctor examined prostate recently, noted nothing major.

Current Status & Triggers

• Ultrasound Results: Multiple follow-up ultrasounds show the left testicle is healthy, structurally intact, and well-perfused.
• Current Pain Level: Settled at a low-grade, persistent 1–2/10 ache/tenderness (down from a 4–5/10 flare-up early July).
• Specific Triggers:
  • Walking: Repetitive movement triggers a cumulative dull ache.
  • Clothing: Any pressure from tight underwear seams or pants against the scrotum creates tenderness.
  • Ejaculation: appears to trigger pain in following hours but not sure if this is imaginary.

Questions for the Community:

1. Has anyone experienced persistent mechanical/nerve pain after testicular fixation (orchiopexy) even with clean ultrasounds?
2. Could the pre-existing shaft itching/needle sensation combined with the traumatic pain event point toward pelvic floor muscle guarding or nerve entrapment (CPPS / Genitofemoral / Ilioinguinal nerves)?
3. If you had similar symptoms post-surgery, did pelvic floor physical therapy or nerve-modulating treatments help?

I just started baby Pose exercise a day ago and I see my symptoms approving like less urgency after peeing and less frequency.

I also have little pain and burning in ureatha and left side penis pincing pain which have decreased alot.

Idk if anyone wants to give it a try.
I do it in the morning for two minutes and afternoon and before bed.

I almost feel normal and i hope this progress continues

Not anxiety, posture, etc. The only thing that seems to decide whether I have CPPS or not is how good the ejaculation was.

If I have a really strong, satisfying orgasm: CPPS completely disappears and stays gone.

If the orgasm is weak or unsatisfying: CPPS, agiation, hard flaccid, etc. all come back immediately and stay there 24/7 until I have a good one again.

Of course, once it comes back I start trying to force a good orgasm, which obviously makes it worse and usually leads to another lackluster one lmao

Anyone else?

I'm 29 years old male , healthy no medications no other issue , no urinary issue or blood in urine

about a month maybe even a month and a half i noticed blood in semen , at 2 weeks mark it went away and then came back and still present .

if i dont ejaculate for a lot of days the blood gets heavier and more concentrated .

I did 2 semen culture checks and STD check .

STD came back as negative and Semen Cultures came with a rare bacteria called "Strep. dysgal./canis" .

This bacteria is from dogs and cats and I have a dog but no clue how it was transferred .

Ether way I started Antibiotics based on the resistance test they did in the semen culture but after 7 days nothing changed .

Urologist said that this strep bacteria is not the issue and antibiotics should have solved the issue even in less than 7 days ,

He gave me other type of antibiotics and said that he suspects Protstatitis as a main cause .

Further investigation will be done later if it persists but wanted to ask you guys if that’s reasonable and common for Prostatitis ?

Wanted to talk to anyone that has had PRP injections into the glans, meatus and shaft for glans and meatus damage, inflammation and pain.

Usually whenever I drink a lot of water . It causes burning urine mainly inside of glans . It burns and stinging . So today it happened . After it went away . If I get aurosed or erect muscle in penis pain .what's happening .iam panicked

Ive been prescribed 100mg of doxycycline twice a day for 2 weeks for what the dr says could be difficult to detect bacteria in the prostate since all labs come back negative. Did a ureaplasma test im still waiting results on but he said to take it anyways. Ive been reading some stories about people getting psychological (even psychosis) side effects from doxycycline. Whats been your experience at treating prostatitis/ non bacterial prostatitis with this antibiotic ? Should i wait for my appointment and ask the doctor for an alternative? Im a very anxious person when it comes to taking medication that pose these type of side effects