Resolved question:
Dear Doctor,
I have suffered from problems with lower abdomen as well as inflammation on the tip of the penis and lower side of the testicles and after several tests for several months I was diagnosed as Chronic Pelvic Pain when all tests shows negative results with urine culture and test, blood test and ultrasound. With time I noticed that the erectile came to be difficult as the mental stress and depression were increasing. however when stimulated I get that erection but I dont seem to get it maintained immediatley when the effect is gone. My marriage is coming very soon and I dont have any sexual activities these days as I dont wanna go through just to test my ability.
The main concern is that is Chronic Pelvic Pain related to erectile dysfunction? or its just a mental disorder because of these pains. Just to remind you these inflammations I'm having is not painful ... its just a discomfort in these areas. its been with me for the last 6 months now. Wish to have an answer from your respected side as it is causing me lots of mental problems.
Waiting for your kind response
Submitted:
4 Days
Category:
Family Physician-GP
Hello, Thank you for asking your query at www.doctorspring.com The answer is provided by Dr. Mathew John, with inputs from Dr. Eric Stanger – Urologist and Andrologist. I am sorry to hear about your health issues and will try to help you the best. I understand that you have been diagnosed with Chronic Pelvic Pain. (CPP) First of all – Chronic Pelvic Pain is a difficult diagnosis. You have to rule out all the other possible conditions which can cause pain in the pelvic area. I am going to assume that all of this has been ruled out by your Doctor before diagnosing Chronic Pelvic Pain. Now coming to your main concern - Is erectile dysfunction related to chronic pelvic pain syndrome? The answer is – NO. Chronic Pelvic Pain syndrome usually will not cause any kind sexual problems or erectile dysfunction. In fact frequent sexual intercourse or therapeutic masturbation is recommended by many doctors as a treatment for this problem as it will relax the enlarged prostates! But in my clinical practice I have come across a few CPP patients having sexual dysfunction (males and females). And almost all of them had issues with the pain. It was the pain that was interfering with their sexual problems. Just like if you have stomach pain or if your leg is hurting you may not get any sexual feeling. Nothing beyond that. And once the pain is controlled their sexual function improved. I am of the strong opinion that there is nothing wrong with your sexual and erectile function. Since you don’t have much pain, the main enemy of a healthy sexual function is psychological factors like over worrying, depression and over anxiety. Even a busy or stressful day in an office can impair a man’s sexual performance. So image if someone is worried and depressed for a long time ! _________ I would personally recommend you the following –
I would personally recommend you the following – 1. You need to understand that Chronic Pelvic Pain is NOT a serious disease. It is NOT a predecessor of cancer or any other serious illness. 2. Almost 10-25 % of men suffer from Chronic Pelvic Pain at some point of their life. 3. Many RCT studies have shown that Chronic Pelvic Pain has no effect on your sexual health or sperm count and quality. 4. The hallmark of Chronic Pelvic pain is that all the investigations are negative for any infection or structural problem. So there is no reason why you should get an erectile problem. 5. 99% of the male sexual problems I come across originate in the head, not in the penis. By head I mean to say the following reasons – Unnecessary worrying, Lack of sleep, over exertion, Depression, Prolonged anxiety. 6. Now, since you know that CPS is nothing serious try to maintain a positive attitude towards life and enjoy it. 7. Don’t hesitate to get help of a Psychiatrist / Psychologist. He can help you a lot if the problems are persisting 8. If your Doctor haven't tired course of antibiotics, I recommend you to take a course of antibiotics (usually Ciprofloxcin) under medical guidance. 9. In case TB (Tuberculosis) of the prostate has not been ruled out, it’s prudent to test of TB also (Which has got a good cure rate) 10. Since you are saying there is not much symptoms now, you can just ignore it. In case if the symptoms are severe get the help of your Urologist. Remember pain also can interfere with sexual function. There are many treatment options for CPP, and the effects differ. Hope this helps. Please feel free to ask follow up questions. You can reply via this email itself.
Dear Dr. Mathew, To follow up with the case listed below. I have avoided myself all the anxiety and the stress that led to have the condition mentioned (Chronic Pelvic Pain) and I can notice a great improvement in my case as I don’t seem to feel the inflammation much often and even my psychological situation became much better. Regarding erection as I mentioned already doctor that I'm about to get marry in few months because I'm currently on a project abroad away from my fiancé. Erection situation became much better when stimulated and I can have full erection when stimulated (phone conversation and no physical contact) but I don’t have that solid erection I used to have few months ago. Is it still psychological or sub-conscious that still controls the mind? And also morning erection (Morning Wood) is not present . is it something that I have to worry about? I just wanna have my normal life back as it used to be few months ago before the whole situation started. Really looking forward for your kind response.