Stress Incontinence/Pelvic Pain Undiagnosed

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Hi 

I am a 40 year old male who is a personal trainer and have been active my whole life.  I am 5’10 175 pounds.

When I was around 22 so about 15 years ago I started getting a lot of groin pain that radiated down to the testicle.  At the time I was taking Propecia for my hair so looking back I do not know if that contributed or was the cause.  I was also doing a lot of running at the time as well.  I believe I had hip impingement as well.

After being bounced around for a year of going to doctor to doctor looking for solutions I was convinced it had to be some sort of hernia.  Even though there was no bulge and no doctor could find one.  However a surgeon said he might have felt something and agreed to operate since I was running around in circles.  He did operate and said he found a small hernia, however looking back I am not sure if he actually found one and somewhat question it.

The surgery did take away the testicle pain and groin pain.  I don’t know if it was from the surgery or from all the down time the surgery caused me to take off.

The groin pain eventually would come back and I have been dealing with it for many years now.  At least 5 years.  It is something that I figured I would just have to live the rest of my life with and I was fine with that.  However things would get much worse.

About a year and half ago I was training hard and dieting.  I would get a lot of groin pain but would just train through it and it would come and go.  I was also doing a lot of unilateral leg work.  My legs seemed to get really stiff, but I would train through it.  My hip would bother me when I would try to stand up from sitting, I would slowly have to stand up and eventually get going.  Once I would walk around it was fine.  I also hurt my low back when I was squatting around this time.  So now Im thinking I have a hip problem, a groin problem that may or may not be caused by my hip, and a back problem.  These were fine and I could live with but things even got worse.

This is where things get bad…

Around this time I was deadlifting one day and felt a pain in my perineum.  I was worried as I didn’t know what muscle or what could have caused this.  A week later I was squatting and felt the same sensation.  Around this time I was playing floor hockey and felt a sharp perineum pain that almost brought me to my knees.  

After the first injury to the perineum I started getting bladder issues.  I now leak after going to the bathroom, I leak a bit with certain movements, I sometimes don’t feel empty after bathroom, sometimes I feel have to go when I don’t, and urethra irritation.  

Also after this I sometime feel ball in rectum and feel weird with certain movements in rectal/perineal area. A year after all of this started I could barely walk for some reason the sports doc said it was either a labral tear or SI joint issues.  This resolved on its own.  Sometimes now I get pins and needles from the waste down when i stand or sit.  This has absolutely affected my quality of life and put me in depression.

I have been tested for prostatitis, had a cystoscopy have been seen by many doctors and urologists with no answer.  My family doctor from day 1 said it is a pelvic floor issue or damage from those deadlifts or years of lifting.  I do believe all of my urinary symptoms are from something structural based on the events.  Maybe neurological from spine or MS.   I do not know if it is from direct damage to pelvic floor, if pelvic floor dysfunction due to hip impingement, labral tear,  a disc issue when I hurt my back (MRI said torn disc but nothing pushing on nerves).  Maybe its Perineal Nerve Entrapment.  I also feel maybe something gave way like a prolapse or something.

I have read that problems/damage to hip can cause pelvic floor/bladder problems/perineum problems.

List of Symptoms:

groin pain

stiff hips

rectal pain sometimes 

when exertion can feel in rectum/perineum

hip pain sometimes

back pain sometimes

bladder issues

hip impingement

drip after pee

bladder issues worse at night

overactive bladder

numbness/tingling perineum

when nervous feel like could easily pee myself

intermittent pins and needles from waste down.  Seems to be worse at night after standing

urethral pain/irritation

I sometimes get really cold and shake for some reason like a blood sugar problem but no diabetes.

bladder issues seem to get worse after i do lower body things like lift things up or leg exercises.  Which i try to avoid now.  

I can feel posterior chain movements un perineum 

When i ride recumbent bike and exert it bothers my bladder and can feel leaking/letting go sometimes.  Exertion for upper body like incline press seems fine.  Chinups sometimes bother.

List of Tests

blood tests

digital rectal exam

cystoscopy

MRI of pelvis and low back ( MRI said mild to moderate bulge with annular tear of L5-S1 causing no neural compression)

MRI of hip looked good but was not done with contrast and power of 1.5 T.

Treatments so far:

pelvic floor physiotherapy

supplements

stretches

Suspected causes:

Disc Problem

MS

Hip labral tear/impingement

Perineal Nerve Entrapment

Pelvic floor dysfunction/damage

Prolapse of some kind

Doctors I have seen:

My GP

2 Urologists

Sports Med Doc

I am at the end of the rope with this and really don’t know where to go to figure out what  is causing this.  I feel I need to get evaluated by a Neurologist to rule out anything with nerves.

I am at the point of going to Mayo/Cleveland Clinic for some sort of answer.  

I am also very close to going to see Doctor Myers and Doctor Coleman in Philadelphia as they are the best when it comes to the groin and hip.  If the problems come from the hip or groin/pelvic floor then they will have the best answers for me.

Coming from Canada this will be out of pocket and these guys are not cheap especially if surgery is involved.  At this point I really feel like I am running out of options and I know I cannot continue living like this.

Any help is appreciated.

 

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  • Posted

    Hi Robert.

    I can absolutely relate to your dilemma, particularly regarding OAB.

    First over-the-counter meds & treatments, then prescriptions and doctor-doctor-doctor who could not come up with any kind of answer

    Life had to be altered to work with the constant leaking, urgency and misery. 

    When I do go out, I must stuff so much protection down there I fear I look like a girl with junk.

    Finally got sent to a urologist who specializes in this.

    She started me on Percutaneous tibial nerve stimulation (PTNS) which specifically treats OAB, as we suspect the nerve to my bladder is defective and got worse as I aged.

    HUGE fight with insurance to cover it, but they eventually did (bless them and the doctors).

    Just finishing up the final twelve weeks of treatments which is like 30 minutes of electrical acupuncture every week.

    Certainly did no harm and had maybe a penny's-worth of occasional improvement. but a cure by no means. 

    Next we're going to do a temporary interstim therapy where a device will stimulate the bladder nerve. If there's at least 50% improvement in a week, they will make the implant more permanent. I wanted the PTNS because it's so non-invasive, but life as a pee-monger is untenable. And this procedure seems like minor surgery. At this point I'll try anything. And prayer.

    If any of my experience is helpful, I am glad. Want to keep in touch to learn about your treatments and results and of course I'll keep you updated with mine.

     

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    • Posted

      Thanks for the reply.  My physio tried that once but it kind of made things worse...the electical tibial thing.

      I do think structurally something let go as I felt the pain during deadlifts then later squats.  This is when all the bladder issues started happening.

      I believe it is either:

      -pelvic floor damage.  However I don't know if its common in males

      -a disc injury thats pushing on a nerve to the bladder

      -a groin/hip injury which is pulling on the pelvic floor causing it to no work properly.

      -maybe a prolapse that affecting bladder function

      Whatever it is it's ruining my life as Im sure you can all relate.

       

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  • Posted

    Well robert89123 it sounds like you gone through alot, I too suffer from incontinence and have to do pelvic floor exercises, I feel you man it can be stressful but remember that the good Lord is watching over you ask for his help and he will give you his hand. I thinkyou should go to the doctors anywhere to be checked, your may have torn you sphincter muscle or even recked your back by lifting the wrong way, I hope I was helpful, get well and may God bless you and keep a watch over you.
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