Urethral Pain when Sitting Overview

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Causes of Urethral Pain when Sitting

There are many causes for urethral pain when sitting. There are jobs that are known to make people more prone to CP or chronic prostatitis, which causes urethral pain when sitting. Other causes include riding a bicycle, prolonged erections, or sitting that cause the perineal area to become compressed. This in turn cuts off blood circulation to the bladder, urethra and prostate. When this goes on for a long period of time, the pressure causes mast cell degranulation and compresses the pudendal nerve in men, leading to PNE or pudendal nerve entrapment. To help with this type of urethral pain when sitting, special donut type cushions are used to help keep pressure off of this nerve as well as the perineal area.

Urethral Pain in Women

In women, sitting jobs and giving birth as well as prolapse of the uterus and numerous urinary tract infections can cause urethral pain when sitting. This is all due to the same causes for the pain in men: sitting upon an area and having the nerve become entrapped or under constant pressure resulting in a lack of blood flow. The cause of pudendal nerve entrapment is the nerve being trapped. The constriction is generally caused by too much pressure or trauma to the area. When the nerve swells due to the lack of blood flow, it is stuck in the area due to natural surroundings. This disorder is also known to be genetic and seen developmentally, and is also called cyclist’s syndrome. This is commonly diagnosed as idiopathic vulvodynia, nonbacterial prostatitis, idiopathic penile pain syndrome and even prostatodynia- all of which are misdiagnoses.

Symptoms

Symptoms that are common in PNE would be pain while sitting that gets better with lying down and taking pressure off the area. The pain is normally felt in the urethra, rectum, or general genitalia depending on the area of the nerve that has become trapped. There are other causes such as disease of the spine, urologic disorders, and gynecological disorder that can be cause for a differential diagnosis.

Diagnosis and Treatment

The treatments for pudendal nerve entrapment includes avoiding whatever causes pain, guided image nerve blocks, medicines such as neurotin or Elavil, or in the last resort, surgery for decompressing the nerve. The guided image nerve block will help as a diagnosis tool for pudendal nerve entrapment, as the area of pain will become numb while this is completed. There is a test called a pudendal nerve motor latency test that is much like an electomyogram that senses the speed that the nerve conducts energy to the area. There are electrodes that are fixed to the perineum muscles under the vulva or the anal passage. These nerves are stimulated through the electrodes, and when the speed is seen to be slower, this means that pudendal nerve reactions are slow and the nerve is compressed or entrapped. This is rarely done, as it has been replaced by the guided image pudendal nerve blocks.

Resources

University of Rochester Medical Center

ChronicProstatitis.com from the article Excessive Sitting