Lump in Perineum

[James]

In recent months I have noticed a lump in the area of the perinium on the left side (which is the side of all of the pain as well).

 

It can not be seen externally - but when pressure applied to perinium it can be felt - it is about the size of a grape - and painful if pressed.

 

I am not looking for medical evaluation - I know tht is not the purpose of this site - I am asking my Doc about it - and so far no luck.

 

Just fishing for possibiliities....as it seems related to symptoms.

 

[Nik]

I imagine a very mild prostatitis sufferer (Like I was for the first 5 years) may find a drop of 6 points helpful, but now it's just a drop in the ocean. I believe they charge $6000 for the privilege of a 6 point drop. That's $1000 per point LOL....!!!

[Arnon Krongrad, MD]

There appears to be another study that uses the "6 points or more" definition of success: Phenotypically directed multimodal therapy for chronic prostatitis/.... This standard was seen in 84% of the patients being studied: Men with symptoms averaing two years in duration and followed for 6 months. The average change in total CPSI score from 25 to 13.

1) Where the men who on average experienced a 12-point drop in CPSI satisfied?
2) What is happening with the 16% who didn't have even a 6-point response?

[Arnon Krongrad, MD]

Incidentally and apart from the technical note made above ...

It would appear based upon a reading of the full article cited above that the patients being treated were new patients. The results seen in this apparently "virgin" cohort may not be easily reproduced in a much "tougher" cohort composed of patients who have already failed many treatments, as is often the case with men who are joining this forum.

[Nik]

Makes sense. At 2 years in I was coping easily with my symptoms which were only really mild discomfort after intercourse and mild constipation, mostly in the 2 days following intercourse. A couple of Ibruprofen and I would forget all about it-they were the days LOL...!!!!

[Arnon Krongrad, MD]

I've posted a copy of the article on the home page, left column. Or click here:
Phenotypically Directed Multimodal Therapy for Chronic Prostatitis/Chronic Pelvic Pain Syndrome

[Arnon Krongrad, MD]

As a followup to some of the discussion points about trigger point release made above, the study has since been published in full form. Its findings are summarized at the links below:

• Myofascial (trigger point) release and paradoxical relaxation training
• Intensive treatment protocol may help patients with CP/CPPS (video on The Doctor's Channel)