Should I push for an appointment? Thank you.

User

Posted 02 Oct 2022 at 12:56

Hello. 54-year-old type 2 diabetic here. I posted on here back in 2018 and received some great support during a bout of prostatitis, which thankfully eventually resolved itself. Since then, I saw a urologist with regard to my frequent urination symptoms who found no problems except for an overactive bladder, and he prescribed me with desmopressin that was great until, as per many such meds stopped working as well after a year or so. I am on the list to see a urologist again to see if any new meds can be prescribed but with the backlog due to Covid it's a year or so down the line and I am still on the waiting list.

Back in 2019 I started getting what I can only describe as terrible rectal pain flare ups. Anything from 5 minutes to 30 minutes and they would just come out of the blue, mainly at night. At the start it was maybe one a month, now it's more often. I saw a specialist late 2019 who performed a sigmoidoscopy, but all that was found was a mild case of diverticulitis. The symptoms the consultant agreed were very likely to be a little-known condition called proctalgia fugax. In the meantime, I stumbled across a way to relieve the symptoms. Firstly, sitting in quite a hot bath seemed to do the trick, albeit not ideal at 3am, and finally noting that two paracetamols worked pretty quickly. I've just lived with it since.

This brings me to last night. Still suffering a bit of nocturia (always have), I was awoken again by a painful fugax attack. This time I needed to desperately pee as well. I rushed down to the kitchen to grab some paracetamol and then up to the bathroom. I tried to pee but was struggling to get a stream going, never had that before. When I did finally pee the rectal pain incredibly vanished. Was it the paracetamol or the urination that cured it, I don't know. Usually, I just then carry on but because having a pee seemed to relieve the pain on this occasion has got me concerned that it could be something going on with the prostate. I have "googled", (yes, I know) "rectal pain relieved by urination" and have found no results as such. Prostate symptoms don't seem to show this at all, and neither do the remedies for proctalgia fugax.

I have a PSA every year. In 2017 it came back as 2.05 so they did it again and it was 1.9. Jan18 it was 1.61, Aug19 2.25, Sep20 1.92 and Mar22 it was 1.77.

I may just have stumbled across another way to relieve the proctalgia fugax but at the same time it's just aroused a concern. My GP, along with everyone else's, seems still reluctant to accept appointments so was just wondering if anyone would push for an appointment as a matter of concern? Thank you.

User

Posted 02 Oct 2022 at 15:55

Hi Max, I think there is a lot going on here and you can try and isolate the causes and effects. Maybe the rectal pain caused you to tighten muscles so you can't pee, maybe paracetamol cured everything, maybe prostate is enlarged causing all problems, maybe...? I used "maybe" a lot there to emphasise, we don't know what's going on and neither will your GP.

Can you always pee fine, when you don't have rectal pain?

As soon as you get rectal pain, go for a pee and see if it clears it up (without paracetamol).

As soon as you get rectal pain try paracetamol (but don't have a pee), see if that clears it up.

If you can get some consistency between pain and peeing, five times in a row, you might be in to something

I would say having a PSA test now and perhaps every six months would be good, until you get to the bottom of this.

Personally I would not be contacting the GP until I had some idea of how consistent this problem is. Mind you if it is getting consistently worse, even with no clear pattern I would then contact the GP. Similarly if the PSA is consistently rising.

These are just my opinions, I have no medical knowledge. Many men don't get diagnosed with cancer til it is too late by having my attitude, but a more proactive attitude leads to over treatment and unnecessary side effects. Take your choice.

Dave

User

Posted 02 Oct 2022 at 16:18

Thanks Dave most appreciated. Never have an issue peeing usually or flow issues, if anything I go too much. I can be up three times a night or sleep right through. I've seen urologists previously due to frequency issues. Started back in 1991 when I went on a horse ride. Unfortunately, it was a rather wide horse and when it went into trot mode, I ripped both groin muscles and have had the issue since! The urologists didn't find issues with volume, just frequency. My diabetes could also cause frequency I guess as my score was a bit high last time but as I say frequency has been an issue for years.

Was comfortable with my PSA in March and after having the sigmoidoscopy was fairly confident that this "pain" was PF, especially as it's been four odd years now. It's just odd how actually having a pee stopped the pain. I certainly can't see anything online re prostate when urination relieves pain, but it was certainly strange. Hope that I am not posting about a "silly" problem on such a serious forum. I certainly don't want to disrespect anyone.

Edited by member 02 Oct 2022 at 16:18 | Reason: Not specified

User

Posted 02 Oct 2022 at 20:47

There are no "silly" problems, well not until you have resolved them. This is only a serious forum whilst one fails to understand the absurdity of human existence, after that it's also a place for laughs and giggles.

The fact you are a male, in your mind 50s, means that prostate cancer will come in to your life in the next 30 years or so. Because it usually has no symptoms, and you have other symptoms which will mask any it does have, keeping an eye on PSA levels is probably your best way to catch it when it does show up.

Dave

User

Posted 24 Jan 2023 at 11:09

I’m a 51-year old awaiting results from a prostate template biopsy. I had proctalgia fugax from 2015-2018 on a frequent basis, typically monthly, usually at around 2am.

I used to treat with 2 x paracetamol and a fair amount of tolerance, especially when it was a bad episode. Typical duration was 30 minutes. Passing urine was sometimes difficult during an episode, even though I felt like I needed to go.

The reason I mention it is that I hadn’t had an episode since 2018, until I had my template biopsy 2 weeks ago.
Now I’ve had two bad episodes of proctalgia fugax since having my prostate “speared” …. Surely no coincidence?

User

Posted 24 Jan 2023 at 11:55

Jezza - Hope all goes well with your results, it certainly is an interesting "coincidence".

My PF has bizarrely subsided in recent weeks but my bathroom frequency has got worse again, every two hours at night it seems on occasion. As said before now this is nothing over new, going back years and it's only the bladder medication that has masked the symptoms over the last few years. Contacted Urology because I was re-referred last March as the3 meds weren't working as well as before, but it's a one year and four month wait, so earliest I will see them is May/June this year.

At my recent diabetes blood test I asked for a PSA to also be done because my last test was last March. They didn't test the PSA. I called to ask why and got a call back saying the GP didn't feel the need for another one as in March 22 it was 1.77. I'm seeing him at the end of this month anyway so will discuss again then.

User

Posted 26 Nov 2024 at 18:20

Hi All, Thought I would add to this old thread rather than starting a new one. The Proctalgia Fugax above has settled and only comes on once in a while and two paracetamol do the trick. However since mid-late 2023 I have been having an issue with sparse intermittent blood on toilet paper or bowl and the awful feeling that I always need to go to the toilet to open my bowels, (tenesmus). I have had 6 FIT tests since 2023 all negative at 1ug/g, although the last one a week ago was 8ug/g, still negative apparently as its less that 10ug/g, (haemoroid suspected).

The Tenesmus whilst subsiding during summer has come back with a vengeance since early October with one instance of rectal bleeding a couple of weeks back one morning, first time since March. The Tenesmus always starts after a morning bowel movement and 9 times out of 10 lasts all day until the evening where it bizarrely stops almost immediately. The routing happens again the next day. To start with maybe three out of seven days were affected, although this last week it has been going on every day. I went to A&E today as it was unbearable this morning and I felt very ill with it. Was seen by a GP as I couldn't get a surgery appt, and he checked abdomen and performed a DRE, both were clear. However he noted what was called a few months ago on an Ultrasound I had for a right sided flank issue a "bulky prostate". He noted that this was enlarged but also noted on my records that the PSA test they performed back in June when this was found was 1.53, ironically the lowest PSA score I have had in the 7 checks I have had since 2017.

The reason for this post however is whilst I have been somewhat concerned about something sinister in my bowel that's causing the Tenesmus because it almost feels like the BM irritates something as it goes past and then stays irritated for hours, the A&E GP suggested the Tenesmus could in fact be caused by the enlarged Prostate,. He has suggested I obviously speak with my GP about being referred to a colorectal specialist and also a urology consultant regarding the Tenesmus, but looking at Google (I know I shouldn't) I can't find anything at all really with a link between a Prostate issue and Tenesmus so I was wondering if anyone here has had such an issue?

Many thanks.

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