OpenHealth Q&A

Seeking Help for Ongoing Issues

I am a 24-year-old male residing in Bangladesh, weighing 73 kg and standing at 5 feet 10 inches tall. In 2017, I experienced an unusual injury while playing with some rope; the rope got tightly wound around the base of my penis, just at the penoscrotal junction. This caused an uncomfortable pressure sensation, leading me to believe that something was blocked internally. Despite my intuition that something was amiss, I engaged in masturbation twice on that same day. On the second attempt, I struggled to achieve a full erection, so I applied pressure to my perineum in hopes of completing the act. Later that day, I ejaculated and noted that my semen appeared normal. However, following this incident, I noticed a series of troubling changes: - **Semen Sensation**: There has been a recurring feeling of blockage when attempting to ejaculate, particularly while lying down, resulting in an internal pressure without a satisfying release. - **Changes in Consistency**: My semen has become more liquid, lacking the typical thickness, and there have been moments of ejaculation where no fluid is produced despite the sensation of an internal release. - **Discomfort**: I experience a persistent dull ache at the base of the penis and along the left side of the shaft, often feeling either tight or torn, particularly during sexual arousal. - **Muscle Pain**: There’s a deep-seated ache in my glutes and upper legs, with occasional sensations resembling nerve pain. - **Anal Restriction**: Following ejaculation or during sexual excitement, I feel an involuntary tightening of my anal sphincter. - **Bowel Complications**: I frequently feel as though my bowel movements are incomplete, often feeling urgent after engaging in sexual activity. - **Delayed Urination**: After ejaculation, there seems to be a delay in my ability to urinate, accompanied by a sensation of pressure. - **Unusual Sensations**: Sometimes, I notice a peculiar link between my libido and sensations in my mouth, almost as if arousal is triggering something in my face or jaw. - **Position-Related Symptoms**: Lying down exacerbates the semen blockage and tension compared to when I am upright. This has become my daily experience — a complex mesh of nerve, muscle, and emotional difficulties stemming from a single incident. Recently, I've dedicated myself to the recovery process, aiming to cultivate discipline through targeted bodywork and resetting my nervous system: - **Physiotherapy**: I have attended three sessions of shockwave therapy aimed at my perineum and BC muscle but didn’t notice significant improvement, prompting me to seek other avenues. - **At-Home Rehabilitation**: I've been practicing guided pelvic stretches from resources like Cure CPPS and YogaBody. My routine includes: - Pigeon Pose, Butterfly Stretch, Figure 4, and Happy Baby. - Utilizing a ball for fascia release beneath my perineum and glutes. - Engaging in Colonel Ian’s stretches along with gentle yoga flows. - **Daily Stretching Routine**: I allot 1 to 2 hours each day for stretching, divided between morning, evening, and nighttime sessions. Additionally, I perform reverse Kegels and focus on slow, calming breathing to alleviate tension. - **Nervous System Optimization**: I’ve ceased the daily use of substances, focusing on maintaining tranquility, stillness, and bodily awareness, while working to diminish my anxiety regarding arousal and semen flow. - **Lifestyle Adjustments**: I regularly attend the gym, engaging in cardio on the cross-trainer and weightlifting, particularly for my shoulders and back. My goal is to walk at least 5,000 steps each day. - **Reactivity to Flare-Ups**: Some of the stretches I perform induce sharp pain or sudden urgency in bowel habits, which I now interpret as signs of fascial or nerve release rather than damage. I’m reaching out to see if my current approach is on the right track. Do you have any recommendations or additional insights to offer?

Answers (1)

7/20/2025, 6:31:02 PM

OpenHealth AI

It sounds like you have been dealing with a complex set of symptoms following an unusual injury, and it's commendable that you are taking proactive steps to manage your condition. Your current approach, incorporating various forms of physical therapy, stretching, and lifestyle adjustments, is a positive direction. Let’s break this down further, emphasizing clarity and actionable steps.

Main Points:

1. Persistent Symptoms: You report a range of ongoing symptoms affecting sexual function, discomfort, and bowel issues.
2. Current Interventions: You are already participating in physiotherapy, stretching routines, and lifestyle changes.
3. Need for Assessment: Given the complexity of your symptoms, a thorough evaluation by a specialist may be beneficial.

Explanation:

Your symptoms suggest potential issues related to pelvic floor dysfunction, nerve involvement, or even a psychosomatic component influenced by the initial injury. The sensations of blockage, discomfort, and the tightness you feel during arousal or after ejaculation could be tied to muscle tension or nerve pathways being affected by the earlier trauma. Your commitment to physiotherapy and rehabilitation exercises indicates you are on the right path, but it may take some time to see significant improvements.

Next Steps:

1. Evaluate Current Therapy: Consider discussing with your physiotherapist or a pelvic health specialist about adjusting your therapy based on your experiences. They might offer alternative techniques, such as myofascial release or additional targeted exercises.

2. Pelvic Floor Specialist Consultation: If you haven’t already, seeking a consultation with a specialist in male pelvic pain or an urologist with experience in pelvic floor dysfunction could provide insights. They may explore other possible underlying conditions or propose different treatment modalities.

3. Symptom Tracking: Continue to keep a detailed diary of your symptoms, noting any triggers, positions that exacerbate or alleviate discomfort, and the effectiveness of your current stretches. This can be valuable information for healthcare providers.

4. Gradual Adjustments in Physical Activity: While exercise is beneficial, ensure that your routines, particularly stretching and high-intensity workouts, are not aggravating your symptoms. Optimal balance is key, so consider integrating more restorative yoga or meditation practices that focus on relaxation and breathwork.

5. Mind-Body Techniques: Since you mentioned feelings of anxiety related to arousal, exploring mindfulness techniques or working with a mental health professional specializing in sexual health may help. These approaches can assist in reducing anxiety and improving your overall emotional well-being.

6. Nutritional Support: Pay attention to your dietary habits, particularly foods that might be inflammatory or exacerbate discomfort. Incorporating anti-inflammatory foods like fruits, vegetables, omega-3 fatty acids, and staying hydrated may also bolster your healing process.

7. Communication and Support: It can be beneficial to discuss these experiences with trusted individuals or support groups. Sharing your journey might help alleviate some emotional burdens.

Remaining vigilant and open to adjusting your approach as you gather more feedback from your body is essential. Please ensure that your care remains holistically focused, integrating physical, emotional, and mental well-being.