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He urinated frequently, and when he did, he felt as if he were urinating boiling water.
His penis hurt, and the pain grew more intense after he had sex.
JENKYNS: I started specializing in pelvic floor dysfunction in 1984 with Elizabeth Noble, an Australian physical therapist who formed the Section on Women’s Health of the American Physical Therapy Association in 1977.
Initially, I treated incontinence in postpartum and elderly women.
The doctor prescribed lorazepam (Ativan), a drug often used as a muscle relaxant, and anti-inflammatory medications.
He also suggested mild exercise, applying heat to the perineum, and sitting in a hot bath.
This time, however, the pain was somewhat different.
It took two rounds of antibiotics and several weeks’ time, but the pain finally went away.
The doctor concluded that James had chronic pelvic pain syndrome (CPPS), a type of prostatitis.
One possible cause: excessive tightness in the muscles of the pelvic floor (see Figure 1).
He suggested biofeedback, a technique that helps one become more aware of unconscious or involuntary bodily activities so that they can be consciously manipulated. If you have pain, just tell the pain to go away and get on with your life,’” James recalled. But one morning in December 2008, James had sex with his wife.
James saw a specialist in mind-body medicine, but the specialist tried a different technique. Later that day, he was in pain and developed urinary urgency, which sent him back to the doctor.
They include the levator ani, bulbospongiosus, ischiocavernosus, and superficial transverse perineus.