Brief Answer:
Need multidisciplinary approach of treatment.

Detailed Answer:
Hi XXXXXXX

Your query is ambiguous. But from what I understand you have pain over the scar, the suspected prolapsed urethra and bladder. The source of pain from these areas are different and should be managed independently. I shall try addressing each of these concern here.

1. Pain along the scar is definitely due to neuralgic reasons. In some unfortunate patients nerves get involved during scarring leading to painful symptoms. Bladder distention may be stretching the nerve aggravating this pain. Pain on the suprapubic region when you sit up may be due to same reasons.
Though scar revision may be helpful, it is routinely not advised since the result of treatment is unpredictable and chances of recurrence can be high. In my opinion you should purse with current pain medications. Hopefully trigger injections help you.
You did not describe your experience with amitryptilline. Gabapentine / pregabalin / carbamazepine are my preferred choice of drugs if you did not find amitryptilline helpful.

2. Pain from prolapsed urethra responds very well to regular sitz bath. You should try this regularly along with other pain medicines. Visit an urologist and discuss about surgical correction.

3. Besides these elements of urinary tract infection as cause of pain needs to be excluded with routine tests. Your local physician/urologist will know about it.

4. Lastly though interstitial cystitis explains your symptoms, we can arrive at this conclusion after all above mentioned conditions are ruled out.

In short, you have been dealing with multiple area pain. I routinely advise my patients to approach multiple specialist for best results. You should try visiting an urologist / gynecologist and a general surgeon and discuss about the aforementioned possibilities.

Hope this helped. Let me know if you need clarifications.

Regards

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Brief Answer:
Positive attitude helps....

Detailed Answer:
Hi,

Chronic pain conditions are slightly difficult to treat especially when expectations are strong. We do not have many magical pills that takes away pain completely overnight. I would be extremely pleased even if 20% pain improves with any treatment. So don't loose patience. Work patiently trusting your treating doctors. You can take second opinions from experts online / at a different hospital. Healthcaremagic.com is open to you if you liked it. You should be able to take an informed decision with multiple ideas and opinions.
Trigger point injections have been wonderful in many of my patients. You will feel feel better after injections and pain threshold lowering medicines that I suggested above.

Please discuss about urethral prolapse and cystitis too with your current doctor and ask for referrals if needed.

As far as Kegel's exercise is concerned, it may be responsible for the cramps. I would suggest you to stop exercises for few days. Try warm sitz bath. If it doesn't improve in 2-3 days, you need a doctor.

Hope this helps you. Feel free to ask for clarifications before closing this discussion.

Regards

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