Brief Answer:
It could be because of post voiding urine retention in bladder.

Detailed Answer:
Hello, XXXXXX ,I am Dr.Maheshwari
Thankyou for your question,
and welcome to the HCM

Detailed answer....

I have gone through your history ,and I understand your concern.Since there can be many causes of recurrent on and off pain for example it can be urethra stone,chronic urinary tract infection and kidney pelvis infection.But from your history it seems that your symptoms can be because of urine retention in bladder.

And main factor causing all this could be L5 and S1 disc herniation.

AS disc tends to be filling very tiny space between two vertebrae and nerves emerge from the side of these process and supply respective areas .Like nerves emerging cervical process would supply upper limbs . Lumbar and sacral nerves would supply from waist to lower limbs.So if there is herniation of disc from respective area ,it would cause irritation and slow but continuous injury to nerves emerging from those areas ,so causing trouble to areas supplied by respective irritated nerves.

Since you have mentioned that you have L5 and S1 slip disc (herniation) problem ,and slip disc at this level can cause leg pain,incontinence and dribbling and retention of urine (as bladder area is supplied by this level).

Now keeping this in mind ,urinary retention can cause your recurrent symptoms and even it can cause stone in urethra,bladder or kidney if not treated properly.

Though your investigational tests come normal,but I would suggest you to get a post voiding ultrasound bladder done and discuss further with your treating doctor or an Urologist .
You may also get an opinion from Neurosurgeon ,and discuss about the extent of lumbar and sacral nerve injury through your recent MRI spine.Because treating the route cause ,can be the most helpfull for the ultimate cure.

Hope I answered your question.You may ask further if you have more questions.I will be happy to help.

Wish you best of health.

Regards,
Dr.Maheshwari

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Brief Answer:
Prophylactic antibiotics, pain killer and opinion from neurosurgeon required.

Detailed Answer:
Since PSA is prostate specific antigen, which is checked to rule out enlarged prostate (benign mass). But Prostatitis means inflammation of prostate gland. The inflammation may spread to the area around the prostate. So can cause pelvic and penile pain.

There are different types of prostatitis. But chronic prostatitis is the most common form of the condition, although it can also caused by bacterial infection but it is least common cause of chronic prostatitis. As disorder of nervous system can also cause of chronic prostatitis (as may be in your case). So keeping this in mind you need to get consulted by a neurosurgeon and discuss about the possible treatment of disc herniation.

As surgery comes in the last option for treatment of slip disc, it can be treated by physiotherapy, back exercises, yoga. For pain you may take tramadol and if you are also getting leg pain then gabapentine can help.

In my opinion, you may need prophylactic antibiotics, pain killer and opinion from neurosurgeon and urologist and follow accordingly. It can prevent you from unnecessary investigation tests and stress of the problem too.

Doing exercise and yoga can also help you relaxing and avoiding from stress.

Hope I answered your question.

If you do not have any clarification ,you can close the discussion and rate the answer.
Wish you good health.
Regards,
Dr.Maheshwari.

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Brief Answer:
Hello,Dear XXXXXXX

Detailed Answer:
Dear ,interstitial cystitis is an inflamatory disease of bladder,that cause ulceration and bleeding of the bladder's lining and can lead to scarring and stiffening of the bladder. The most suspecting symptom of this disease is tenderness of the bladder while pushing on the abdomen over the bladder.
If you have got tenderness on the bladder side with touching on that side (which you have not mentioned above), for confirmation you may go through Cystoscopy under anesthesia with bladder distention and discuss with Urologist.

I hope my answer will be helpfull,
Wish you best of Health.
Regards,
Dr.Maheshwari

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