Dear Concerned., Thanks for writing to us. The history does not indicate whether you also suffer from constipation.Any issue related to perianal region with history pointing towards diagnosis of Anal fissure/Fistuala/Piles/ Haemorhoids are always associated with irregular bowels and constipation. A)Kindly get your stools examined for routine and microscopy to rule out Amoebiasis/Helminthiasis.Amoebic Colitis is associated with Tenesmus which is akin to your symptom.Kindly get treated for the same if the results are positive. B)Consume high fibre diet to keep the bowel movements normal.Simply consume two bananas at bedtime for a better bowel evacuation in the morning. C)For Pain and piercing in the anal region you can adopt Sietz Bath which is a time tested procedure.It involves opening your rectum into a basin of warm water treated with antisceptic repeatedly and indrawing the liquid and leaving the same back to the basin. After this procedure pls apply an antibiotic cream . I do not think you have prostatomegaly as in that case you would have urgency/frequency and precipitancy of urination symptoms.The more you try ,the less you would void urine. If the above measures do not help , pls consult a general surgeon for relief. Best of regards, Thank you, Get well soon, Dr Lt Cdr ASN Bhushan.