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Urology/Urinary Urgency


I have been struggling with urinary urgency off and on for several years.  Along with it, I get mild pain and the sensation of heat in the perineum and anal area. I have had an assortment of tests and diagnostic procedures done.  Diagnosis have varied with the most common being either Overactive Bladder or Prostatitis. A couple of doctors acknowledged that they were not certain what was going on. My prostate was found to be boggy on one occasion, otherwise I have been told it is normal.  My PSA score has always been low.  I have tried a number of bladder medications,antibiotics and anti inflammatory medication with no improvement. At times my symptoms have disappeared for months with no intervention in place, only to return at a later date.  My symptoms are most intense after urinating or having a bowel movement.  I have also noticed pain and a slight bulge where I suspect my left transverse perineal muscle is.  Is it possible my symptoms are being generated by the muscles of my pelvic floor?  If so, what type of professional could help with this? ( I ask the last question because a urologist once gave be a blank stare after inquiring into the possibility of  pelvic muscle issues.)  Your assistance is much appreciated!


Anything is possible in medicine so I suppose pelvic muscle issues can have some effect, but your symptoms include both prostatitis and OAB as possiblities as well as interstitial cystitis.  The fact that things are worse after a bowel movement suggests prostatitis.


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Stephen W. Leslie, MD


Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.


Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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