Cysta-Q is a clinically proven natural supplement used to address bladder dysfunction, frequent urination, pelvic pain and sexual dysfunction caused by inflammation. Learn more about common conditions below:

Interstitial Cystitis
Vulvodynia
Chronic Pelvic Pain Syndrome
Sexual Dysfunction

Interstitial Cystitis

• What is Interstitial Cystitis?
  
• Causes of Interstitial Cystitis
  
• Diagnosis of Interstitial Cystitis
  
• Symptoms of Interstitial Cystitis
  
• How to Address the Symptoms of Interstitial Cystitis
  
• Naturopathic Methods to Address the Symptoms of Interstitial Cystitis
• Special Concerns with Interstitial Cystitis
  
• IC: Dietary Do's and Dont's
• Interstitial Cystitis Research

What is Interstitial Cystitis?

Interstitial Cystitis (IC or PBS) is a long-term condition where the bladder wall can become irritated and inflamed, causing its victims to get up as often as 10 times in the night to urinate, with pain in the pelvis, bladder, and vagina. These symptoms may come and go, and can occur all at once or at different times. Interstitial Cystitis is not yet an explicitly defined medical diagnosis with a clearly understood cause yet the disease is very real. Because the inflammation that produces the symptoms is within the wall of the bladder, it is out of reach of the usual diagnostic tests for bladder disease.
However it is important to realize that Interstitial Cystitis is not a psychosomatic disorder. It is a physical problem and not an indication of any form of emotional issues or poor mental health.
Cysta-Q has been shown to effectively address the symptoms of Interstitial Cystitis by promoting bladder health in a study done by Dr. Daniel Shoskes of the Cleveland Clinic, Ohio. See a transcript of the IC Net lecture*.
 

*This statement has not been evaluated by the FDA. The products detailed on this site are not meant to diagnose, treat, cure or prevent any disease. If a medical condition exists, see your health care professional.

Causes of Interstitial Cystitis
Interstitial Cystitis is a poorly understood disease with unknown causes. Although no bacteria or viruses (pathogens) have been found in the urine of Interstitial Cystitis sufferers, an unidentified infectious agent may be the cause. Others believe that Interstitial Cystitis occurs with ischemia (tissue death) or a deficiency of GAG in the epithelium. It may be an autoimmune disease, in which the immune system attacks healthy cells, perhaps following a bladder infection. Spasms of the pelvic floor muscles may also contribute to the Interstitial Cystitis symptoms. It is likely that several factors cause the condition.

Diagnosis of Interstitial Cystitis
Because the symptoms of Interstitial Cystitis are similar to those of other disorders of the urinary system, and because there is no definitive test to identify Interstitial Cystitis, doctors must rule out other conditions before considering a diagnosis of Interstitial Cystitis. Among these disorders are urinary tracts or vaginal infections, bladder cancer, bladder inflammation or infection caused by radiation to the abdomen, eosinophilic and tuberculous cystitis, kidney stones, endometriosis, neurological disorders, sexually transmitted diseases, low-count bacteriuria, and, in men, chronic bacterial and abacterial prostatitis.

Medical tests that help identify other conditions include a urinalysis, urine culture, cystoscopy, and biopsy of the bladder wall and, in men, laboratory examination of prostate secretions.

Urinalysis and Urine Culture
These tests can detect and identify the most common organisms in the urine that may be causing symptoms. There are, however, organisms such as the bacteria Chlamydia that can't be detected with these tests, so a negative culture does not rule out all types of infection. A urine sample is obtained either by catheterization or by the "clean catch" method. For a "clean catch," the patient washes the genital area before collecting urine "midstream" in a sterile container. White and red blood cells and bacteria in the urine may indicate an infection of the urinary tract, which can be treated with an antibiotic. If urine is sterile for weeks or months while symptoms persist, a doctor may consider a diagnosis of Interstitial Cystitis.
Culture of Prostate Secretions
In men, the doctor will obtain prostatic fluid from the patient. This fluid will be examined for signs of an infection, which can be treated with antibiotics.
Cystoscopy Under Anesthesia With Bladder Distension
During cystoscopy to diagnose Interstitial Cystitis, the doctor uses a cystoscope--an instrument made of a hollow tube about the diameter of a drinking straw with several lenses and a light--to see inside the bladder and urethra. The doctor will also distend or stretch the bladder to its capacity by filling it with a liquid or gas.
Because bladder distension is painful in Interstitial Cystitis patients, before the doctor inserts the cystoscope through the urethra into the bladder, the patient must be given either regional or general anesthesia. These tests can detect inflammation; a thick, stiff bladder wall; Hunner's ulcers; and glomerulations (pinpoint bleeding) that may be seen only after the bladder is stretched.
The doctor may also test the patient's maximum bladder capacity, the amount of liquid or gas the bladder can hold under anesthesia. Without anesthesia, capacity is limited by either pain or a severe urge to urinate. Many people with Interstitial Cystitis have normal or large maximum bladder capacities under anesthesia. However, a small bladder capacity under anesthesia helps to support the diagnosis of Interstitial Cystitis.
Biopsy
A biopsy is a microscopic examination of tissue. Samples of the bladder and urethra may be removed during a cystoscopy and examined with a microscope later. A biopsy helps rule out bladder cancer and confirm bladder wall inflammation.

Symptoms of Interstitial Cystitis

Pain and Pressure

You feel unexplained pain and pressure in the urethra, vagina, area above the pubic bone, inside of the thighs, lower abdomen, lower back, or groin area, in any combination.

Frequent Urination and Urgency

You are unable to hold a lot of urine.

You wake more than once a night to urinate.

You may feel the urge to urinate, sometimes even after you've emptied your bladder.

Pain during Intercourse

When sex hurts, relationships may suffer. Even an understanding partner may become frustrated. Therefore,you may wish to speak with your doctor about pain you experience during sex. Here are some measures to discuss with your healthcare professional to see if they are right for you:

• Wash with a warm rinse after sex
• Use a plentiful amount of lubrication (such as K-Y® Brand Liquid or Jelly)
• Use a soothing gel or ice pack on the external genitalia

For men, symptoms may include pain and inflammation of the prostate (prostatitis). Women may suffer increased vulvar pain. Both men and women may experience pain in the perineum (space between the vagina or scrotum and the anus) and painful or uncomfortable sex, including intercourse and touching. For some men, ejaculation may be painful.

In addition to looking at these symptoms, it can be important to:

Types of treatment include the following:
Biophysical Techniques
Biophysical techniques used to control Interstitial Cystitis symptoms include bladder retraining, transcutaneous electrical nerve stimulation (TENS), stress reduction with biofeedback, diet modification and exercise. Physical therapy for the pelvic floor muscles may help decrease pain and spasms. Bladder retraining is a self-help process in which patients learn to control their urge to urinate. The theory behind bladder retraining is that the bladder muscle actually weakens with frequent urination because it is not allowed to distend fully. Patients with Interstitial Cystitis experience the impulse to urinate frequently because they have pain or urgency as the bladder fills. Bladder retraining programs vary. Generally, the patient schedules times for urination (a voiding schedule) and uses a series of relaxation techniques and distractions to help keep the schedule. The interval is progressively lengthened, thus strengthening the bladder muscle. Bladder retraining may be complicated by severe pain.
Transcutaneous electrical nerve stimulation (TENS)
TENS involves the application of mild electric pulses to the body for minutes or hours a day. It is believed that the electric pulses increase blood flow to the bladder, strengthen pelvic muscles that aid in control, and trigger the release of pain-blocking hormones. TENS therapy may help with Interstitial Cystitis pain, though it may take a couple of months before any benefit is realized. A TENS device is worn outside of the body, usually near the sacral nerve.
Sacral Nerve Stimulation
The InterStim® device, used traditionally to treat bladder-control problems, is being used experimentally in pre-clinical trials to evaluate its effects on Interstitial Cystitis. It is implanted under the skin of the lower back, near the sacral nerve, where it delivers electrical pulses to the nerves involved in bladder function. It may help control frequency and urgency associated with Interstitial Cystitis, although the Food and Drug Administration (FDA) has not approved it for Interstitial Cystitis therapy.
Stress reduction techniques, biofeedback, and exercise may reduce the occurrence of flares by strengthening the muscles of the pelvic floor. For some, exercise exacerbates symptoms by irritating an already tender bladder or sore abdomen.
Diet
Many people find that eliminating acidic, spicy, and sugary foods, as well as dairy products from their diet helps to control symptoms. The Interstitial Cystitis Association (ICA) provides a list of dietary suggestions:
See Section on Interstitial Cystitis Dietary Do’s and Don’ts listed below.

Naturopathic Methods to Address the Symptoms of Interstitial Cystitis
Interstitial Cystitis (IC) is a chronic inflammation of the urinary bladder. Naturopathic methods involve inhibiting the inflammatory process by removing inflammatory and irritating foods from the diet, taking nutritional supplements, and using herbal support.

Nutrition

The importance of nutrition cannot be overstated and changing to a healthy diet may help address symptoms.

• Eliminate food sensitivities, which are often the cause of chronic inflammatory conditions. To determine food sensitivities, use elimination and challenge diet.
• Eat whole, fresh, unrefined, and unprocessed foods. Include fruits, vegetables, whole grains, beans, seeds, nuts, olive oil, and cold-water fish (salmon, tuna, sardines, halibut, and mackerel).
• Avoid sugar, dairy products, refined foods, fried foods, junk foods, some beans (fava, lima, black, soy) and caffeine. Coffee, chocolate, alcohol, carbonated drinks, citrus fruits, and tomatoes often worsen symptoms.
• Drink 1/2 of your body weight in ounces of water daily (e.g., if you weigh 150 lbs, drink 75 oz of water daily).

Supplements

• Calcium citrate alkalinizes the urine, which decreases irritation to the bladder.
• Bromelain provides anti-inflammatory action. Take away from food.
• Quercetin is an anti-inflammatory bioflavonoid with potent antioxidant effects.

Herbal Medicine

Herbal medicines usually do not have side effects when used appropriately and at suggested doses. Occasionally, an herb at the prescribed dose causes stomach upset or headache. This may reflect the purity of the preparation or added ingredients, such as synthetic binders or fillers. For this reason, it is recommended that only high-quality products be used. As with all medications, more is not better and overdosing can lead to serious illness and death.

The following herbs may be used to address the symptoms of Interstitial Cystitis:

• Gotu kola (Centella asiatica) - Take 30 mg standardized extract triterpenes 3 times a day. It enhances the integrity of connective tissue by stimulating production of glycosaminoglycans, which are an integral component of the protective mucous layer in the bladder.

Herbs to consider as a tea:

Homeopathy
A trained homeopathic practitioner is needed to diagnose and prescribe a deep-acting, constitutional remedy. The standard dosage for acute symptom relief is 3 pellets of 30C every 4 hours until symptoms resolve. Lower potencies, such as 6X, 6C, 30X, may be given every 2 to 4 hours. If the right remedy is chosen, symptoms should improve shortly after the second dose. If there is no improvement after 3 doses, a different remedy is given.
The following remedies may be effective in addressing the symptoms of Interstitial Cystitis:

Special Concerns with Interstitial Cystitis
Cancer
There is no evidence that Interstitial Cystitis increases the risk of bladder cancer. However, the long-term effects of Interstitial Cystitis require further observation and research.
Pregnancy
Researchers have little information about pregnancy and Interstitial Cystitis, but believe that the disorder does not affect fertility or the health of the fetus. Some women have a remission from Interstitial Cystitis during pregnancy, while others have more pain and pressure during the third trimester, possibly due to the weight of the fetus on the bladder.
Working
Symptom flare-ups that result in frequent absences from work may make it difficult to get or keep a job. The Social Security Administration provides information on Social Security Disability benefits. The National Organization of Social Security Claimants' Representatives can refer you to a lawyer experienced with Social Security claims. (See "Other Resources.")
Coping with Interstitial Cystitis
The emotional support of family, friends, and other people with Interstitial Cystitis is very important in helping patients cope with the disorder. Studies have found that Interstitial Cystitis patients who learn about the disorder and become involved in their own care do better than patients who do not. The Interstitial Cystitis Association can provide the address and phone number of the nearest support group. (See "Other Resources.")
Other coping tips:

Interstitial Cystitis Diet Suggestions: Do's and Don'ts

Discovering which foods you should restrict can be a lengthy process which requires discipline. You may also want to consider working with a nutritionist and/or a specialist in food and environmental allergies.

The idea behind curtailing your diet is to avoid foods that may irritate your bladder. Here is a list of some of the suggested items to restrict, followed by foods that a number of Interstitial Cystitis patients have noted do not cause them problems.

Milk/Dairy Products

Avoid: aged cheeses, sour cream, yogurt and chocolate.
Okay to try: white chocolate, non-aged cheeses such as cottage, American, or ricotta, frozen yogurt and milk

Vegetables

Avoid: fava beans, lentils, lima beans, onions, tofu and tomatoes
Okay to try: other vegetables and home grown tomatoes (which may be less acidic)

Fruits

Avoid: apples, apricots, avocados, bananas, cantaloupes, citrus fruits, cranberries, grapes, guava, nectarines, peaches, pineapples, plums, pomegranates, prunes, rhubarb, strawberries and juices made from these fruits

Okay to try: melons (other than cantaloupes) and pears

Carbohydrates and Grains

Avoid: rye and sourdough bread.
Okay to try: other breads, pasta, potatoes and rice

Meats and Fish

Avoid: aged, canned, cured, processed or smoked meats and fish, anchovies, caviar, chicken livers, corned beef, pickled herring, and meats which contain nitrates or nitrites
Okay to try: other poultry, fish and meat

Nuts

Avoid: most nuts
Okay to try: almonds, peanuts, and pine nuts

Beverages

Avoid: alcoholic beverages, beer, carbonated drinks, coffee, tea, cranberry juice and wine
Okay to try: bottled or spring water, decaffeinated, acid-free coffee and tea, and some herbal teas

Seasonings

Avoid: mayonnaise, miso, spicy foods (especially such ethnic foods as Chinese, Indian, Mexican and Thai), soy sauce, salad dressings and vinegar
Okay to try: garlic and other seasonings

Preservatives and Additives

Avoid: benzol alcohol, citric acid, monosodium glutamate, aspartame (Nutrasweet), saccharin, foods containing preservatives and artificial ingredients and colors

Miscellaneous

Avoid: tobacco, caffeine, diet pills, junk foods, recreational drugs, cold and allergy medications containing ephedrine or pseudophedrine, vitamins buffered with aspartate

Although the list of forbidden foods may initially appear daunting, remember that there are still many foods you can enjoy. Many Interstitial Cystitis patients report that they have the least trouble with rice, potatoes, pasta, vegetables, meat and chicken. With these foods as a base for your diet, you can create nutritious and flavorful meals. You can still cook for family and friends and share meals with them because the foods you can eat are the basic elements of a healthy, balanced diet. However, you may need to make some minor adjustments, such as setting your serving aside before adding seasonings. Add a source of fiber to your diet to promote regular bowel movements.

Suggestions

With some imaginative effort, you should be able to come up with substitutions for favorite foods and drinks which aggravate your symptoms. Here are a few suggestions:
          - Add a pinch of salt to carbonated beverages to make them flat
          - Try reduced acid orange juice now available in supermarkets.
          - Boil down all sauces containing alcohol

Interstitial Cystitis Research
Although answers may seem slow in coming, researchers are working every day to solve the painful riddle of Interstitial Cystitis (IC). Some scientists receive funds from the Federal Government to help support their research, and some receive support from other sources such as their employing institution, drug companies, and the Interstitial Cystitis Association. Researchers and doctors around the country, regardless of who funds their work, may competently diagnose and treat Interstitial Cystitis.
 

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), a part of the National Institutes of Health (NIH), leads the Federal Government's research efforts on Interstitial Cystitis. Most studies funded by the NIDDK are a result of unsolicited grant applications sent to NIH by scientists at universities and medical centers throughout the United States. Other NIDDK-funded studies result from solicitations issued to encourage increased research on a certain topic.

• What is Vulodynia?
• Causes of Vulvodynia
  
• Symptoms of Vulvodynia
• How to Address the Symptoms of Vulvodynia
  
• Vulvodynia Self Care
  
• Resources for Vulvodynia

What is Vulvodynia?

At least 200,000 women in the United States have Vulvodynia, but experts believe the condition is greatly underrecognized. Some research suggests the disorder may affect as many as one in six women at some point in their lives. There are several reasons Vulvodynia may be underreported. It may be partly due to the absence of visible signs of the condition. Or it could be the reluctance of many women to talk about their symptoms.

Vulvodynia is the term used to describe women who experience the sensation of vulval burning and soreness in the absence of any obvious skin condition or infection. The sensation of burning and soreness of the vulva can be continuous (unprovoked vulvodynia) or on light touch eg. sexual intercourse or tampon use (provoked vulvodynia).

This condition is a cause of vulval burning and soreness usually as a consequence of irritation or hypersensitivity of the nerve fibres in the vulval skin. The abnormal nerve fibre signals from the skin are felt as a sensation of pain by the woman. This type of pain can occur even when the area is not touched.

Another example of nerve-type (neuropathic pain) like Vulvodynia is the pain some people experience with an attack of shingles. Once the rash of shingles has disappeared the area of skin where the rash was can be intensely painful and sore despite the skin appearing normal. The condition is called post-hepatic neuralgia.

Causes of Vulvodynia

Doctors don't know what causes Vulvodynia, but contributing factors may include:

• Injury to or irritation of the nerves surrounding your vulvar region
• Past vaginal infections
• Allergies or a localized hypersensitivity of the skin
• Muscle spasms

Many women with Vulvodynia have a history of treatment for recurrent vaginal yeast infections. Some women with the condition have a history of sexual abuse. Vulvodynia isn't sexually transmitted or a sign of cancer.

Symptoms of Vulvodynia

The pain described by women with unprovoked vulvodynia is often of a burning, aching nature. The intensity of pain can vary from mild discomfort to a severe constant pain which can even prevent you from sitting down comfortably. The pain is usually continuous and can interfere with sleep. As with long-term pain of any cause you can have good days and bad days. Itching is not usually a feature of the condition. The pain in unprovoked vulvodynia is not always restricted to the vulval area (area of skin on the outside of the vagina) and some women get pain elsewhere. This can be around the inside of the thighs, upper legs and even around the anus (back passage) and urethra (where you pass urine). Some women also have pain when they empty their bowels. Unprovoked vulvodynia can have an affect on sexual activity and is associated with pain during foreplay and penetration.

In some women with unprovoked vulvodynia the burning sensation can be generalised over the whole genital area. Alternatively it can be localised to just the clitoris (clitorodynia) or just one side of the vulva (hemi-vulvodynia).

How to Address the Symptoms of Vulvodynia

Treatments for Vulvodynia focus on relieving symptoms. No one treatment works for every woman, and you may find a combination of treatments works best for you. Available options may include:

Medications. Tricyclic antidepressants such as amitriptyline (Elavil) can help lessen chronic pain. This type of antidepressant may work better than some of the other types of antidepressants, such as Prozac or Zoloft, for this condition. Anticonvulsants such as carbamazepine (Tegretol) and gabapentin (Neurontin) also may lessen the pain of vulvodynia. Antihistamines such as hydroxyzine can reduce itching.
Biofeedback therapy. This therapy can help reduce pain by teaching you how to control specific body responses. The goal of biofeedback is to help you enter a relaxed state in order to decrease pain sensation. To cope with Vulvodynia, biofeedback can teach you to relax your pelvic muscles, which can sometimes contract in anticipation of pain and actually cause chronic pain itself.
Local anesthetics. Using medications such as lidocaine can provide temporary relief from the pain.
Topical creams. Creams that contain estrogen or cortisone can help alleviate the pain.
Phytotherapeutic agents. Plant extracts.
Sitz baths. Bathing the area around your external genitals and buttocks in a saline solution can sometimes help make you feel better, but it also has the potential to aggravate your discomfort.

Vulvodynia Self Care

The following tips may help you manage the symptoms of Vulvodynia:
Cold compresses. Cool compresses placed directly on your external genital area may help lessen pain and itching.
Avoid tight fitting pantyhose and nylon underwear. Tight undergarments restrict airflow to your genital area, often leading to increased temperature and moisture that can cause irritation. Wear cotton underwear to increase ventilation and dryness.
Avoid hot tubs. Spending time in a hot tub may lead to discomfort and itching.
Avoid excessive hygiene. Washing or scrubbing the affected area harshly or too often can increase irritation.
Try an antihistamine at bedtime. This may help reduce itching and help you rest better.
Look for triggers and avoid them. The triggers that can make vulvar pain worse tend to be different for each woman. Your observations of what causes you pain are important. Avoid potentially irritating soaps, clothing dyes, creams and bath products.
Work with your doctor. Over time you can work with your doctor to identify the approaches that work best for you.
Exercise and stay active. Regular exercise can help ease chronic pain, but stay away from exercises that put pressure directly on the vulva, such as bicycling.
Accept small steps of progress. Don't expect instant cures. Have confidence that you'll feel better over time.

Resources for Vulvodynia

National Vulvodynia Association
P.O. Box 4491
Silver Spring, MD 20914-4491
Phone: (301) 299-0775
http://www.nva.org
 

• What is Chronic Pelvic Pain Syndrome?
  
• Causes of Chronic Pelvic Pain Syndrome
  
• Diagnosis of Chronic Pelvic Pain Syndrome
  
• Symptoms of Chronic Pelvic Pain Syndrome
  
• How to Address the Symptoms of Chronic Pelvic Pain Syndrome
  

What is Chronic Pelvic Pain Syndrome?

 Chronic Pelvic Pain Syndrome (CPPS) occurs just in men. It is a persistent discomfort or pain that you feel in your lower pelvic region-mainly at the base of your penis and around your anus. The source of the pain is thought to be the prostate gland. The prostate gland is only found in men. It lies just beneath the bladder. It is normally about the size of a chestnut. The urethra, a tube that passes urine from the bladder, runs through the middle of the prostate. The prostate helps to make semen. However, most semen is made by the seminal vesicle.

Currently, the National Institute of Health refers to Chronic Pelvic Pain Syndrome as Category IIIa Prostatitis or Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS). Chronic Pelvic Pain Syndrome is another name for Chronic Nonbacterial Prostatitis (or close medical condition association). The Noninflammatory Chronic Pelvic Pain Syndrome was formerly called Prostatodynia.

Causes of Chronic Pelvic Pain Syndrome

The cause is not known although symptoms are thought to come from the prostate gland. Many theories have been put forward as to the cause. These include:

Diagnosis of Chronic Pelvic Pain Syndrome

A typical diagnosis includes:

• A urine sample - to rule out urine infection
• A sample of fluid (secretions) from the prostate may be collected to rule out infection in your prostate. To do this, a doctor can gently massage your prostate with a gloved finger in your rectum. By doing this, fluid from the prostate is pushed out into the urethra and comes out from the penis to be collected and tested for bacteria (germs). If you have chronic pelvic pain syndrome, no bacteria are found in the prostate fluid or urine. (Prostate infection can cause symptoms similar to chronic pelvic pain syndrome.)
• Other tests may be advised to rule out other conditions of your prostate or nearby organs if your symptoms are not typical.
 

Symptoms of Chronic Pelvic Pain Syndrome

The common symptoms associated with Chronic Pelvic Pain Syndrome include:

• Pain or discomfort - lasting several months, and often longer
• Pain is usually at the base of the penis, and around the anus and lower back
• Sometimes the pain spreads down to the tip of the penis and/or into the testes
• Painful ejaculation - pain may vary in severity from day to day
•  Mild urinary irritation - mild pain when you pass urine
• Urine urgency - at times, some hesitancy when trying to pass urine
• Poor urinary stream
• Tired feeling
• General aches and pains

How to Address the Symptoms of Chronic Pelvic Pain Syndrome

The principle proposed natural method to address the symptoms of chronic pelvic pain syndrome by promoting prostate health.

• Bioflavonoid (e.g. quercetin)- A class of water-soluble plant coloring agents, which have anti-inflammatory and antioxidant properties.

What is Sexual Dysfunction?

Do you experience pain before, during or after ejaculation? Are you less interested in having sexual encounters?  Do you live with prostate pain, chronic pelvic pain, or rectal pain? Have you confronted penile dysfunction due to pain or are you experiencing an uncomfortable throbbing sensation in your genital or rectal areas? Are you suffering from prostatic congestion? While regular ejaculation and prostatic massage are helpful for some patients many patients with post-ejaculatory pain can exacerbate their symptoms with repeated ejaculations, thereby creating no long-term relief.

20 million men of all ages share the symptoms of non-bacterial chronic prostatitis. While there are several types of prostatitis diagnosed in men, including bacterial prostatitis (acute and chronic), non-bacterial prostatitis and prostatodynia account for 95% of all prostatitis diagnoses. Symptoms can include perineal pain, reduced urine flow and possibly impotence and pain before, during and after ejaculation.