CodeBlu

*Disclaimer: Not a substitute for actual medical advice. Without a physical exam and a proper history it is hard to make a judgment.

Hey patient4. MD in training here. Not a urologist. But I'm into pain management and anesthesiology. I've actually seen a few clinical trials for pelvic pain syndrome. I got to work with this urologist in Switzerland who is publishing this study right now. I'd print this out and show it to your urologist. The only problem is that there hasn't been an RCT (randomized control trial), which is medical speak for sexy study that has great evidence backing it up (placebo vs. treatment). I can assure you that this is not always the case with RCT. http://www.ncbi.nlm.nih.gov/pubmed/23433012

In the acute sense, I am averse to alpha blockers for the sole reason that they suck and can really mess up your blood pressure. And I don't like that. Opioids in excess can actually cause a urinary retention and make it worse. I would drop the Vicodin. More inflammatory pain we're working with here, I'd actually discuss the option of steroids with your doctor, at a high dose, then taper it (Medrol Dosepak). See how that goes. You might be able to wean yourself off the steroids for weeks/months at a time. If you have positive effects from the steroids, you might be able to continue alternating taking them and not taking them for the purpose of being able to function. At least until a better treatment becomes available.

Good luck dude.

Damn. The experiments suck, but hey, it's for SCIENCE! Here's my suggestion with the steroids at least. Day 1 dose hard in the morning, I mean 60 mg of Prednisone. Day 2 mid day, 2 hours after you eat lunch, take 5 mg of Dexamethasone. Don't do anything, on day 3 and just see how long this will last. Dexamethasone takes a longer time to be active, but it's half life is longer as well. I really think that you should be good until day 6.

As I'm sure you know, steroid use long term has some nasty side effects. Things like Cushing's type syndrome (moon face, thin skin, stretch marks, bla bla bla). They're very real and very annoying. Be cautious.

Here's to hoping for happy arousals for you!

Do you wish that you could do adult Emerg as well?