Ache where prostate used to be

I had my prostate removed a year ago and my PSA remains at zero. However I periodically get a dull ache in the area where the prostate used to be - the same symptom that led to the original diagnosis of prostate cancer. My urologist has no explanation but because of the zero PSA he does not think it is cancer related. Any ideas on the cause?

Right from day one my perineum hurt, then it ached, then it was uncomfortable, then it was sortta sore, and now, two and a half years later, I only notice it when sitting on a really hard chair, or towards the end of a long day.

I posted here once asking about it, I believe, but never worried too much. Tylenol worked in early days and later I realized every two weeks was better than it had been two weeks before, then every month was better than the previous month, and now, when I look back six months it's better than it was then. My self diagnosis is whatever it is, it's healing itself and a small price to pay for getting rid of that cancerous sucker.

Sheldon AKA Sleepless

Welcome,
I had the ache after surgery and and still get it. Sheldon & Ken describe it about the way it was for me.
I think that when they spare the nerves they also somehow mess with the nerves that detect pressure etc in the area. That ache now really tells if my bowel is (partially) full or if a fart is on the way, but a while after a fart or a BM the ache usually goes away. I don't need to think about taking anything for the pain/ache anymore.
With me there is also definitely something odd down there with the nerves (="crossed wires") as, often when I sit to have a BM I now get a "feeling" where the prostate used to be and find I am getting a partial erection. (I guess it must be something like the reflex reaction that gives you a morning wood.) Needless to say an erection in such circumstances does not provide much in the way of pleasure, anymore than when it's the other way round and I end up feeling like I need to go to the bathroom when I'm having sex. But I can put up with this as a price I can pay for having made it to the zero club.

Alf

I get a cramping ache after orgasm, but I'm good the rest of the time.

Good to hear this isn't unheard of... been lurking here on-and-off for months since my diagnosis back in Aug.  I had my LARP on 11/21/11. 

For several years, I complained off and on (about 5-6 times a year) of a pain in my prostate after ejaculation.  It most often occurred after bowel movements within 20-30 mins after ejaculation.  I frequently had UTIs and was originally diagnosed with bacteriological prostatis, due to reduction in elevated PSA (4.5 down to 3.0) following a month of levaquin (and my age... 43 at the time).  Turns out I was very early stage, but I did have an enlarged prostate (about 45cc).  Doc said I may have had the infection along with the cancer.

Since my RP, I've been able to achieve orgasm (with no erection) without much problem (although I note that I've had at LEAST "10 different versions" of orgasms in this past month or so since the catheter was removed).

Anyway, since the RP, I've noted after several orgasms, I've had the EXACT same pain in the area where the prostate used to be (like Snowbound).  Not quite as intense or as long-lasting, but same general feeling and location.  It's like someone pinching that area real hard for about 3-4 seconds; similar to a muscle spasm or charlie horse feeling.  Prior to surgery, this pain might last as a throbbing/droning "pinch" for about a minute.

I rationalized that it was probably the nerves dealing with the rectum/bowel moving into that space where the prostate was, but it was a bit unnerving, since it was the same feeling before the prostate was removed.  BUT, I also noted that I had a HORRIBLE problem with an (mostly) external hemorrhoid due to constipation following surgery.  I'm thinking this issue may potentially be something with internal hemorrhoid issues.  (Still investigating that). 

I'd be interested to hear if any of you experiencing this pain also noted any problems with hemorrhoids.

I find this thread to be very interesting because I suffered with an ache back there for years. It would happen many times in the middle of the night following one of those events that doesn't happen anymore since my surgery (erection while sleeping - at least I don't think so). Sometimes it would happen in the daytime for no apparent reason. I would be in pain for about a half-hour. It felt like it was centered in the area of my prostate. My MD suggested that it was congestion. My urologist followed up with the old "blue balls" theory. I guess they thought I wasn't getting enough. Tell that to my wife, LOL. But now, following my prostatectomy, I still get the very same ache/pain from time to time, particularly following an orgasm. It doesn't last as long, but it still happens. When I found out I had PCa, I thought that maybe that was where the pain came from. Apparently not.

For those of you who had this ache or pain both before and after prostate surgery, look up "proctalgia fugax". This may be the condition that you are suffering from. I plan to ask my MD at my next appt if this could be what I was experiencing all along.

Mike H, Your very welcome. I suffered for many years not knowing what that pain could be. It was also a nighttime thing for me. Once in a while, it happened in the daytime. Glad I could help.