how can I diagnose and treat pubococcygeus muscle spasm. I am a 68 year old man who is also on flomax for BPH. I have had a normal cystoscopy, pelvic CT, normal PSA (1.0) and normal exam by my Internist and Urologist. But, I continue to have nocturuia, urgency, hesitency and tightness and pressure in my perineum, rectum and tip of the penis.