Hi Nicole, welcome,
One of the longest threads on HOPE is about persistent genital arousal disorder so you are definitely NOT alone. There are many people here who will totally understand your problems.
http://tinyurl.com/d2kbjzg
I remember Calluna saying that slow release tramadol did help her with this issue. Of course everyone is different so it's an individual experiment with medication. Tramadol can be very constipating so movicol or senna type tablets may be a necessary addition if tried.
If your problem is neroligical a combination of anti depressant and anti seizure drugs is often effective; again experimentation with different brands and close monitoring is necessary to really monitor any beneficial effects (and side effects)
Most doctors would prescribe both together but I would always try one first (my choice would be an anti depressant) so that you can properly establish weather it is working or not. Then phase in the other medication and to the same.
Just because something works doesn't always mean that if you take more it will work better btw. It is often the case that lower doses especially with antidepressants are as effective as higher ones. There is more info on this on the home page.
In the mean time try ICE. We all love ice here.
Try not sitting too (very important)
Trying these meds and some lifestyle changes will help hopefully and of course it will also point to the fact that the problem IS a nerve issue and not psychological.
On the surgery front, don't even think about it at the moment. There are many therapies that may help before that stage. However any surgery would decompress the pudendal nerve and not sever it so function would remain in tact.
So very glad you are here.
Take care
Helen
Fall 2008. Misdiagnosed with lumber spine problem. MRN June 2010 indicated pudendal entrapment at Alcocks canal. Diagnosed with complex variant piriformis syndrome with sciatic, pudendal and gluteal entrapment's by Dr Filler 2010.Guided piriformis botox injection 2011 Bristol. 2013, Nerve conduction test positive; new spinal MRI scan negative, so diagnosed for the 4th time with pelvic nerve entrapment, now recognised as Sciatic, pudendal, PFCN and cluneal nerves at piriformis level.