Pudendal neuralgia on dorsal nerve?

[Violet M]

Tommy, I have used soothenol brand of capsaicin but you are right, it does burn. I think it would be better for itch or PGAD than for pain. I don't think you need to worry about PGAD in the future. It's pretty rare. No need to borrow trouble, right?

Violet

[tommy72]

After all that pain meds with no relief, i've tried now 3 days each 100mg Prednisolone (Cortisone) which had some effect on the swelling of the flaccid glans and the persistent pain. Could this help in case of a nerve injury or would this rather point to another problem?

Tommy

[Violet M]

Can't say for sure but in my own experience, rectal steroid suppositories helped my pain initially. Steroids reduce inflammation so I think what you can conclude that since the steroid helped, then maybe you had some inflammation. Whether it was nerve inflammation or inflammation of other tissues is the question. And then there is the question of whether the surrounding tissues were inflamed due to malfunction of the nerve or for other reasons. Sorry, there's not an easy answer to your question.

Violet

[tommy72]

Thanks for your answer, Violet.

Since my first symptom after the incident was that massive emission of prostate secrete during erection, i've read now that this also could be caused by the hypogastric nerve.

https://en.wikipedia.org/wiki/Hypogastric_nerve
"The hypogastric nerve is responsible for emission (prior to ejaculation, which is instead the pudendal nerve); emission is sympathetic nervous system-mediated."

I wonder if that pain and swelling also could be due to an injury of this nerve or its offshoot, the penile cavernous nerve, but i don't know if it can be injured in the area of the glans/urethra opening,
but the prostate seems to be mainly innervated by hypogastric nerves. And i also have this strong pain in glans after prostate palpation and with full bladder.

Maybe anybody has any further information about these contexts?

Tommy

[Violet M]

It can be a trick to isolate which nerves are involved. Some docs perform hypogastric plexus nerve blocks but you would want to be sure it was someone who knew what they were doing. You could also have your PT check the psoas muscle for tension.

Violet

[aussie_pain]

Just another reply to Violet in relation to Small Fiber Neuropathy. This nerve is a mixed nerve!! It has motor, sensory and autonomic functions!! Small fibers also directly innervate the vascular supply (adrenergic fibers)
For you to just say it's only nerve endings and not apart of the main trunk just goes to show how clueless you really are with this. Oh my! The entire nerve supply is innervated with postganglionic autonomic fibers. Autonomic fibers are unmyelinated small fibers!.
Why do you think so many people have muscle issues? It's because the autonomic side blood innervating muscles is altered and norepinephrine is a component to. You have no idea Violet, stop giving your "professional takes" you have no clue
John

[Violet M]

For you to just say it's only nerve endings and not apart of the main trunk just goes to show how clueless you really are with this.

Hi John, I went back and read my post that I think you are referring to in this thread. I didn't say that it is small fiber neuropathy or only nerve endings in Tommy's case. I brought up small fiber neuropathy as a hypothetical, using the word "if". Based on this pubmed article, I'm not prepared to say that it would be impossible: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5999027/
And this article that was originally published in Pain Medicine:
https://advances.massgeneral.org/urolog ... px?id=1139

But of course, it could be the main trunk as you say. So I actually agree with you on that possibility.

You have no idea Violet, stop giving your "professional takes" you have no clue
John

I agree there is a lot I don't know. I have this habit of speculating possibilities -- maybe you could call it a bad habit. Your "professional take" could be correct, and I could be wrong. I don't know what your profession is, but you are welcome to help people brainstorm ideas here. Maybe it will help them come across a treatment that works for them. That is our primary goal here.

Violet