I am very glad to have found this forum/website. I have been on a rollercoaster for the last 2 years and don't know where to go anymore.
I will tell you my story.
I am a 28 year old male from Sydney, Australia. Fairly athletic before the injury. Average weight.
For many years I had a small discomfort in my left groin. I had multiple ultrasounds and they all came back with nothing. I have had lower back pain which has worsened as the years went on.
I was quite active before my injury, I cycled 3 or so days a week for an hour(20km roughly). I did lift weights for a little while, but gave up on that due to a shoulder injury and the groin discomfort.
In December 2013 I was out cycling. What used to happen is, when I was out of the saddle, as I peddled, I had a build up pressure/discomfort feeling in my left groin. I would relieve the feeling by sitting back down on the saddle, and peddling slowly for a minute or so. This particular day I think I pushed too hard, while I was out of the saddle, and something felt as if it dropped into my scrotum, with excruciating pain. My initial thought was a hernia. But everything felt normal on touch, and looked normal.
Since then I have seen many doctors, specialists, have had multiple mri and ultrasounds, etc. The only thing that has ever come up on the scans was 'mild adductor tendinopathy. And SIJ instability, sacroilitis. It was all focused on a groin injury. I tried PRP injections into the adductor, with no success. Lots of meds, NSAIDS. Physio would make everything worse. But still no relief.
About 6 months after the initial injury, I started having a burning sensation when I would urinate, and the groin pain would get worse with urination. No one could explain why I was having this.
A year later, I had a random fever and an odd sensation in my perineum. My doctor ordered a PSA blood test to check my prostate, and it was a shock! 6.7! They all freaked out a little and said that was 3 times more then it should be. Not to mention they have never seen a 27 year old with prostate cancer. I saw a urologist, who put me on antibiotics for 6 weeks. And the PSA dropped to a normal level. But my groin pain and burning sensation didn't go away. The Urologist said my prostate is now fine. He referred my pain to the pubic tubercule. Along the spermatic cord.
Then finally I saw a groin surgeon. One of the best doctors I have seen through this process. Dr Garvey. He recognised that I have a groin disruption injury, but also symptoms of pudendal neuralgia. I had slight loss of sensation to the left side of the tip of the penis.(This was new to me as to me it felt fine, but I couldn't really feel a needle prick in that area). I do note that around this time, the burning sensation in the penis had settled down a little. I wasn't sure what to think of all this. An ultrasound that I had of my groin came back with a slightly thickened spermatic cord, but still normal. And pain in the spermatic cord region.
So, I had 2 pudendal nerve injections into the alcocks canal, to try and sort out the pudendal side of things. I found they didn't help with my symptoms.
Then I saw a physio. I was a little constipated at the time, so she gave me a list of foods to eat, etc to help. But the exercises would aggravate my groin pain too much so I didn't really do them. I started walking heaps, and found that the burning sensation in the penis was slowly going away. But groin pain was there. But I could now point to the exact spot that hurt, it was as if the pain centralised to a particular spot in my groin.
I started getting an odd pain/pulling sensation just under my scrotum on the left while walking, and the doctors were saying it is to do with the pudendal neuralgia. It was affecting my ability to walk without discomfort, and was making it worse by walking.
I had 2 MRI's of the pudendal nerve. One came back with nothing, but the other showed some fibrosis tissue near the perineum. Still no entrapment, and the nerve looked fine. So we went on the search of someone to inject the pudendal nerve around that fibrotic area.
During my search, I came across another radiologist in December 2015, who performed the injection further down about 7 cm from the other 2 pudendal injections. And I am here now!!! It has flared up all my symptoms and even made some worse! My groin pain is a lot more now, I cannot exactly pinpoint where it hurts. I have pain in the tip of the penis. Pain and burning when urinating. And I have become a little constipated again with pain when going to the toilet.
I am in desperate need of advice and help with this. The injection flare up has not really settled down(has been about 6 weeks since I had it done).
Any thoughts, ideas, help, would be much appreciated.
My main concern is, do I have pudendal neuralgia? My groin/testicular cord pain comes on at the same time as the burning in the penis. So I can only think that they are related, and not 2 separated injuries. But does the pudendal nerve have anything to do with the testicular cord/adductors/conjoint tendon/groin?
Dr Garvey has proposed a groin reconstruction operation, since I have tenderness along the conjoint tendon, cord and adductor. But he isn't sure it will help with the burning sensation I have in the penis. But I think they are all related. Especially since my initial problems were only the groin. And the burning/penile issue, only came 6 months after. Mind you, I stopped all form of exercise from the initial injury as I was in too much pain to do anything.
Looking forward to your responses.
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