Health Organization for Pudendal Education

Hello,

I am a 25 yrs old male from New Delhi, India.

I have following symptoms from last 10 years :

1. continuous urinary urge (even on empty bladder or even when I have just urinated). Need to void upto 30-40 times during the day.
2. continuous sexual feeling and heaviness at back of penis(where the perineum starts) without desire,
3. penile pain and worsening of symptoms in cold temperatures and after defecating.

If penis and perineum are divided into 2 halves, then I have symptoms only in the right half and not on the left side.


3-Tesla pelvis MRI Report Summary :
"No Pyriformis syndrome
Normal obturator nerves
Normal internal pudendal nerve on left
Minimal intraligamentous compression of IPN on right by hook like sacrospinous ligament on right
Normal Alcock’s canal on either side."


I underwent following fluoroscope-guided diagnostic blocks 7 days back which my doctor here in delhi had prescribed:
a. Right-side pudendal nerve block (through perineum)
b. Iupar(??) plexus block

I noticed that the sexual arousal symptom is cured after the block but continuous urinary urge is still the same which is very bad. My doctor diagnosed me with pudendal neuralgia.

I am wondering how this continuous urinary urge will go, it will be great if somebody could give inputs.

It is great the nerve block has helped you with one of your symptoms. If you have urinary urge you could try pelvic floor physical therapy first. I am not sure if there is anyone that will be able to do that in Delhi. Hopefully there is.

You may have tensed up your pelvic floor in response to an aggravated nerve so hopefully physical therapy could loosen and relax the pelvic floor. This may help to reduce the urinary urge.

Was the urgency gone immediately after the block or did it return after the block wore off? If you can't find a PT in Delhi that can help you with internal work you could try a massage therapist. Even though the massage therapist can't work on the pelvic floor maybe working on the legs and butt would help any tense muscles in those areas. There are a couple of books that you could purchase to do your own internal work: "Heal Pelvic Pain" and "Headache in the Pelvis."

Thank you for taking time out and replying.

Yes, there is tightness in the pelvis due to 10 yrs of PN which may be causing the urinary urge. But I tend to believe that if there was no urinary urge, there would have been no tightness. I urinate 40+ times per day, even on empty bladder and bcoz of the stress of having to hold the urinary feeling, I have developed permanent head tightness in the last 2 years which is very very depressing and I had to quit my job due to these symptoms.

I dont want to take any psychic medicine as mind pills make me even worse, but I desperately want to get rid of this head tightness.

nyt wrote:Was the urgency gone immediately after the block or did it return after the block wore off?

I think the urinary urge was there after the block, I was too tense to notice the immediate effects. Its been 7 days since the block, thankfully sexual hyper-arousal hasn't returned though the urinary urge is still the same.

You are very lucky the nerve block has taken away the sexual arousal feeling. There are people who develop the sexual arousal feeling as a result of nerve blocks but for you it has been the opposite and that is good.

I had the urinary symptoms you are describing and the sexual arousal feeling. Neither were helped by nerve blocks or PT but both are mostly cured from surgery so that may be something you want to consider if nothing else helps -- although I'm sure you are aware there are no guarantees with surgery either.

Who are the doctors in India who are treating you? I wonder if they would like to have their names listed on the website in case future patients from India are searching for physicians.

Take care,

Violet

Hi my name is mahzi and I live in Kolkata I also suffer from PNE problems. I would like to know where you had youe 3tesla MRI done in delhi as i would like to get it done as well.