Health Organization for Pudendal Education

Hi all!

I've been away from the board recently, and wow, there's a lot new going on here. I'm still not caught up reading everything. But I'm just wondering... do we know of any successful dorsal nerve releases among the members of this board? Anyone?

I'm still confused as to how a person can be sure their dorsal branch is causing a problem. There's MRI. As far as blocks -- it doesn't seem anyone isolates the dorsal branch with a block. Is that correct? And then there are symptoms/location of pain -- but those really don't seem like absolutes in terms of localizing an area of compression.

Hi Susibee,

I can only answer your question as far as a male is concerned.Dorsal Nerve in a male is the culprit when one has a numb Penis as well as scrotum pain.It isn't gping to address your sitting pain,bowel issues sacrum pain,Urinary frequency,Painful Urinary Urgerncy etc.Those are all PNE symptoms.

I hope that it helps.

Kind Regards,
Ali

Hi,
I think I may have a dorsal nerve compression based on my pain location and symptoms, and based on a visit with Dr. Dellon. I am still unsure though if all this is the only branch I have affected, or if is another branch compressed in addition to the dorsal branch or if another branch is mimicking the symptoms that resemble a dorsal compression. I am unsure because some people report having penile numbness and erection problems which I do not have. I mainly have urination problems, some scrotal pain, and pain in my upper perineum, but I also have some pain in the middle of my perineum and a light amount to my left perineum. I don't think there is a definitive test as to whether you have dorsal or not, but I think if you exclusively have the symptoms Ali mentioned such as penile numbness, penile pain, and erection problems and no other problems or similar problems for a female, then you probably exclusively have dorsal branch entrapment. I think that not a lot of doctors do dorsal nerve blocks, but I would think that would be a great test for it. I heard that Hibner has done a few of these dorsal block tests, and one was a male I think, so I may get one done when I see him in November. There have not been too many cases I am aware of of not only people being diagnosed with this, but also having surgery for this to give you the best opinion and facts on this though. I am going to email Dr. Dellon to ask him some of these questions, and will let you know what he says later.

Shawn

I was also almost sure that I have dorsal nerve entrapment, having the pain in the upper part of penile shaft and around the base of penis. No urinary problems, no erection problems, no numbness, no sitting pain, only dull ache in the base of penise.
On 20th July I had an exam by Dr.Aszmann in Vienna, he was very kind and communicative, we spend more than one hour talking about my problems and examining the issue. Basically he said after the exam he can 99,9 % exclude pudendal nerve entrapment, even dorsal nerve entrapment is highly improbable (I have no sitting pain, no perieum pain, no anal pain, only pain at the base of penis). He thinks that it is related to microtrauma to penile crura ligaments or maybe some autoimmune inflammation of adjacent structures. My pain was always provoked by some mechanical irritation: sex, heavy lifting, tennis playing etc. He said that I am not a candidate for dorsal nerve decompression and my condition requires conservative treatment.
I felt some relief that I dont have neither PNE nor dorsal nerve entrapment. Whatever it is, it is easier to fight than PNE.
All the best
Matt

Far as I know Dr. Hibner is the only one doing dorsal nerve blocks. I do not know how many he has done to date but his associate Dr. Castellanos (not sure I spelled his name correctly) told me they are done ultrasound guided under anesthesia, they have gotten quite good at them and are happy with the results for diagnostic purposes. I do not know if anyone has been cured yet. I am scheduled for one with Dr. Hibner in October.

Dr Hibner recently said that [b]entrapment[/b] is often caused by some trauma, a fall,problem with surgical procedure etc and will be associated with a sharp onset of symptoms.
Nerve irritation and or intermittent compression would usually have a slower onset. Would the slower onset of symptoms be true of your situation Matt?
I hope that the conservative treatments work, let us know how you progress.

Hi, I just wanted say that since my last post, I have learned that someone can have the dorsal branch of the pudendal nerve compressed and not have erectile dysfunction or penile numbness and still have pain at any area of the penis,scrotal pain, or female genital area for women, and or pain at some other part of the perineum, but not usually any rectal problems unless you have both dorsal and another branch affected. It is possible to have both dorsal and another branch of the pudendal nerve compressed also. If you have a pain that you can duplicate any time of day by pressing on any part of your male or female genitals or a constant pain there, it is possible after you have ruled everything else out that you could have dorsal branch compression. Dr. Hollis Potter's MRI can also sometimes show scar tissue around the dorsal branch, varices, and or compresssion of this area. The only surgeon in the U.S. who does dorsal nerve decompression is Dr. Lee Dellon in Baltimore, Maryland.

Shawn

Hi guys and girls,

My scotrum pain,Penile pain and urinary burning is back with a vengeance.

Ali

I'm so sorry to hear that, Ali.

Ali,
I'm so sorry you're hurting! Do you think you're having a flare from PT or perhaps the nerve block? I certainly hope this subsides for you soon!
Hugs,
Karyn