Health Organization for Pudendal Education

I just received my MRN from Dr. Potter. It came back as having asymmetric thickening of the left sanctimonious and proximal left sacrotuberous ligament adjacent to the pudendal nerve, potentially to be implicated in pudendal nerve irritation, with additional asymmetric scarring of the anterolateral left aspect of the levator anti muscle, abutting inferior perineal branches of the lower rectal and anal distribution. There are varices coursing the dorsal nerve to the penis, more prominent on the left then the right. No scar entrapment of the pudendal nerve is seen in the posterior midportion of alcocks canal.


I have posted my story under, Can piriformis syndrom cause pudendal pain.

That's really interesting Redz. Do you have any information as to the course of treatment? From what I can "gather" from research on this site and beyond, neural abutting tends to be easier to treat than neural entrapment?

I myself haven't had an MRN (or even an MRI) but I wonder if my situation is also due to ligament thickening and neural abutting, rather than full on entrapment; mainly because I seem to have good phases and bad phases.

Thank you so much sky blue for responding.
I would agree with you about neural abutting.
I'm not sure what to do .My Dr want to do a series of ganglion impar nervre blocks. Which everything I read is on track with may pain. I have moderate bladder pain,Level 1, 3 on bad days. I can sit in a car with minimal pain. I cannot how ever sit for any length of time on a kitchen chair or a strait back chair. I sat for hours with not even a twinge of pain at a party in a cloth beach chair. I do have bad urethra pain, and I'm lost in what to do. I have been out of work for 3 months and money is starting to get tight. I thought that more people would respond with something that they have had done in a similar diagnosis. I my be thinking of having my ligament released.
Thank you
Redz

If you haven't seen someone who specializes in PN that should be your next step and maybe talk to a PT who specializes in PN. I found interesting the scarring of the levator ani muscle on the left side. Do you have any rectal symptoms because you didn't mention any. It seems to me if the scarring of the levator ani muscle is abutting the perineal rectal and anal pudendal branches that you would have rectal pain. However, maybe it is really impinging on the perineal urethral branch thus causing all the urethra pain. I'm wondering if manual PT could help break up some of the scar tissue in the levator ani muscle or EWST. Are your symptoms one sideded since it seems that what was seen was mostly one sided? The varices she sees of the dorsal vein might be something she sees quite often as several individuals have mentioned this on the forum. Do you have any ED problems that would suggest you might need to have the dorsal vein investigated? I know for myself she saw enlarged dorsal vein but when Dr. Hibner did the ultrasound they were perfectly normal.

I don't want you to take this the wrong way but I do want to correct two things and this is only meant so you don't mispeak to a dr. and for your own understanding. Dr. Potter does MRI not MRN and it is sacrospinous ligament not sanctimonious.

Good luck with your next step and prayers are sent your way for pain free days.

Hello NYT.
Thank you for responding. I do not have rectal pain but maybe ounce a month I will have a muscle spasm in my pelvic floor. All my pain is in my urethra and that is brought on by sitting. My bladder seems to tighten causing pain but is not brought on by any specific event other then lifting. This may sound wierd but since this has started it seems my erections are longer. I also wake up with erections that last along time. I get numbness in my genital area at times. I do have more pain in my left side but I have been getting piriformis injections and that seems to help with pain in my left butt cheeks. I have not received an injection on my rightside and that has a sensation of sitting on blisters or my skin is like sand paper.

I look forward for any more info you may have.
Thank you
Redz
P.S, No offense taken on the correction. My iPad likes to guess what I'm trying to say and auto corrects without me noticing.

Hi Red,

This may sound like an oversimplification, but if your ligaments are thickened and potentially impinging on or irritating the pudendal nerve as the MRI states, the only way I know of to stop the irritation is to get the ligaments out of the way -- otherwise they will continue to irritate the nerve. I think it always makes sense to try conservative therapies first but I'm not sure they will help if in fact your pudendal nerve is constantly being irritated by enlarged ligaments. If your pain is low and it's something you can live with it might not be worth it to try invasive therapies but since you are unable to work it sounds like your pain may be somewhat intense at times.

Violet