Health Organization for Pudendal Education

Can anyone recommend something for penis and maybe rectom, testicular pain.

Has anyone ever had any resolution from this symptom, by botox, operation, nerve block, amitriptyline. Could you please tell me?

Could you also comment on how the treatment if any effects erections?

Thanks in advance

healin

It really depends where it is located. I read some papers saying that base of the penis pain can be from an inguinal hernia. Tip of the penis pain can come from bacterial prostatitis (in this case, antibiotics are required). Also the side of the penis is innervated by the dorsal nerve. So far dorsal nerve decompression surgery has not been conclusive.
Men with penile pain seem to be responding okay to Tramadol (as reported on several male pelvic pain sites but certainly not validated by any rigorous study). Alpha blockers do help some people diagnosed with prostate conditions. You should talk to a urologist about it.

You are not alone. I have horrible pain in my rectum, scrotum, not so much in the penis itself. More just discomfort. But pain in that area. I have spasms and severe pain in my rectum, crawling feelings in my scrotum and rectum, and a very heavy feeling in general behind my rectum. sitting is almost impossible for more than a few min. I am 44. During bad flare ups which last hours. Much worse at night, I get unbearable sharp pains in my rectum. I now wear only loose fitting jogging pants. I can no longer get an erection, it suddenly just happens but i cant really feel anything and it doesn't last . It happens without warning lie its a spasm.

Even boxers hurt to wear. Nothing has helped me yet. I am new to this so I am still working on finding something that works for me. Let me now if you find anything. I also have peripheral neuropathy in my feet from scar tissue in my spine from an old spinal surgery. After living for years with chronic pain in my spine and legs. I suddenly had horrible sharp pain, burning and numbness in my feet, mostly on the pads . More so on my right foot. shortly after this new diagnosis of peripheral neuropathy I tried Lyrica with no success but an old medicine Amitriptyline was able to settle down my flare ups of peripheral Neuropathy. However, it was then that these new Pudendal N pains started. They spread and got worse. I have to say its one of the worst pains I have had to deal with. If one thing is not hurting something else will. Further tests on my spine shows allot of damage, arthritis etc.

I am at a loss as treatment. I am allergic to steroids. My next step is to get a nerve bloc without steroids to see try and pinpoint that it is my Pudendal nerves. Its hard to talk about this stuff to family and friends. But I simply don't care anymore to be embarrassed. I want relief. I found many doctors have no idea what this is. I had to educate my own doctor. Many people end up going from doc to doc getting no where. My neurologist was better but tells me there is no cure or treatment. I refuse to believe that. I have had doctors tell me this before. It simply means it is out of their realm of expertise. Its wrong of docs to dash peoples hope. sorry to babble on. This is my first post. Mostly I just wanted you to know you are not alone.

Cheers

Welcome andgladyou know you are not alone. Have you tried seeing a PN aware PT from the list off the homepage? They may beable to help with some of your pain, pelvic floor muscle spasms and other rectal pain may be tight muscle or ligament. Also they may know a local doctor who has a clue about PN who could try some more meds with you. Sorry you have had such a rough time and we have little awareness of this condition beyond those of us with it! As my one doctor says this sucks. I am with you on this being worse than my 20+ years of chronic foot pain but together I have issues sitting walking and standing but am still doing better now post PNE surgery. Hope we can guide you to less pain. Check out the FAQs off the homepage for steps to get a diagnosis and things you can do for lifestyle changes (do not do anything that hurts, minimize sitting, etc.). I am on amitriptylene for the chronic foot pain which actually stopped the shooting nerve pain but I was not able to tolerate a higher dose for the PN so I am taking gabapentin/neurontin as well for that. I am hoping now that I am post surgery someday I can stop(gradually wean off) the neurontin. You are right this is clearly outside most doctors realms althhough it really hits many areas. Some day I hope word gets around and we get a PNE pudendalogist specialty, so those coming after us have it easier and all those areas it crosses get enough knowledge to know this exists and where to send people besides nowhere. Gotta dream! Take Care
Janet

Payitforward, I was just wondering what level your previous spine procedure was at. The pudendal typically comes off of S2,3,4 so if you have problems with the sacral nerve roots in those areas it can cause pudendal neuralgia. Hopefully you have access to having a really good 3T MRI of the lumbo-sacral and pelvic areas. Good luck with your nerve blocks.

Violet

Have you tried a ganglion impar block?

I agree that either ganglion impair or hypogastric plexus block might be a solution for you both.
These blocks are aimed to tame visceral pain transmitted sympathetically and are often used when it is not clear whether pudendal or other nerves are involved.
I had superior hypogastric block in March, and it delivered 5-6 rather comfortable weeks, I felt the difference.
Regarding Tramadol, it helps with penile pain, but for me it has unpleasant side effects of insomnia, so I am always choosing whether I will be in pain, or tired like dog netx day...
But trying to limit intake of TRamadol to 4-5 pills monthly...
Overall, after quite good 3-4 months, till NOvember, I am struggling again. Having physiotherapy with internal trigger points release, to no avail, maybe even slight worsening.
This cold weather is killing me. Another reason of worsening is maybe the fact, that I stopped Amytriptilin as well as Neurontin and Alphablockers. ONly some enzymatic pills, low dose Baclofen and PT.
Suffering quite heavily. But still alive.

Sorry you are having a rough time, Flyer. Are you going to try to tough it out and see if PT works? That sounds difficult.

Violet

Violet after latest PT session I had very good 2 weeks, with significant decline of pain, I was functioning quite normal, 2 times sitting in restaurant for 3-4 hours with no problems. Now I am struggling again.
I have next PT session on Saturday, we will see how to proceed. But the fact that I had those 2 fabulous weeks is a good sign.

Have you tried an antispasmodic such as Detrol LA.

I had a diagnosis from Hollis Potter as being entrapped Dorsal nerve to my penis by pelvic varices.

Unable to come up with treatment satisfactory to me.

However, I had read that tip of penis pain could be caused by bladder contractions.

I had problems with dizziness with Detrol so I switched to Oxybutynin-XL 10 MG twice daily.

I had tried Vesicare also, too constipating.

On Oxybutynin-XL, extremely less pain - especially tip penis.

Rick