Health Organization for Pudendal Education

Hello all,

I was recently told by my Neurologist that I had potential PNE. I had an MRI done with a 3T machine and the results stated: "mild hyperintense signal in the LEFT pudendal nerve" and " a partially sacralized left L5 vertebral body". He has referred me to a neurosurgeon but did not give me any info on treatment options or what to do/what not to do.
I have aching and soreness in my lower back right above my tailbone, penile numbness (zero sensation), and occasional mild burning when I urinate. My doctor prescribed Meloxicam for inflammation. The medicine helps a little but not much. Does this sound familiar to anyone else's symptoms that have been diagnosed with PNE?

Thanks,

JT

I strongly believe (through research and talking to many experts) that pudendal issues cannot accurately be diagnosed through any type of imaging or MRI. I don't know about back pain, however. Did your doctor suggest you consult a neurosurgeon for PN issues or back issues? If your doctor provided such little information and direction, perhaps you need a new doctor. Maybe a urologist can help you find conservative treatment to help with your potential pudendal issues. There are many posts on this site about physical therapy, mind-body approach, lifestyle modifications, etc. that may help you.

Stephanies

Thanks, I will look at more posts to see what I can learn. My doctor is sending me for the PN issues. The back & PN issues both seem to be related to one another because they both tend to flare up at the same time. My entire saddle region stays sore (lower back/hips & genitals). Hopefully I will learn more about my specific symptoms from the neurosurgeon.

JT

Welcome JT,
I agree with Stephanies there is no positve test for PNE except when they go in for the surgery! However in addition to surfiing around the forum the FAQs off the homepage has guidance on tests to rule out other possible causes of the symptoms, medications, etc.
Janet

JT, some of the PN docs don't put much stock in MRI's for diagnosing PNE. A neurosurgeon is trained to do surgery and that's typically going to be their recommended method of treatment because that's what they are trained to do. Personally I see surgery as a last resort if nothing else has worked because it can present it's own set of new problems, etc.

Keep in mind that PN and PNE are two different things. PNE specifically means a nerve entrapment and it's difficult to accurately diagnose. If you are having lower back pain I think it would be unlikely to be coming from the pudendal nerve. I had some low back pain as well as the typical PN pain but the low back pain was due to sacroiliac joint dysfunction due to chronically strained ligaments.

Have you had an evaluation by a pelvic PT to determine if you have any musculoskeletal issues such as sacroiliac joint dysfunction or pelvic misalignment contributing to your problems? I suppose the L5 vetebra could be impinging on the nerve root that feeds into the pudendal nerve although typically the PN comes off of S2,3, and 4.

Good luck sorting this out. The pelvis is a complicated area.

Violet

Violet is right that lower back pain is rarely attributed to PNE. It is either more a muscular condition or dysfunction of other nerves, not pudendal.
On the other had, numbness of penis is a hallmark of pudendal neuropathy. In most cases, the numbness indicates more sever entrapment than pure pain without sensitivity distortions.