Health Organization for Pudendal Education

Hello everybody,

I'm 38yo male with recent rectum trauma which made me Google for my symptoms...and well, path led here.
What has happened to me over week and a half ago. I ordered few packs of special condoms from local webstore for me and my wife. There was a free "gift" included, which was a prostate massager similar to this https://www.amazon.de/gp/aw/d/B000S1VMD ... ref=plSrch

Well one day I decided to give it a go. I coated the massager with water based lube and inserted it to my bottom. Insertion was totally pain free and I just laid on my bed enjoying.

Things started to go terribly wrong after 30 minutes, when I decided it's time to remove the massager from my bottom. I grabbed the small knob (left outside when inserted) and started pulling outwards steadily. It didn't move. Only tissue around my anus bulged slightly outwards while I tried to pull. I panicked and made new attempt, using more force while my rectum muscles were still tightly contracted. It was just a sheer panic reaction. Suddenly it popped out (no blood) and I was relieved. There was no pain at this point.

Few hours later, the pain in anus and around started and I was getting really scared. At break of dawn I headed to E.R. and tell doctor exactly what has happened. I also realized I should have get there earlier and not attempt to remove toy by myself.
Doctor did proctoscopy on me and said that there's just few small scratches on anal canal. No tears, bleeding or anything. Sphincter tonus was normal. He said I was good to go. I was relieved but this was premature.

9 days have now passed since my visit to E.R. and from day 2 I started to experience burning terrible pain on my rectum, perianal and scrotum area. Tip of my penis - or actually urethra - hurting like hell. There is some weird sensations on my both buttocks and feels literally like an ice cube is placed on my rectum. All these symptoms come and go through out the day. Doctor dismissed me saying that it's only prostate which has take some hit. Said I shouldn't worry. I find it hard to believe, because doctor feeled my prostate with finger and it was not painful at all.

As you may guess, I'm in total misery. I've lived past 9 days in some sort of living nightmare, being afraid what happens next. I truly believe I've acquired permanent nerve damage with this stupid act.

I've read some posts here and noticed there's many good, compassionate people here. Wish good health for everyone here!

Hello!
my advice to you - stop any sexual activity and masturbation for 2-3 weeks. It will be better not let to examine you prostate anymore (it could make symptoms worse)
Try to relax your pelvic floor muscles (make reminder on your phone for 10 minutes, and when it rings - relax your pelvic) do not try any kegel exercises!
Avoid long sitting on hard surfaces.
Avoid active exercises - running, biking, stretching.

If it will get worse - consult your doctor about MRI to exclude any tumors at this area.

Hi Morterwind!

Thank you for replying me.

After two weeks I have noticed that initial pain has been getting less, but I'm still feeling very uncomfortable from my perineum, scrotum and tip of penis. It's like I had lost some sensation. Feeling my testicles is more like shaking hand. Prolonged sitting seems to make burning and buzzing sensation on my buttocks so I'm trying to avoid it. I'm also feeling urge to urinate 10+ time a day though I'm not drinking more than I've used to. Erection seems to make my perineum hurt a bit. I've also noticed that penis+testicles are constantly feeling really cold!

I went to see urologist two days ago and he did ultrasound scan to my prostata which was clear. However, his diagnosis was chronic prostatis (surprise, surprise!). He was confident that those sensations on my buttocks can be referred pain from my prostate and prescribed me alfuzosin. I haven't started it, because I got very anxious after reading it has caused priapism to some individuals. I know it's so rare side-effect, but...I tend to be cautious with drugs I haven't used. I thought alfuzosin is effective only to help urination flow.

I've read about PN and symptoms sound too much what I'm going through right now. But I must hope for the best and not let my self to sink in the misery. This was definitely the last time sticking anything to my rear!

I saw neurologist yesterday. He did some basic sensory test for me, but they were not remarkable. I asked him if my symptoms could be caused by PN. He said it's not impossible, but unlikely because there was no visible signs of tissue damage inside rectum or perineum area. He asked if I would like to start anti-neuropathy drugs like Lyrica, but I refused for now.

Later yesterday I was sitting in a sauna on hard wooden bench maybe for 15 minutes. Made my buttocks tingle and burn. I tried parasetamol (1g) but no avail. This was followed by very unpleasant wake up. There was a electric shock like twist on my perineum. It happened couple of times during the night. Feeling quite awful at the moment. I also started taking B6,B12 supplements.

Just be careful with the vitamin B6 because it can make nerve pain worse instead of improving it.

Hi nyt,

Thank you for advice. Definitely going to stick in recommended dosage with my B supplements.

Today I started etoricoxib (Arcoxia) 120mg for pain + opaxzepam for anxiety.

I saw my PCP today regarding burning sensations which traversing around my rectum and buttocks.

Told her I'm worrying I have caused strech-type damage to my pudendal nerve while I pulled prostate massager out two weeks ago. She said I should not be worried and told me about normal medical procedure where patient's tight scpinchter muscle is made wider using "extension" tool which diameters many times wider than my prostate massager (size of index finger). And patients are not getting nerve damage from that procedure. I wish she is right.

She also prescribed me syringes containing 2% lidocaine for use topically on my buttocks.

Hopefully she is right. But in my experience PCP gynecologist pain docs have no idea about this issue.

There are so many options you can try for pain relief and healing. One option is to see a physiotherapist who treats chronic pelvic pain to find out if there are any stretching exercises or massages you can do to relieve the tension in your pelvic muscles.

You can try invasive things like pudendal nerve blocks and neuromodulation, or you can make some lifestyle changes and avoid anything that aggravates the nerves and wait for them to heal.

You can go the route of using pain relief medications. Some of the urinary symptoms might be relieved by a tricyclic antidepressant such as amitriptyline or a combination of cymbalta and lyrica. I wasn't able to tolerate the tricyclic antidepressants due to thyroid issues but I found lexapro to be helpful in relieving the frequent urge to pee.

If you injured your nerves then the goal would be to do what you can to promote healing. I am a fan of water therapy, especially alternating heat/cold therapy for pain relief and healing. I think science backs me up on this. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4049052/
It's natural, it hardly costs anything, it's soothing, and since you are improving your circulation to the area you are promoting healing. I did alternating hot/cold sitz baths several times a day after my PNE surgery and I really think it helped in the healing process. I described what I did in the following post: http://www.pudendalhope.info/forum/view ... =25&t=5267
Another type of water therapy is in a warm therapy pool where you start out with just relaxing in the water and slowly work up to some water exercises.

Or you can try a combination of things which is what I did -- some of the invasive stuff and some of the natural remedies.

If you suspect you have pudendal neuralgia you might want to visit one of the pudendal neuralgia physicians listed on our website and get their opinion. It's really a matter of what you feel comfortable trying and whether you want to go the conservative route or try aggressive treatments which sometimes end up making you worse.

Violet

Hello,

Thank you Violet for information.

Some update...

Unfortunately I've not improved a bit during past weeks. Since my previous post I've done lumbar spine MRI, bladder and prostate sonogram all came back clean. No residual urine after voiding. However, on my urologist appointment week ago my prostate was extremely painful during examination. He said my symptoms correlate with chronic prostatis, but was baffled with why symptoms developed after using prostate massager. I asked him about possibility of damaging PN, he didn't deny it but think it's very unlikely.

I've been on pregabaline (Lyrica) over a week and it makes me feel like drunk and nauseus. I'm going to drop out of it soon because of these side-effects.

Worst symptoms are 24/7 burning pain in anus and top of my buttocks.