Please help

[james023]

I am a 19 year old male and here are my symptoms.

Erectile dysfunction, no morning wood, weaker orgasms. Those were my first symptoms after injuring my penis 8 months ago. Here is where things have gotten real bad for me. 4 days ago I got this very uncomfortable sensation in my penis, felt like I had to pee but also felt a tingling sensation. It is very had to describe but if I even touch my penis it hurts or when I shower an the water hits on my penis it hurts, after I ejaculate my penis still feels sensitive. My testicles have also felt tingling and this feeling in my penis has been constant for 4 straight days. I am very concerned and can not imagine having to feel this everyday for the rest of my life. Do you think I have this condition or could it be someting else, like low testosterone? I dont have any burning sensation and the main pain is located in my penis only. I dont have a lot of money and either way I dont think doctors can help when it comes to this condition. This is really getting to me and I am trying to stay strong. Please help me guys.

[Ray P.]

Have you been to a urologist?

[Violet M]

Chances are you will not have to live with this pain the rest of your life so take hope and seek some medical help. Urologist is a good place to start to rule out anything serious. You could also ask for a referral to physical therapist who can evaluate your pelvic floor and musculskeletal system to see if there are any factors there contributing to your pain.

Violet

[james023]

I have just found I have low testosterone, which would explain most of my symptoms except this over sensitive feeling in my penis which I think is tied to nerve damage. Now heres the thing I did injure my penis a while back but since the pudendal nerve is not located there I dont think I could of damaged it right? I can sit down for hours with out the pain getting worse but the feeling is still there in my penis, it just doesnt get worse when sitting. I have found out that dht is very important for the nerves in the penis, I have low dht due to having low testosterone, could this be fixed with taking the tesoterone replacement? If it wasnt for this over sensitive pain then I wouldnt think I could have pudendal neuralgia but like I said that is the only main symptom as well as erectile dysfunction that has gotten worse since this new feeling arrived. Also when I wake up there is very little pain but after I pee the sensitive feeling becomes much stronger.

[Violet M]

One of the branches of the pudendal nerve innervates the penis (dorsal nerve of the penis). A different branch of the pudendal nerve innervates the bladder sphincter.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1502389/ (see the main points at the end of the article).

I think sitting becomes more of an issue if the main trunk of the pudendal nerve is involved but may not be as much of an issue if a more distal branch is damaged. You can see Prof Robert's description of the problem with sitting at the following link: http://www.pudendalhope.info/node/45

Often there is more than one thing that causes pudendal neuralgia. It may be a combination of factors. Good luck as you try to sort this out.

Violet

[james023]

Violet I just started to have burning when peeing and burning after pooping. I am not constipated but I am worried things are getting worse. Do you think that I will be okay and I wont devolp new symptoms like not being able to sit? I am very concerned now.

[Violet M]

I don't know James. No one can predict really. I know one person who has had mild symptoms off and on for many years and they are fine as long as they avoid activities that trigger their pain. It might not be a bad idea to be evaluated by a physical therapist trained specifically in treating pelvic floor pain. Just don't go to someone who has you do a bunch of stretching and strengthening exercises that could actually flare things up. If it flares you up or doesn't help right away then I would shy away from it.

I think it's important not to get overly anxious about it because that could just exacerbate the symptoms. Having a game plan and feeling like you have options and some control are important. If you feel like anxiety or stress trigger your symptoms, you might want to read the most recent posts by Ezer on this forum about the mindbody approach.

Violet

[james023]

Thanks violet. I have one question, I am pretty sure the reason I am experincing this is because of injury to the dorsal nerve of my penis, which would explain the sensations down there and the burning urine, but could that be causing burning in bowel movements as well? I would like to also mention before the sensations in my penis I had pain in my hip bones for months.

[Violet M]

James, often what happens with pudendal neuralgia is that you may initially have pain/symptoms in one place and over time your pelvic muscles tense up due to the pain/symptoms and you start having symptoms in other areas too. The pudendal nerve runs between the obturator internus and levator ani muscles. If you have symptoms in one branch and then if those muscles tense up, they can impinge on other branches of the nerve.

Regarding the hip pain, you may want to read the most recent posts on this forum by a former member with username Lernica. She has posted quite extensively on femoral acetabular impingements and labral tears in relationship to pudendal neuralgia.

Violet

[Redevil]

James
Your case sounds very similar to mine mate.
Don't underestimate the hip pain, it might not be on your priority list. But it might be the reason for entrapment of pudendal nerve.
See a good orthopedic doctor who specializes in lower back pain.
In my case sacroiliac joint dysfunction may have caused the sacrotuberous ligament to press against pudendal nerve.