Extreme Penile Pain & Burning - Need help and guidance

[david1992]

Hello all,

Six months ago, I began feeling a pinch at the tip of my penis. It was slight, but bothered me enough to have a full panel STD and urniary analysis done. Everything came back normal, but the feeling persisted.

Before this started, I suffered from psychosis (manic episode) that lasted for a couple months and totally changed my life. I had a bad reaction to Lexapro, an anti-depressant, as previously I only had issues with depression:

When I was manic, my body was under immense stress. As I came down, I had awful panic attaxks and anxiety. I was also in a car accident during this time that I seemingly came out of ok, but there was a big whiplash.

I was put on a lot of medication when I was manic that made things worse and I suffered from intense tremors for a few months.

Meanwhile, the pinching in my penis began to feel more painful and it was accompanied with burning and a sensation like something was stuck inside there. I was given plenty antibiotics to treat a pitentional infection, but nothing has taken the pain away since it's started- it's only gotten worse.

I eventually found the right medication that stabilized me mentally and I've been doing really well on that front, but now my penis pain is extremely bad (9 out of 10 and constant).

So far I've been taking amitriptyline 50mg and Lyrica 375mg and doing pelvic PT twice a week. I had a guided pudendal and sympathetic nerve block that slightly numbed me for a bit, but the pain came roaring back after a few hours and has left me with some sitting pain. I'm also taking opioids for pain but they barely do anything.

I'm not sure what do next. Do I have just PN or PNE? Is this ever going to go away or heal by itself?

I am looking into shockwave therapy in Canada and I am starting TMS treatment in LA in the following weeks.

To add, I also have kyphosis and slight scoliosis which makes my pelvis unaligned. I'm not sure if this set me up for this or not.

What can I do to make this pain more manageable? Should I start looking into surgery? Is it possible to heal from this without surgery? Any more ideas or recommendations for me?

Thank you for reading. I may have missed some details, but I guess I'll start with this.

-David

[david1992]

Excuse all the spelling mistakes. To add, I've had a few infections in the past. Could it be that the infections led to scar tissue formation that is now entrapping the nerve?

[Violet M]

Hello David,

Often with pudendal neuralgia there is more than one thing going on that can trigger the symptoms and you may need to pursue several different therapies in order to achieve pain relief. Have you had an MRI to rule out any sacral nerve root impingements? I don't know if your scoliosis is playing into this or not, and if it is, whether it is something that can be corrected non-surgically. There can be impingements at the nerve roots or there an be an impingement farther down at the peripheral nerve level along the course of the pudendal nerve. Personally, I had a pelvic misalignment that caused ligament impingement of the pudendal nerve at the level of the ischial spine deep in the pelvis. This type of impingement or nerve entrapment would typically cause pain mostly on one side.

Given your history of car accident and musculoskeletal anomalies, I think you are smart to pursue PT, but if all you are getting is pelvic floor PT and no manual therapy to help correct the misalignments it may not be enough to relieve the pressure on any nerves that might have impingements. You might consider contacting Jerry Hesch to find out if there are any manual therapists in your area who are trained in the Hesch method of manual therapy.
Jerry Hesch, MHS, PT
Hesch Institute
1609 Silver Slipper Ave
Henderson, NV 89002
Tel: 702-558-6011
E-mail: heschinstitute@yahoo.com
Website: www.heschinstitute.com
Website: www.3Dpaindrawing.com

If you think anxiety could be contributing to your pain or pelvic tension, you could consider trying the mindbody approach as described by Ezer on this forum. You can do a search on his posts.

It sounds like you have already read about Dr. Kirk Andrew in Canada -- maybe you read Konedog4's posts. In answer to your question as to whether you can heal without surgery the answer is sometimes yes and sometimes no. You do still have some options you can try before trying surgery and as you probably know from reading this forum, surgery isn't always a guarantee. I see surgery as a last resort when conservative therapies have failed and something you should not consider unless your quality of life is so bad that you are willing to risk getting worse. That being said, it would not hurt to get an appointment lined up with a PNE surgeon in the future in case there is a long waiting period to get in. In the meantime, you can continue to pursue some conservative therapies in hopes that they will work.

All the best,

Violet