PN from rectal exam?

[Lostintorture]

So 2 weeks ago I went to my doctor for DRE because I was having prostatitis symptoms. For some reason pushed way too hard causing immense pain. Since that visit my situation has gotten worse, erections are down, penis feels numb pain and itchiness in the anus feeling constipated, cant have a bowl movement and if I do it just oozes out. Asked the doctor about it and he insisted that no damage was done from what he did but im sure it was the cause as the change was immediate. Ive had prostate exams before and they never felt like that. Now my question is this PN? If so is this permanent? Will it heal completely at least improve over time? With all the straining over the last couple weeks now I've gotten hemmoroids. Do I need to go to see a neurologist. I have booked an appointment with a PT who specializes in pelvic floor dysfunction hope she's able to help. Is there anything I could do at home? Your advice would be really help.

Thanks

[Violet M]

Hi Lost,

Symptoms of prostatitis and PN can be similar so it's possible you already had PN before your visit and the exam just aggravated it. If it is PN, there is a chance it will heal since it's a peripheral nerve and and it's only been 2 weeks since the incident. I think it's good that you are taking a proactive approach and seeing a PT. Just be careful to avoid things that aggravate your pain further -- for instance stretching or exercises that cause irritation. It's important to avoid straining with BM's so maybe you can take something like miralax or magnesium citrate to keep stools soft -- ideally like the consistency of applesauce.

Violet

[Lostintorture]

Hi Lost,

Symptoms of prostatitis and PN can be similar so it's possible you already had PN before your visit and the exam just aggravated it. If it is PN, there is a chance it will heal since it's a peripheral nerve and and it's only been 2 weeks since the incident. I think it's good that you are taking a proactive approach and seeing a PT. Just be careful to avoid things that aggravate your pain further -- for instance stretching or exercises that cause irritation. It's important to avoid straining with BM's so maybe you can take something like miralax or magnesium citrate to keep stools soft -- ideally like the consistency of applesauce.

Violet

Thanks for the reply. So how would I know for sure its PN? Do I need to book an appointment with a neroulogyst? Would they be able to tell through a MRI? Or an EMG?

[Violet M]

Diagnosis of pudendal neuralgia is discussed at the following link:
http://www.pudendalhope.info/node/69
Keep in mind PN is not the same as PNE. You can have an irritated pudendal nerve without having an entrapment. The trick is to figure out what is irritating the nerve. If you are having symptoms in the area innervated by the pudendal nerve then there is a good chance that your pudendal nerve is irritated. I was initially diagnosed by a PT who specialized in the pelvic floor and was knowledgeable about pudendal neuralgia. The doctors I had seen, including a neurologist, did not have a clue. Sometimes it's just a matter of finding a doctor or PT who is knowledgeable about this disease. Some doctors base the diagnosis primarily on your history, clinical exam, and symptoms.

There aren't any tests that are 100% accurate in diagnosing pudendal neuralgia or pudendal nerve entrapment but there are tests that can point toward a likelihood of having PN There are things that may or may not show up on an MRI that can point toward PNE, especially if the MRI has special software settings that enhance the nerves such as the MRI done by Dr. Hollis Potter. An EMG of the pelvic floor muscles can show if there are motor conduction problems in the branches of the pudendal nerve that innervate the pelvic floor. There aren't many doctors who perform this test though.

Violet

[Lostintorture]

Thanks for the reply again. My condition has gotten worse. Still have constipation. Stools are very narrow. When I take stool softer, stool just oozes out followed by pain in my rectal area. It's also been hard getting erections and maintaining them. Since yesterday I've also experiencing pain in my left lower back which shoots down the leg toes feel numb. Talked to my family about possibly having PN but they don't believe me saying it's just in my head. I have already been to ER and they still wouldn't do a MRI. I'm totally lost and I just want my normal life back.

[Violet M]

Can you go to your GP and see if they will order an MRI for you? If you are having more widespread symptoms it seems like they should at least rule out cauda equina or a sacral nerve root impingement. My physician wanted me to have an MRI of the lumbosacral area and the lumbosacral plexus. Some doctors also recommend an MRI of the pelvis. Unfortunately, the ER visits I've heard of from PN patients have not been very productive. I think you are going to be better off if you can go to your regular doctor and get a referral to a specialist, or just go straight to a specialist if your insurance doesn't require a referral. You want to choose a specialist who knows how to diagnose pudendal neuralgia. For me, that was a physical therapist who had training in treating PN. It sounds like you have appointment with a PT already. When will you be seeing them?

I'm sorry your family is not supportive. Sometimes family members aren't able to cope with having someone sick in the family, especially since they have never experienced what you are going through so they can't relate. I am quite certain that what you are experiencing is not just all in your head. Many of us on this forum have been told the same thing, only to find out that we really did have a medical condition but the doctors were just uninformed. So don't let anyone talk you into thinking it's all in your head because it's highly unlikely that it is.

Stool softeners are quite ineffective for constipation, in my experience. It's not unusual to have changes in your stools with PN. You can go to the following link for a list of suggestions from people who have experienced problems with constipation. http://www.pudendalhope.info/node/32

Violet