UPDATE -Introduction - Penile Pain, Dr Gajraj...Hip labrum

[wendy7]

Hi Sabot,

I am glad to hear that you finally received an anwser about what is going on with your chronic pain. What would you be doing to address the hip issues? I think it's wonderful that you have a solid plan however, to help with your current pain.

Take care,
Wendy

[RJC]

Sabot,

You have an important PM.

[sabot]

I've now seen Dr Potter, Dr C in Phoenix, a local Ortho, and Dr Meyers in Philly, and all agree that I have FAI in my left hip and a labral tear. That consensus combined with the relief that I got from the steroid injection in my hip has me leaning toward getting hip surgery next month. While it is not clear whether the dorsal nerve pain is referred or a seperate issue, it seems clear to all that fixing the hip makes sense before considering any attention to the dorsal nerve issue.

What i can say for sure is that my penile pain is ALWAYS present in conjunction with the hip/groin pain, and there are times when they "twinge" at EXACTLY the same moment based on an angle of movement of my pelvis. I am extremely hopeful that correcting my hip issues will bring my entire pelvic area back into proper alignment. Since the dorsal pain begain at the exact, acute moment of the injury to my hip/groin, it makes sense that fixing that area can't hurt!

i see my ortho on the 31st.

[Lernica]

Good luck, Sabot, and please keep us posted! I'm following this thread with great interest.

[sabot]

Well, I had the hip labrum surgery one month ago. Like all of you, I continue to ride the roller coaster.

The good news: In the days following surgery, I presented with classic symptoms of chronic, non-bacterial prostatitis. As I correlated those symptoms to other "flares" I've had, it became clear that my burning and aching had more to do with an irritated prostate than a pudendal nerve. The symptoms resolved at about week 2, and have not returned. It seems reasonable that the pelvic floor muscles were in spasm from the surgery, and have now relaxed. I have little to no more nerve pain in my penis since the hip FAI surgery.

The bad news: I have been doing standard PT for the hip, and in the past week, the sore feeling in my groin crease has returned. I don't really know how to describe it, but if i am standing holding on to the kitchen counter and slowly move my left leg out to 45 degrees, there is point in that range of motion that there is a aching pain in my groin that seems to be a muscle spasm. That muscle spasm twinges my dorsal nerve as well. I have no idea which muscle or group of them is causing a clenching in the adductor region that chain reacts over to my dorsal nerve. The pain is tolerable, but consistent every time my leg passes through that specific point in range of motion.

I do not have any more classic PN burning pain, but i still have a nagging, mechanical, muscularly triggered groin pain that activates my dorsal nerve. I'm still only a month post op, and the Orhto said full recovery is 4 months, so maybe it will get better as I press on. The pain is bearable, not constant, and often not even noticeable. It seems to get better with stretching.

[helenlegs 11]

Such good news about the burning nerve pain, hope it's gone for good, certainly sounds extremely positive.
I have no experience of the type of op you have had but hopefully your physio will be able to give you an explanation of which muscles may be responsible (guessing at piriformis and/or obturator 's)
Good luck with your recovery
Take care

[Question]

Hi Sabot - just wondering whether adressing the labral tears changed your penile symptons etc. Dr Potter also saw I had major Labral tears but not much else apart from from large veins in the Alcock's canal/near Dorsal nerve, so wondering whether my symptons are actually being created by my hips.

[nyt]

Sabot, this is great news. Keep us posted on this recovery. This is a very important issue for all us. I know many of us Dr. Potter has seen labral tears on the MRI so now it is figuring out how this contributes to the PN pain and the order of things if one needs surgery should be done first. I am just so happy for you though!

[sabot]

All,

I have been slow to update, because of the up and down nature of post-surgical life. Here is what I have been able to figure out:

Labral tear surgery was a success. Much improved groin pain.
Stabbing sensations in my penis are 90% better. I get an occasional dull twinge, but totally managable.

NEW PROBLEM

Last summer, I had the sports hernia/pelvic floor surgery from Dr Meyers. In the months following, I began to get a burning pain in my penis tip after exercise. I tried Lyrica for a while and then went off due to side effects. After about 6 months, the burning episodes were pretty much gone. The best guess is that the surgery cause some pelvic floor dysfunction that led to a form of prostatitis?

This year, I was 6 weeks post hip labral tear and doing great. Exactly one week ago, I had a sudden onset of the same type of burning sensation in my penis but this time it also has a serious burning pain in my rectum! What the heck? I've never really had any rectal symptoms before and now the rectal burning is worse than the genital burning and is flared by sitting and worse at night (it started during a long poker game on a hard chair).

I've read all of the prostatitis stuff and I have little doubt that my pelvic floor is in some type of spasm, but I'm kind of lost on what to do next...i really thought i was close to being out of the woods and i am grateful that my penis doesn't hurt much anymore, but this rectal pain is troubling. I don't think it is bacterial because I don't really have the urinary symptoms or any fever.

Help!

My CONCLUSION - post my original groin injury I have developed some form of chronic pelvic floor tightness which i mistook for pudendal nerve pain because of the penile component. Looking back at my symptoms over the past 4 years, it's obvious to me that when my pelvic floor is in spam, i get these pains and when things are relaxed I'm fine. The rectal pain is pretty intense, new and I can't trace the origin, so I'm lost there. It has been nearly constant for a week. Finally, the FAI, hip labral tear was worth having, but may have exacerbated the pelvic floor due to crutches, limping, etc.

[helenlegs 11]

You do seem to be prone to muscle spasms, as possibly we all are due to the nature of our pelvic problems. It's a question of trying to break the cycle.
If you know that something brings the pain on try not to do it too much (like sitting) and 'pace' activity, which is far easier said than done, but if you made a concerted effort for say a couple of weeks, just to evaluate if it has any effect.
Then of course there's physio, dry needling, and/or acupuncture which works for some. I heard that Dr Hibner advises ketamine infusions post pelvic surgery to try and break any post surgery cyclic muscle spasm. Valium is a muscle re-laxer too and a few have posted it's positive effects (never tried it personally)
Water walking is a good form of exercise to try too.
There is the risk of post surgical scar tissue which water walking and physio help combat. Hope something works for you when you have had so much done to help your situation.