Health Organization for Pudendal Education

Hi Ali,
I'm so very happy to hear your urinary issues are better! It must seem strange (and exciting) to be able to pee normally again! Are your stitches dissolvable, or do you have to have them removed? Are you experiencing any numbness in the perineal area?
Warmest regards,
Karyn

Hello Ali,
I am happy you have improvement this early - that sounds promising. Did I understand you correctly that Dr A. decompresses the perienal and dorsal nerve? What is the extent of what he can decompress...ie does it pick up along the 3 branches at points where TG surgury ends?
Best on your recovery,
RR

Hello RJR,
What are the three branches? dorsal, perineal, and what else?

Hi RJR,
The two branches i.e dorsal and perinial nerves branch out of the Alcock's Canal.He did decompress the dorsal nerve around the region of the Pubic symphysis where it usually gets entrapped.The perenial nerve is much smaller than the dorsal nerve and usually goes to our testicles.

The third branch which is the rectal banch is mostly in the Alcock's Canal but 10% of the time it branches off before it enters the Alcock's Canal.The rectal branch is usually addressed by all PNE surgeons,but the inferior rectal branch isn't.

Dr. Aszmann does decompress the dorsal and perinial nerve but not the rectal branch,because he doesn't do the traditional TIR or TG approach.

To answer your question correctly,please refer to the following text.

The pudendal nerve arises from the sacral
plexus. Subsequently, it passes around the ischial
spine and reenters the pelvic cavity through the
lesser sciatic foramen. It then courses under the
levator ani muscle on top of the obturator internus
muscle. Along its course in the ischiorectal fossa,
the nerve gives off small inferior rectal branches
and one or two perineal branches. It then pierces
the superior urogenital fascia to penetrate the urogenital
diaphragm (Fig. 1). Up to that point, the
nerve was protected by the bones of the pelvis;
however, it then enters the dorsum of the penis in
a distinct canal built by the bone of the pubic symphysis
dorsocranially (Fig. 2). The lateral border is
defined by the inferior pubic ramus and a strong
ligamentous portion of the suspensory ligament.
Inferomedially, the canal is formed by the ischiocavernous
body and the tunica albuginea (Figs. 3
and 4). This osteofibrous canal is about 3 cm long
and was found in 100% of our specimens. It begins
right where the dorsal nerve of the penis, having
pierced the inferior urogenital fascia, approaches
the pubic symphysis and ends where the pars fixa
extends into the pars pendula of the penis. In two
specimens, pseudoneuromas were found

Take care,
Ali

Hi Karyn,
The stiches are dissolvable.There is no numbness at all in the perinium area,but just tightness because of the stiches and today I experienced a few mild zaps for a a minute or two.It is great to urinate normally once again.it's a great feeling.I was so embrassed before because my 70 year old dad had a much stronger Urinary stream than me.

However,the burning penile pain and Urinary burning is still there which is making me anxious because tha was the primary reason for thi surgery.
Warmest of Regards,
Ali

Hi Mulan,
Te third branch is the rectal branch.

Kind Regards,
Ali

This drawing from Dr.Antolak shows well the 3 branches of the pudendal nerve:

Dear Ali Pasha,

This is so wonderful that you have proof now that Dr. Potter's MRI was correct, and that Dr. Aszmann could decompress your dorsal nerve. This is a great breakthrough for all PN sufferers. I can only congratulate you and hope that Dr. Hibner will start the dorsal and perineal nerve decompression also, that those of us who cannot afford Dr. Dellon have a chance to get relief.

I am looking forward to your continued progress and report about it. May your recovery be speedy and full!

spirit42

Hey Ali, you don't waste any time do you. Wishing you the best with your recovery and thanks for reporting back.

Violet

Dear Violet,
I need to get well and help other patients out for the sake of humanity.This is a war that we cannot loose and we won't loose.Unfortunately, I have lost my career, money,precious time and the prime of my life fighting this condition.

On another note,I wanted to share with the forum,that my Penile Suspensory ligament was also repaired and tightened.It was incredibly loose and Dr. Aszmaan was quite surprised to see it in uch poor faashion.

But I am quite pleased and hopeful with the results so far from Dr. Oskar Aszmaan.He is quite a jovial,full of humor and humane doctor.

Kind Regards,
Ali