Health Organization for Pudendal Education

Today I noticed more pain in the bulbocavernosus area. I'm scared to get aroused. Has anyone else had pain in this area? Also there was more burning in both of my inner thighs.

I think the muscle has been affected over time maybe even before the injury. When I have sex or masturbate, I used to edge a lot. It tenses up the BC muscle. I think my injury may be related to the overuse of this muscle.

It's been three months and there's barely been any forward progress, if any. Sometimes I just get really down about things and freak out.

It's really hard not to get aroused at some times as well. Would having an erection hurt this area? Am I doing damage by even getting a tiny bit aroused? I'm really confused and could use some advice. I'm still youngish and have a really active sex drive. I'm scared that things won't get any better andI won't be able to have sex or masturbate again without damaging myself. I'm in a weird place.

Lostinaz, I feel empathy for you, my problems started also as the post-ejaculatory pain, both from sex or masturbation. I also remember there was a lot of tensing and clenching the pelvic muscles...I think that most probable reason behind are trigger points in your thrashed and knotted pelvis muscles, but not only those superficial (bulbocavernosus, ischiocavernosus) but maybe the main culprit is pubococcygeus muscle. Trigger points there are very painful and stubbor and according Wise/anderson more than 90% of their patient do have puboccocygeus trigger point radiating to the base of penis. PT is essential and might help you in great scale. Another your enemy is anxiety, which is highlighting your pain and tensing.

A tight obturator internus can cause inner thigh pain. Hopefully PT will help you get these muscles relaxed. I found a TENS unit helpful in getting the OI muscle to relax. Also alternating hot/cold sitz baths might help get the muscles to relax.

Violet

This week, I was doing some relaxation exercises when I noticed a pain in the area directly behind my testicles. It was a spot right behind where I remember applying pressure during orgasm before I felt my first instance of PN.

The exercise involves me laying on my back in front of the couch with my legs up on the seat. I will spread my legs farther in timed intervals while i do yoga breathing, which should relax my pelvic muscles.

Anyway, I felt the pain in the wall right behind my testicles and applied a tiny bit of pressure with one finger, attempting to massage it. The pain was so bad I almost passed out. I think that's the BC muscle?

Since then, I've flared up twice for different reasons. I'm feeling pain or sensations in my lower body every minute of every day. Is this normal for PN? The pain in the noted area isnt there all the time but when it is, it's noticeable.

I had an pelvic MRI with no contrast and it showed nothing weird. I'm already in PT which makes me flare the same day but provides relief the day after.

What do I do next? I don't want this to last forever. I'm just kind of lost at this point. I'm so mentally fatigued.

You haven't been doing PT very long -- so one option would be to continue with it and wait a little longer to see if you improve. In the meantime, if you aren't sleeping well at night due to pain you might want to consider trying an opioid in the evening, while you are going through treatment. I don't see opioids as a permanent solution but they can help you get through the treatment period until you find the right treatment that works for you.

There are so many treatment options it's hard to say what is the right one for you to pursue next. (many of the options are listed on the Pudendalhope website http://www.pudendalhope.info/node/11 and the flyer on the homepage at pudendalhope.org) Some of the ones not listed there are the mindbody approach as described by Ezer on this forum, electroshock wave therapy ESWT as described by konedog4, restorative exercise, and cryoablation . It kind of depends on your history and whether you think your symptoms are activity related or more stress/anxiety related. A typical approach is to start out with least invasive treatments first.

I remember how difficult it was deciding what treatments to try and which providers to see. What do your doctors recommend as far as treatment?

Violet

Violet where did you put the tens unit to help your OI muscles?

I described the TENS unit electrode placement for OI muscle at the following link:
http://www.pudendalhope.info/forum/view ... =36&t=5266