Pudendal nerve block scheduled for the first time

[Anxiety]

I have been scheduled for a pudendal nerve block for sitting pain and penal pain which occurred after a prostatectomy. I had pain prior to this for many years in the Perinium area that they thought may be prostatsis so I suspect the pudendal nerve was hypersensitive prior to my prostatectomy. I also have frequent urination feeling like I have to urinate all the time and urge. The pain is stopping me from driving long distances. Also I have awoken to tremendous pain throughout my pelvic area up through the bladder.
I am getting very little sleep and am depressed. I have tried pelvic physical therapy and cymbalta. I am getting the nerve block to see if it helps and also it can identify if it is the pudendal nerve. I think it is because I have experienced many different pains in the pelvic area. I have read many post that have not been positive but I have to try something. I would be happy if the pain could be lessened to a tolerable level. Do we have people on the forum who have been helped?

[Violet M]

Hi Anxiety,

Yes, I am 90% better and I know many people who have gotten better. A lot of them move on with their lives so we quit hearing from them.

Did physical therapy make you worse or did it just not help?

Sleep deprivation can be a real problem. I remember I went for months feeling like I had very little sleep until I finally got on some medications that helped with sleep. There can be some trial and error to find out what medications work for you. Sometimes lyrica (pregabalin) is helpful in combination with cymbalta for some people. I found clonazepam to be helpful with sleep. I don't like taking medication but it sure helped me get through the worst of PNE and now I don't have to take any medication for it. So hopefully, with some more diagnostics such as nerve blocks you will be able to find the right treatments that will help you to improve.

Good luck with the nerve block. I would be interested to hear how it goes for you.

Violet

[Anxiety]

Hi Violet,
The physical therapy has not worked. The sleep deprivation does not help. I got my best sleep right after the prostatectomy when I had the catheter in me for seven days sleeping through the night. Once it was taken out the sitting pain got intolerable and the penal pain makes me feel I always have to go. I hope this block can lower the pain. If this does not work I may try the lyrica. I too do not like medication but am taking Cymbalta and oxybuttin to try to stop bladder spasms.
Did you get immediate relief from the nerve block then got better over a length of time? Did you get the flare up? Merry Christmas to all and wishing people happiness always.
Timmy

[Anxiety]

I should have said physical therapy helped some but then the pain took off.

[matthewroots77]

Hi
This is my story,I had a fall while doing a tough mudder course,I didn't remember falling at the time as I didn't have any injury. A few days later I developed a stinging pain in the very tip of my penis which made me want to go to the toilet alot. I had this for 3 weeks and then all of a sudden it completely went away for a week, and all my toilet habits went back to normal,I was away fishing at the time.
I came back home and and a few days later everything came back but this time I had pain in the perineum and found it hard to sit,it seemed to be triggered by sex.
The pain in the perineum also went away while I was on a alpha blocker given to me by a urologist,its been a roller coaster for about 7 months now and I'm currently having constant burning/stinging sensation in the penis tip also a weird cold sensation all of this is increasing my bathroom trips.
I've seen several urologists and been treated for prostatitis I'm currently seeing a pain management specialist who believes I've oversensitised a nerve,I've had mri scans which all came back clear and have had several nerve tablets and have only found it settles down at night now that I'm starting to sleep again. Going to the toilet and sex really upset it especially after I pee which makes me want to go again.
I'm really struggling with life and am considering a nerve block to atleast maybe give me a diagnosis.

[April]

Hi Matthew,

Welcome to the forum. I'm so sorry to hear about your pain. The symptoms do sound like pn, but the diagnostic nerve block would be helpful. Have the urologists you saw considered pn as a diagnosis? Have you seen a pelvic pt? Sometimes they can be helpful with the diagnosis too. Interesting that the pain declined with the alpha blockers. Maybe due to the relaxation of the muscles? If so, you might be a good candidate for pt since that can help to relax pelvic muscles.

April

[Violet M]

Hi Violet,
Did you get immediate relief from the nerve block then got better over a length of time? Did you get the flare up? Merry Christmas to all and wishing people happiness always.
Timmy

Hi Timmy,
Yes, I had some immediate partial relief from nerve blocks and the relief lasted for a few hours but then I got flare-ups that lasted for several weeks after the nerve blocks. It was worth it for the diagnositc value but it wasn't a long-term solution for me.
Violet

[Violet M]

Going to the toilet and sex really upset it especially after I pee which makes me want to go again.
I'm really struggling with life and am considering a nerve block to atleast maybe give me a diagnosis.

Hi Matthew,
It's tough when you are struggling like that, and 7 months is a long time. Many of us do get better so please don't give up hope.

I had a similar problem with the frequent need to pee and feeling like I needed to go all the time, even after just going. I think it's reasonable to take medications to relieve that feeling, at least temporarily until you get a diagnosis and treatment for the root cause. Have you had any MRI's or PT evaluations to help you zero in on a diagnosis or rule out anything obvious or serious? If not, you may want to ask your doctor about those. One thing I would say about PT is that while an evaluation might help you with a diagnosis or to find out if there are any musculoskeletal factors that are contributing to the problem, if your nerve is already over sensitized you have to be careful about irritating it further with lots of stretching or physical therapy exercises, especially if you have a possible nerve entrapment where the nerve can't glide. But the more diagnostics you can do, the more confidence you can have in knowing what you are dealing with and pursuing the right treatments.

Violet

[matthewroots77]

Hi violet
Thanks for your reply
I've had MRI on the pelvic which showed no entrapment,damage or inflammation to the pudendal nerve,an MRI on the lower back showed a bulged disc on l5 s1 but not compression and the guy I've been seeing thinks it's been there many years due to my manual work as I've always had a stiff back.
Like I said it completely switched off for a whole week and then just came back which is very weird as I was still doing everything like exercise etc prior to it going away.
I've seen urologist and had many tests and all they found was I had a tight bladder neck but didn't seem to think it would cause any penis pain.

Thanks Matthew

[matthewroots77]

Hi Matthew,

Welcome to the forum. I'm so sorry to hear about your pain. The symptoms do sound like pn, but the diagnostic nerve block would be helpful. Have the urologists you saw considered pn as a diagnosis? Have you seen a pelvic pt? Sometimes they can be helpful with the diagnosis too. Interesting that the pain declined with the alpha blockers. Maybe due to the relaxation of the muscles? If so, you might be a good candidate for pt since that can help to relax pelvic muscles.

April

Thanks April for your reply
The urologist didn't even mention pn it was me who suggested it when I started searching for answers I found the Pn so I asked and they referd me to a pain management specialist.
I've not tried it but maybe il consider it,unfortunately with all this going on I've developed so many other symptoms from anxiety and depression that I don't know what my body is upto