New and lookig for advice

[turtle]

Hi all, wanted to share my story and get some potential advice regarding new symptoms.

5 months ago I did something stupid and hurt the skin on the underside of my penis shaft (forcefully held a finger to the middle of my shaft while using a fleshlight, repeatedly crushing the skin between my finger and the toy). There weren't any changes in the skin appearance and for a week it hurt like a normal injury, but then developed into nerve pain with symptoms changing every few weeks: stabbing pain, burning pain, cold/icy sensations, pressure-like pain, hypersensitivity, warm sensations - all at that spot on my penis shaft.

1 month ago I finally got to see an urologist, who said they can't see any injury and that it was probably a pelvic floor + nerve issue. Right after that I stopped sitting down and started doing daily pelvic floor stretches, and noticed immediate improvement to the pain the next morning. I also started seeing a PFPT. At this point my symptoms were constant burning pain and occasional stabbing pain. 1 week later, a new symptom came up which was allodynia - pain that occurred when something gently rubs against the skin, as well as if I lightly press on the skin. Now 3 weeks later the burning pain has gone away, and the stabbing pain has decreased a lot in intensity, but the allodynia seemed to have gotten worse - sometimes feeling irritation like a sunburn even if nothing is touching or rubbing against it. It's also very different from my other symptoms as I don't notice it flaring up when I sit down or press on trigger points that flare up my other symptoms, and also can wake me up in the night (when I get an erection and it rubs against my underwear), unlike my other symptoms which disappear when I sleep.

Another thing is that 2 days ago, I felt a brief mild pain to the right of my bladder (between my abdomen and pelvic bone). And last night suddenly felt an urge to urinate along with an intense warm feeling on my penis shaft. After I urinated it turned into an excruciating warm, burning, pressure-like pain in my penis unlike any of the pain I've experienced before. 10 minutes later I had the urge to urinate again, and the pain went away after I urinated.

The pain yesterday and my allodynia have really spiked my anxiety recently as doctors haven't been able to tell my what is causing them. Maybe the allodynia is just from nerve irritation, but why is it acting differently and getting worse when my other symptoms are improving, maybe it's central sensitization? Could the pain yesterday be a kidney stone that blocked my urine flow and the pain just referred to my penis where the nerve is irritated? Exactly 1 week ago I had a very intense and painful massage around my right abdomen, thigh, and pelvis. Could that have something to do with it?

[Violet M]

Hi Turtle,

In answer to your last question, yes the painful massage could have caused a flare-up in the allodynia if you have pudendal neuralgia.

Allodynia is a type of nerve pain, and since your pain is in the area innervated by the pudendal nerve, it makes a lot of sense for you to be considering pudendal neuralgia. But you can't really know for sure unless you have some more diagnostics, such as a pudendal nerve block to confirm that it's the pudendal nerve. If your PFPT is knowledgeable about pudendal neuralgia, they can press on your pudendal nerve via the rectum to see if it is tender.

I could see a scenario where stretching initially relieved your pain because it helped the pelvic floor muscles to relax. But then, maybe the symptoms got worse because the stretching caused the nerve to be stretched, especially if it isn't able to glide well due to some type of impingement or entrapment. Sometimes the pain from the nerve stretching can be delayed.
But I don't know if any of this is true in your case. Just brainstorming.

So, it's also possible you had a kidney stone in addition. You may never know since you didn't actually see one. This website has an interesting discussion about the 4 stages of passing a kidney stone. https://www.verywellhealth.com/stages-o ... ne-5215247
What you described sounds entirely plausible.

If PT doesn't help within 6-12 sessions, you might want to consider seeing a physician who treats pudendal neuralgia so they can help you with a more prescise diagnosis.

All the best,

Violet