Health Organization for Pudendal Education

Hi new here and this is my story. I am looking for input and hoping that someone can help me.

In Nov 2011 during mustarbation, I started jelqing (which I just learn from internet, stupid me) my penis and felt a sharp needle like pain just below the tip of my penis in the farlum area on the left side. I stopped everything for couple of weeks and symptoms went away. But during mustarbation I again felt the same sensation but a bit more stronger. Next day I the symptoms got worse, burning while urination, redness under the tip on the left side. I guess I irritated the nerve more. My urologist thought it was probably a rash, however the redness and burning sensation wouldn’t go away.

Months passed and the symptoms got worse and worse, burning, redness, swelling and hypersensitivity. I also started having pain, burning in the pelvic area and couldn’t sit for more than 5 minutes. Laying down on my back and left side made it worse.

Back in July 2012 I saw a chiropractor for 1.5 months which helped a lot and my symptoms almost went away, about 75% improvement. However, one day I had to travel for a doctor’s appointment and sat in the care for 3-4 hours. After that all the symptoms came back and even got worse. Since them I have not had any relief. Physiotherapy has not helped much.

Now I have redness, swelling in the farlum area and on the tip of my penis which does not go away. I also have similar symptoms on the right side as well. Lots of burning and bruising pain in the pelvic area. Which exuberates the pain on the tip. I do not have any pain alone the shaft or the base, however there is some tenderness on the pubic bone on the left side just above the base of the penis

I recently saw a neurologist which confirmed the lesion to the dorsal never on the tip, and has put me on lyrica which has not helped. He does not seem to be very experienced in this area, since he told me that this is the first time he as seen this kind of a case. MRIs of the back and pelvic area came clear.

I have somewhat similar problems, my problems started also after prolonged sex (or masturbation), pain at the base of penis and along the shaft.
I guess that this condition is not purely nerve related, but it is the overall dysfunction of pelvic floor. Muscles were thrashed and got to spasms, pinching the pudendal/dorsal nerve.
I had this conditon 5-6 times in 2009/10 (with full recovery) before my pain became chronic.
If you have had profit from chiropractor and PT, it shows this is the way how to treat it, it might take more time. I also profited somehow from PT. On the other hand, dorsal nerve block was completely ineffective.
There is a lot of usefull info on the webpage www.forum.hardflaccid.org (sometimes the webpage is off)
Would say that you are struggling rather with complex myoneuropathy of pelvic floor than with classical PNE

Flyer, i am really confused about my condition. Because I had a direct trauma to the dorsal nerve at the tip of the penis. I had a rash and burning pain and the other symptoms came on couple of months later. I have emailed Dr. Dellon and he things dorsal nerves are compressed either at the base of the penis or along the inferior pubic ramus.

Now i am confused at to how this can happen, because the location of the trauma is at the tip no the base. Although i do have some soreness on pubic bone just on the left side.
I am also confused as to how the chiro was able to help me so much and now when i go to chiro i get more burning pain. He did say that my left hip is out of alignment, and i do have soreness on my outer thigh and just underneath the left bum cheek it feels like muscle knots.

Difficult to say. I am somewhat in same boat. Chronic penile pain, and pain at the base of penis, no sitting pain.
Dellon might be right, but might be mistaken. Dorsal nerve might be pressed by muscles, that means no classical entrapment.
Some sources state that the hallmark of dorsal nerve entrapment is more numbness and sensitivity disturbances than pain.
Anyway you shlould try the following steps:

-3Tesla MRI of pelvis
-Dorsal nerve block or Alcock block
-PSSD test (available at Dr.Dellon)
-evaluation of tenderness along pudendal/dorsal nerve, TInel sign examiniation

of course, the none of the above mentioned tools is totally conclusive, but might help shed a light on your condition.
did not you have pain later after stimulus? (because in the beginning I had the onset of pain 2-3 days later after sex/masturbation), that pointed me toward nerve issue, because delayed pain is typical for nerves. I dont have any numbness/ED/sensitivity issues so I think that my dorsal nerve is pressed by spasmatic muscles. We can discuss more via PM, if you want.

Flyer i am really confused.
I contacted Dr. Dellon and first he said that dorsal nerve maybe have been compressed at the base or at the pubic bone, i sent him some photos showing the redness and lump on the left side. And he replied back that i might have tore some forskin and i should go back to a urologist to fix that.

I have been to 4 urologists and they just say it is nothing. How can a skin irritation/lump cause so many other symptoms? How and why was chiro able to help me then?
I have had this redness and lump for over a yr now and I have tried anti-inflammatory medication.
If it is just irritation then why do I have burning and soreness in the pelvic floor muscles. Can just irritation cause hypersensitivity, burning, and soreness in the muscles? I also get this redness and burning sensation in my testicles now and also along the anus.

I am so confused and no one seems to be able to help me or give me some answers.

anon123, I feel for you, I know how these things might be devastating.
Nobody, neither dr.Dellon can diagnose you only via internet or pictures. These two conditions (lesion on glands and pain in pelvis) might or might not be mutually interdependent.
But the larger extent of symptomatology (pain in pelvis, burning during urination, lesion on glans) point toward broader pathology with pelvis. And the fact that you heavily profitted from the first cycle of PT is also indicative.
I am also struggling with penile pain, and dont think that my case is purely neurological, because I had this condition several times with full recovery.
I was asking prominent urologists and neurosurgeon if you can damage your dorsal/pudendal nerve by sex/masturbation, they said "highly improbable". BUt you can thrash and injure your pelvic floor, if it was weakened down before, if there was pre-disposition for pelvic floor dysfuncion (high tonus, or clenching during masturbation etc.).
I believe I have some pudendal neuropathy, but this is a part of broader picture of pelvic myoneuropathy - my pelvic muscles are clenched, my prostate is painful at examination, my pain is bilateral and even some parts of body, which are not innervated by pudendal nerve (suprapubic region) are tender and painful.
If you dont have loss of sensitivity (numbness) and ED, it is highly improbable that your dorsal nerve is damaged beyond repair. On the other hand, this nerve is probably constatntly irritated by spasmatic muscles, thrashed vessels and other issues as a consequence of repetitive stress injury (which is also my case).
First and essential line is PT, especially if you have had profit in the past.
But, maybe more essential,you should visit neurologist who is able to detect pudendal neuropathy and then try next steps. PSSD test at dr.Dellon is not absolutely conclusive, but in border-line cases like yours it might help to complete diagnostic picture.

Anon123, what does "farlum" mean? Not familiar, and nothing on Google.

I think it should be "frenulum"

I agree with Flyer, definitely pelvic floor dysfunction. I used to have all these symptoms, after a year and 4 months of my own therapy, I am feeling awesome.

flyer, you are right it should be frenulum,

Boby, could you please describe what therapy you used? thanks