Health Organization for Pudendal Education

Hi everyone! I'm yet another newbie here. I'm really quite confused because I seem to have a lot of symptoms and I'm hoping for some insight. They started a little over three months ago. Also, I think I might be able to pinpoint how these symptoms began.

Right now, my symptoms tend to vary throughout the day. The most annoying is a painful, pinching feeling at the tip of the penis. It can last anywhere to a couple hours to all day, but if I start to squeeze it lightly, it'll burn and pinch again. It also sometimes has the feeling of a trapped fluid. The penis in general is also just really sensitive to touch, feeling sore and kind of flinches or tickles. Sitting doesn't regularly seem to hurt, but when "flare-ups" are at their worst, I can occasionally get that golf ball feeling or general discomfort. Even worse is a strong tingling or almost throbbing sensation in my perineum that sometimes occurs throughout the day usually when sitting or laying down.

I urinate mostly okay. Sometimes it feels like the urethra is too narrow or something and that the urine is flowing out faster than the urethra can handle, if that makes sense. It does also feel like I have the urge to urinate more often though, and I notice it's sometimes hard to squeeze the kegel muscles to finish peeing. Sometimes a little extra trickles out later on too. Erections are often just ever so slightly painful and uncomfortable, and orgasms can sometimes burn a bit.

Here's where it seems to have begun though. Prior to the symptoms, I had been masturbating with sort of a weird technique. I would make circular motions on the area of the penis right below the glans on the backside. It seemed to stimulate quick arousal, and then I would masturbate regularly to completion. I thought nothing of it, even though I realized over time this became one of the only ways for me to get truly aroused. The shaft became almost desensitized as a result. I also noticed in the months leading up to these symptoms I'm having, that when I was at the gym, certain weight lifting exercises would make my penis super tingly. Again, didn't think much into it. Then sure enough, one day I masturbated using that same technique, and my penis felt really sore afterwards. Within 48 hours, all the symptoms I'm having emerged and never went away.

I have found that letting hot water run down through the perineum in the shower every night for like 5 minutes really helps reduce symptoms by about 50% every day, especially the tip of the penis pain. But I've also had to quit my gym routine, and have general anxiety and pretty bad depression over what I've been experiencing. I also drink alcohol more often as it seems to help somewhat. I just miss my old life, and feel stupid for not paying attention to the signs prior to this.

My question is though, is this PN, PNE, prostatitis or something else? (To sum up: pain at tip of penis, hypersensitive penis, tingling perineum, increased feeling of having to urinate, occasional golf ball feeling, sometimes slightly painful erections, sometimes burning ejaculations, often phantom shock pains or throbs in penis shaft). I've been to two urologists with another appointment coming up soon and both seem uninterested in getting to the bottom of what it is, but one thinks it's nonbacterial prostatitis.

Thank you for any thoughts or encouraging words you may have.

Hi George,

I think you are going to need some more diagnostics to really narrow this down as to what is going on. One place to start is with a good pelvic floor PT who is knowledgeable about pudendal neuralgia and can evaluate the pelvic floor for tension or for tenderness along the course of the pudendal nerve or at the ischial spine via a finger exam of the rectum. PN often has more than just one trigger, and it's really impossible to say whether there could be some small nerve fiber neuropathy as a result of the way you masturbated, or whether there is some pelvic floor tension due to weight lifting that caused the pelvic floor muscles to impinge on the main trunk of the pudendal nerve -- or something entirely different. Since you have penile and perineal symptoms, it seems possible that it is more than just small nerve fiber neuropathy at the tip of the penis. I can't say for sure if it's non-bacterial prostatitis. Is your prostate tender?

For me, weightlifting is what triggered PNE and it turned out that my ligaments were strained. Due to my age at the time (40's) my ligaments were becoming somewhat hardened and sclerosed and impinging on the PN. But some people just get tense pelvic floor muscles that irritate the nerve and don't have ligament involvement. My experience was that the physicians in my area didn't have much of a clue as to what was going on but the pelvic floor PT figured it out immediately.

My encouraging words to you are that it sounds like you are on the right track as far as discontinuing the weightlifting for now and focusing on getting a proper diagnosis. It may take some research and maybe even some travel to find the right docs and right treatments but you most likely will get this figured out and find what works for you. If the pain is unbearable or causing you a lot of anxiety, don't be afraid to ask your doctor for some medication to help while you are seeking solutions. The following link might help you with some medication ideas: http://www.pudendalhope.info/node/20 Many people also use ice and heat for natural pain relief.

Violet

I recognise a few of those symptoms. I was diagnosed with PNE. Cycling & heavy lifting was the cause.

Violet M wrote:Hi George,

I think you are going to need some more diagnostics to really narrow this down as to what is going on. One place to start is with a good pelvic floor PT who is knowledgeable about pudendal neuralgia and can evaluate the pelvic floor for tension or for tenderness along the course of the pudendal nerve or at the ischial spine via a finger exam of the rectum. PN often has more than just one trigger, and it's really impossible to say whether there could be some small nerve fiber neuropathy as a result of the way you masturbated, or whether there is some pelvic floor tension due to weight lifting that caused the pelvic floor muscles to impinge on the main trunk of the pudendal nerve -- or something entirely different. Since you have penile and perineal symptoms, it seems possible that it is more than just small nerve fiber neuropathy at the tip of the penis. I can't say for sure if it's non-bacterial prostatitis. Is your prostate tender?

For me, weightlifting is what triggered PNE and it turned out that my ligaments were strained. Due to my age at the time (40's) my ligaments were becoming somewhat hardened and sclerosed and impinging on the PN. But some people just get tense pelvic floor muscles that irritate the nerve and don't have ligament involvement. My experience was that the physicians in my area didn't have much of a clue as to what was going on but the pelvic floor PT figured it out immediately.

My encouraging words to you are that it sounds like you are on the right track as far as discontinuing the weightlifting for now and focusing on getting a proper diagnosis. It may take some research and maybe even some travel to find the right docs and right treatments but you most likely will get this figured out and find what works for you. If the pain is unbearable or causing you a lot of anxiety, don't be afraid to ask your doctor for some medication to help while you are seeking solutions. The following link might help you with some medication ideas: http://www.pudendalhope.info/node/20 Many people also use ice and heat for natural pain relief.

Violet

Thank you so much for your thorough response Violet. I have an appointment a week from today and I'm really going to try to be firm about finding a solution.

Andy_Pablo wrote:I recognise a few of those symptoms. I was diagnosed with PNE. Cycling & heavy lifting was the cause.

Which symptoms do you have Andy?

Burning, aching, stabbin pain in perineum, penis, testicles, groin, etc. Painful erections, ejaculation. Loss of overall control when trying to "push out final urine". ED issues. Over sensitive penis. Numb penis. Golf ball feeling in anus. Severe constipation. Temperature regulation issues. Unable to sit. Unsble to stand for more than five mins. Unable to do any physical activity without flaring my symptoms up for weeks. And probably a lot of other issues. Surgery has helped with things like ED & stopped the numbing sensation in penis, but other pains have intensified. There are a few in your description that I recognise. My initial advice is to slow down any severe physical activity & speak to your doctor about potential treatments. Non invasive to start with. Hopefully you can get sone help to get your life back on track. Good luck.

Let the diagnosis define it a PT is good option to begin with. For us all it can be different reasons behind PN. All the best for the appointment, do keep us updated!!