32 year old male, almost permanently impotent.
Posted: Sun Jul 21, 2019 9:11 pm
last year i did a cystoscopy and a retrograde urethrogram, after that i developed pelvic floor dysfunction. Turns out My pudendal nerve is being compressed, but my pt dosent know exactly where it's being compressed.
When it's compressed i have the following symptoms numb penis, extremely low ejaculate, loss of ejaculate power, erectile dysfunction, loss of anal sphincter contractions, loss of morning erections,scrotum numbness but here is the weird thing whenever i do PT i get a lot of that function back for a couple of days until my muscles start spazzing out and it becomes tight again. So far she said my piriformis is tight and my obterator internus is tight.
I understand that the pudendal nerve can get entrapped in the Large sciatic foremen as the piriformis muscle compresses it because the muscle is too hypertrophic, But when this all started i had pain in my sit bones and next too my anus where my obterator internus is. I want to know where this pudendal nerve compression is. Should i do a 3T mri or should i do a MR neurography? I also have pain sitting down i have sharp pains in my sit bones and around my hips. On july 7th i moved apartments and pulled a washing machine on a dolly up 3 floors, after i carried the washing machine up i had an extremely sharp pain in my butt/hips and couldn't walk normally. I couldn't move my foot forward properly. then at 3:30am that night i think my pirformis started spazzing out like crazy. Ever since then i don't get morning erections unless it's the day or two after PT. I also got into a huge car crash after the cystoscopy/rug. I rear ended someone and pushed on the brake pad extremely hard. I don't think that caused the pains that i have now since i had ejaculating problems and pain before then, but i also don't think that it helped. all signs point to my pudendal nerve being compressed or trapped by a muscle or something. I just don't know which muscle it is. I've also have this pinching burning feeling near my sciatic foremen 24/7, i feel like it's where my pudendal nerve is being compressed. I have an appointment on august 6th with my orthopedist, i think i am going to push a MRN and trigger point injections. My PT seems to think that i have a pudendal nerve compression somewhere by the muscles. Before this PT i had previous PT and all we did was internal myofascial release and dry needling which didn't help at all, I did that for 12 sessions. So now i'm pretty lost because i have all this pelvic floor pain and i know my pudendal nerve is being compressed by the obterator internus or the pirformis muscle. When the pain first started it defitely started at my sit bones then reached out to my hips, then i started limping because it was affecting my hips. I don't know if i have hypertonic pelvic floor dysfunction because my pudendal nerve is being compressed or if the hyptertonic muscles are causing my pudendal neuralgia. So what do you guys think? is it more likely that the pirformis is compressing the pudendal nerve or is it more likely that the obterator internus is compressing the pudendal nerve. Will a 3t MRI with dr. potter protocol be able to see muscle compression on the pudendal nerve? or will a MR neurography be able to see that? If it's something someone can fix under the knife should i do it? My PT says usually it just causes more damage.
So far i've had a ct scan, pelvic mri, semen analysis, retograde urinalysis, lumar mri, which all came back normal.
When it's compressed i have the following symptoms numb penis, extremely low ejaculate, loss of ejaculate power, erectile dysfunction, loss of anal sphincter contractions, loss of morning erections,scrotum numbness but here is the weird thing whenever i do PT i get a lot of that function back for a couple of days until my muscles start spazzing out and it becomes tight again. So far she said my piriformis is tight and my obterator internus is tight.
I understand that the pudendal nerve can get entrapped in the Large sciatic foremen as the piriformis muscle compresses it because the muscle is too hypertrophic, But when this all started i had pain in my sit bones and next too my anus where my obterator internus is. I want to know where this pudendal nerve compression is. Should i do a 3T mri or should i do a MR neurography? I also have pain sitting down i have sharp pains in my sit bones and around my hips. On july 7th i moved apartments and pulled a washing machine on a dolly up 3 floors, after i carried the washing machine up i had an extremely sharp pain in my butt/hips and couldn't walk normally. I couldn't move my foot forward properly. then at 3:30am that night i think my pirformis started spazzing out like crazy. Ever since then i don't get morning erections unless it's the day or two after PT. I also got into a huge car crash after the cystoscopy/rug. I rear ended someone and pushed on the brake pad extremely hard. I don't think that caused the pains that i have now since i had ejaculating problems and pain before then, but i also don't think that it helped. all signs point to my pudendal nerve being compressed or trapped by a muscle or something. I just don't know which muscle it is. I've also have this pinching burning feeling near my sciatic foremen 24/7, i feel like it's where my pudendal nerve is being compressed. I have an appointment on august 6th with my orthopedist, i think i am going to push a MRN and trigger point injections. My PT seems to think that i have a pudendal nerve compression somewhere by the muscles. Before this PT i had previous PT and all we did was internal myofascial release and dry needling which didn't help at all, I did that for 12 sessions. So now i'm pretty lost because i have all this pelvic floor pain and i know my pudendal nerve is being compressed by the obterator internus or the pirformis muscle. When the pain first started it defitely started at my sit bones then reached out to my hips, then i started limping because it was affecting my hips. I don't know if i have hypertonic pelvic floor dysfunction because my pudendal nerve is being compressed or if the hyptertonic muscles are causing my pudendal neuralgia. So what do you guys think? is it more likely that the pirformis is compressing the pudendal nerve or is it more likely that the obterator internus is compressing the pudendal nerve. Will a 3t MRI with dr. potter protocol be able to see muscle compression on the pudendal nerve? or will a MR neurography be able to see that? If it's something someone can fix under the knife should i do it? My PT says usually it just causes more damage.
So far i've had a ct scan, pelvic mri, semen analysis, retograde urinalysis, lumar mri, which all came back normal.