Health Organization for Pudendal Education

Hi ! Let me introduce first: 37 yo, male. In july of 2018 something happened to me. First of all, my penis "died". No sensibility. No erection. Flacid, cold.
After this short period, things changed: high sensibility, burning, pain after pissing, pain on ejaculating, pain on then scrotum. Same case of everybody here : lots of urologists. Lots of tests. No IST, no prostatitis, no bactérias, everything normal on the tests. I started to have anal burning too. Várious proctologists . Nothing abnormal. I started.to freak out. Everything got worst 5 months later with strong.hip pain ....buttocks....inguinal region, groin, . I thought that i was Crazy. I thought that i was fighting against Three problems now: anal, penis and hip.

I was diagnosed with a hip labral tear on the left hip and FAI.

After everyday researching, studing pelvic anatomy, talking with people around the world, i found a connection between HIP Labral Tear and PN.

Let me explain: If you look for the pelvic anatomy, there's no connection between the Head of the fêmur or acetabulum with the pudendal nerve. They are in distinct areas.
But, there's an important information: one of the most common complications of the hip arthroscopy is the pudendal neuralgy. Why? Something happens when the doctor dislocates the Head of the fêmur tô fix the labrum ir acetabulum. For a reason, pudendal nerve is stretched. Whe are talking about a minimum dislocation. Less than 10cm. And It can cause a long pudendal neuralgy.

So, labrum represents 20% of the fêmur Head coverage. Is one of the most important things that keep your femur Head on the place that its must tô be. When you have a labral tear, you Lose this. Then the Head of your femur starts to move out,. You keep stretching your pudendal nerve constantly. PT can give you some relief of course: you gain muscles that help tô mantain your fêmur Head on the place. But the effect is limited. The only way tô solve that IS fix the labrum or replace the hip.

Thats It. I talked with many people that, after hip arthroscopy, started to have a normal life again.

I remember the week when everything started: i was playing soccer and i felt my leg getting out of the place...failing.......probably was the moment of the labrum lesion. And my pudendal nerve stretching at that time, causing the loss of sensibility. And then, after some days, he got inflamed, the body restsuring him, causing the pains.

I am waiting for my hip arthroscopy, which i think will happens next days.

Unilateral PN sufferer for 9 years, but saw amazing improvement in daily pain (but still had flares with triggers such as running, cycling, sex) with hip steroid injection in 2015 when surgeon said my labral tear was too small to be causing an issue. Fast forward to now, and PA that has done my injections over time also reports many, but not all of a handful of patients, see improvement of PN/Pelvic Pain symptom with labral tear repair. My PT suggests a slightly different theory than what you suggest, that the femur not being tight in socket causes the Obturator Internus muscle to be constantly spasmed, tight, etc. as it is trying to stabilize the hip and the pudendal nerve runs along side this muscle so it gets compressed or yes, I guess stretched. I am seeing the surgeon again in March and strongly leaning towards surgery as well. Please read up and ask your surgeon on which method they use during the surgery for traction (giant pole between your legs, which can cause PN and genital issues due to pressure OR a newer method, special tilted table called the Guardian, by Stryker, no pole needed). Mine uses the latter, this made surgery seem more feasible, as I am terrified of coming out worse. I do understand that pain is not resolved immediately but after several months and even up to a year. Good luck and please keep posting how your are doing here!

Well, I Just had my labral tear and FAI fixed. Surgery happened last april 11. Im having a great recovery. LETS see what happens next. If pelvic burning sympthons Will decrease..now that my hip has no more problems.

That was nice of you to come back and report. Most don’t. Look forward to your update. I too have torn labrum but the worst PN is on the opposite side.

That was nice of you to come back and report. Most don’t. Look forward to your update. I too have torn labrum but the worst PN is on the opposite side.

Great to hear that you are doing better, Jake!

Yeah
I Will give a feedback after 6 weeks, which is the períod of moving restrictions.
Well, right now, 4 weeks since the surgery, the FAI pain Just gone. No more clicks and lateral hip pain.
I AM feeling more confortble to sit. Looks like things are getting better day by day.

Please keep us updated! I have labral repair surgery planned for June 13th, so a month away. I'm flying out to Denver for a top doctor (500+ arthroscopies a year) who also doesn't use a perineal post for the traction. Post-less scope, so no chance of pudendal nerve damage. Very nervous, but I'm hoping my hip pain and my pelvic floor symptoms are related.. I have a lot of rectum pain and spasms.

Hi!!

Next monday Will complete 6 weeks since surgery. Probably doctor Will end ALL movement restrictions and positions.

Well, let me Tell you which improvements i am having:

1- my hip is "free"...no more "clicks", no more blocks...I am walking almost normal....almost like the other side.

2- my pain after piss JUST GONE!!! 3-4 years having pain after piss. I cant believe that. I had forgot How pleasure is tô piss.

3- my pain after poo Just gone too.

4- no more muscle spasms. Gone. Now i understand that the hip problem was causing a great muscles problems around It...

5- still having Butt pain after long sit períods. Now, with no more restrictions of positions...(specially put my hip less Than 90 degrees) I Will do other exercises on PT....LETS see if that Works now.

6- glans burning also decrease a Lot.

Well.....thats It. I Will update you next week. Now with more exercises ...LETS see If the improvements keep happening....specially the Butt pain

Thanks for the update. Great news that you are seeing some early improvements!