Pudendal Neuralgia

[Webster123]

My brother is 30 years old has been had pain in his perineal area for 3 years now.  The pain comes every other day.  It is light in the morning and gets worse as the day goes on.  On the days he has no pain, he is able to walk around for an hour in the morning and the pain goes away.   He has seen 2 urologists and has had 3 surgical procedures.  The first was to remove a very small cyst in his ejaculatory duct.  Due to pore catheter removal he developed scar tissue in his urethra, the second surgical procedure was to go in and scope the tissue.  Neither relived the pain.  His latest surgery was a urethroplasty to remove the scar tissue all together and graph his urethra with tissue from his mouth.  The scar tissue was believed to be causing his inability to urinate properly (unusually frequent).  He has had CT scans and MRI’s that have come back negative for any abnormality in prostate area.  He describes the pain as unbearable, he explains that it feel like his perineal area is in a vise constricting more and more as the day goes on.  He has been treated for prosititus without any results.  Could this be Pudendal Neuralgia??  I was reading about it online, and it seems to fit the bill.  I should also mention that he has been suffering from a neurological disorder that has been tentatively diagnosed as hereditary spastic paraplegia.  He has a great difficulty walking and maintaining balance due to the spasticity in his legs.  Could the HSP be putting pressure on his Pudendal nerve?  Or perhaps pelvic floor constriction?  Could any of these conditions be related?  I would love for him to be able to speak with someone or be seen in relations to Pudendal Neuralgia.  Please Help…

[blueunicorn]

if your brother has had a trauma in his anus or perineum area or suffered a major fall, my humble and personal experience is that his tendons in that area are ¨frozen¨or have suffered a trauma and are not allowing the free movement of the muscles said tendons are attached to. i was also diagnose with hereditary spastic paraplegia 18 years ago and told i would never walk again. when i was a child, i suffered a major injury to my perineum. it was by healing the perineum, the anal ring and the perineal membrane that i was able to heal myself. good luck.

[MadCG]

I am recently diagnosed with Pudendal Neuralgia. So here are my symptoms..
Groin is burning 90% of the time.
Sitting causes extreme burning on my testicles and penis.
laying down can cause burning, but sitting is the worst.
I have terrible back pain and I do not know if is related.

Sex is very painful due to burning when its over.
Masturbation is out of the question.
Friction is extremely painful.

It is quite maddening. I am seeking help from a staff at a local university's neurology department and have an appointment soon.

So, far to come to the conclusion of this problem, it took 43 doctors because I had to be seen at grand rounds. The head of the dermitalogical board at this university had me go to grand rounds to nail down what it was. He theorized it but wanted to make sure.
It has been a slow proces.

I have an appointment with a pain clinic too which may help. Your brother should look into a pain clinic.

[Vanessa Lacuesta]

Hi

Pudendal neuralgia usually presents with pain when sitting down or lying down. Diagnosis may be elusive as this may be misdiagnosed most of the time. Several factors appear to contribute to your brother's symptoms .This includes his previous surgeries, his neurological problem and a possible underlying surgical complication. Neurological deficits may cause neuralgia as part of the disease condition. Pudendal neuralgia may be a differential here but this pain readily involves pain in the groin and the anal regions. If this is consistent to your brother's case, an EMG may be done to determine involvement of the pudendal nerve.

[Webster123]

Any thoughts???