Is it pudendal? Opinions Welcome.

[ChrisUK]

Hello

I hope you can help. I am 42 yr old guy.

Am looking for opinions from PN sufferers that may help sway me whether should go for nerve block and poss sgy or not. I have already had one unessasary op done (sphincterotomy). Have been told to avoid nerve block as risk of impotence and other unpleasants.

Fissure developed after hard stool 12 months ago. Visible to eye by doctor. After 6 months fissure healed but pain remained. I had 3 botox injections as doc thought must be down to spasming following chronic fissure. No relief although after 2nd botox did improve for about 5 weeks. Does pudendal nerve prob give ups and downs this long?
6 Weeks ago had sphincterotomy. No change, pain remains.
Symptoms: Only in and around Anus. Sometimes burning sometimes dull pain. No pain or sensation elsewhere. Worse when sitting. No trauma other than fissure although rough digital rectal exam brought on pain again after fissure healed and has never got better. Can pain only be in anus. I have read it can but how common is this not to have symptoms elsewhere? PN Yes or No? Also how quickly does it progress.

Kind Regards

Chris

[johnd.h]

Hi Chris. My symptoms are essentially the same as yours, stinging/burning pain in the rectum, provoked by sitting down (I do use a 'doughnut' cushion whenever possible), but also the pain is brought on by bowel movements. I get a few minutes relief immediately following the BM but then the pain comes on. I have no other symptoms really, other than on the rare occasion when I might get a bit of pain down into the tops of my thighs. I should point out also that the frequency of my BMs has increased, two sometimes three times a day. Not nice stuff to talk about, but I want to help you by being as informative as possible.
I would just add that I am not in pain when in bed, my sleep is not affected, and when I get up in the morning I am pretty much pain-free. As the day progresses, so the pain returns and gets increasingly more painful.

When my symptoms first started in July last year the pain was at times very severe reducing me to a shaking wreck, but as I learned more about what could potentially be the problem so I started to avoid doing things which clearly make matters worse. I am indebted to the kind people on this site who made it possible for me to understand these things, and gave me the courage to get on with it and do my utmost to manage the condition. This has made me determined to help others where and if I can.

I do believe most strongly that stress is a MAJOR factor in exacerbating the condition, as a result I have given up my job and am now in retirement. This of course brings with it other concerns, mostly financial, but I definately am in less pain now that I am able to relax more and the long drive to and from work has stopped. I'm fortunate insofar as I am at retiring age anyway, it would be tougher if like you I still had to support my family.

I have had days where frankly I have been lulled into a false sense of security because the pain levels have all but disappeared, and then back they come. This made me quite depressed at times, but now I know what to expect I'm just grateful for the better days as and when I have them. So, yes, ups and downs are consistent with PN it would seem to me, but that's my personal experience only.

Regarding your question of how quickly does it progress, this I think varies so much between individuals based on what I have read on this site, but the main reason I have pushed to get my nerve blocks done as quickly as possible is to avoid if I can, any further serious damage being done to the nerve.

No doubt others will give some input also Chris, but hope this is of some help to you.

Kind regards,

John.

[ChrisUK]

Hi John, thought would drop you a quick email asking how you are doing? Hopefully by now you will have had second op on nerve. Are you feeling different, won't say better as understand takes a while. Fingers crossed it helps. Dr greenslade reckons I have chronic pelvic pain syndrome which has similar symptoms. Guess i am unsure. Be good to have a chat when you are feeling better. Regards, Chris

[Lernica]

Hey guys,

I also have a chronic anal fissure. Very painful and alarming. It comes and goes. But I also have other extremely debilitating pelvic pain in my private parts, lower abdomen, sacrum and buttocks. Just thought I'd let you know that you're not alone with the fissures.

[sam]

My symptoms are identical to Lernica's, in addition I also have prolapsed haemorrhoids.