Is this cpps or pudendal problem ?

[Erna]

I am strugling all the summer and I don't know, am I can relate to this that I have had multiple episodes in three years gap, but mostly symptoms were my penis burning and bladder, but strong, no tests no nothing I had, just presciption of antibiotics and afterwards I got fresh, but I can mention I haven't had no sexual intercourse. By the way I am person who had depression episode, not one and sometimes I am anxious just worring (maybe perfectiosim). I think it can be the reason. In the end of this may I have reovered from depression, but then at that time I have really felt some kind of stress, just studies, driving school, so I don't know, cause everything just have happened in a days after riding my bicycle.

So I got suddenly all the symptoms some of them are new, burning anus, burning penis, sometimes big pressure comes to pubic zone, it seems something will crash. Doctor prescribed me recently elavil and it helps, it seems I get better. In begining when pain have decreased, I felt that something is not right with my muscles, i think elevator ani, near anus, I couldn't walk faster. Later pressure had come to pubic. And later on, I started feeling heat going down the right hip, just exactly from right side of the hip and through the whole leg, also I have felt burning/tingling in right buttock, sometimes to my chest and belly. Its muscles thing for sure, they are like comunicators. I think its a reason. So in conclusion the main symptoms mostly radiating are pressure in a pubic or burning sensation in the anus. But also I've noriticed when I am sitting more I am starting feeling burning in anus or even more thats why I afraid tingling in right buttock {like some kind of nerve)

So this is my story, I don't know is this so serious, compare other people experience but I was disabled, it was real. No I am better, but not good, not still me. I must do something. I dont know how to differentiate cpps and pudendal nerve problem . Maybe someone know ? I am in Lithuania, its very far from good pelvic specialists

I hope you guys know good enough about pundedal neuralgia and can relate something to my experience

I am just young 24 guy and dont know whats going on..

I am Ernest

Thanks for support

[helenlegs 11]

Welcome Ernest,
First of all nerve pain is usually very different from 'normal' pain like burning, tingling as you have described so there could be some evidence of a pudendal nerve problem. The important thing is trying to find out what is causing it.
Being a person who may be prone to depression and anxiety may be making matters a little more noticeable and may cause a central sensitization or CPPS that you have noted in your post.
I would think that a good place to start would be with some pelvic physiotherapy. The problem as you say could be muscle related and a good pelvic physiotherapist will hopefully be able to see if you have any particularly tight pelvic floor muscles that could be relaxed and released to help you. The piriformis muscle is another one to get checked out.
There is a absolute ton of information on the home pages too which will undoubtedly help although it is quite easy to get overwhelmed by too much information in the beginning.
I am very glad that you found this site, hopefully we will be able to help.
Take care,
Helen

[Erna]

I appreciate for answer, Helen. Yep I know, I am trying to find. Its not that easy. I've already red a book by Amy Stein. Its very useful guide to learn about pelvic structure and all those ton of new diagnoses. But thats not enough, damn its hard . The more I know the more I don't know nothing, that means possibly I have confused a lot. Now I just can wonder whats going on. I have already found a physiotherapist. He is good one, one of the olympic athlelets trainer ;o. Not some "junk food" . But he right now after meeting has proposed me a diet for a month , to cut all the milk products, breadstuffs and chocolate. The reason are worms, he has diagnosed by muscles impulses and strength of my legs. It was some kind of interesting practise as I have never seen it before. So thats could be a possibe reason. He has prescribed me some meds and vitamins. So..
So I am just trying, but to read its not enough. I am just worring (probably Iam repeating) for like a new symptom, that tingling or ache in down side of my buttock (nor in the up, nor in a middle). It not bothering me a lot. But I am feeling it sometimes, when I am ready to sit or actually sitting. For example that symptom or problem can exist also in cpps ? Or muscles are haply touching some tissue nerves

Ok, Iam done

Thanks for answers

[helenlegs 11]

If you take a look at the Anatomy diagrams on the home page you might be able to work out if the tingling you can feel in your buttock could be related to the path of this nerve or another one, especially if you get a good idea of the a specific line or position of this tingling when it happens. I think that if the tingling follows the same line or pathway in your buttock it is definitely worth checking out for a nerve issue. Also ask the physiotherapist what he thinks.
I would also suggest not sitting as much as possible, this could make things a LOT better especially if the pudendal nerve is involved.
I don't know if you are taking any medication at the moment but antidepressant and anti seizure medications are often a good combination for neurological pain. There is more information on the home page about this. Many people need to try a few different combinations of medication to get something that works for them. It is often trial and error. I wouldn't ever recommend taking medication on and on without good reason, obviously if a drug doesn't help or doesn't help enough and there are some significant side effects, don't keep on taking it. However in the early days of any nerve problem with typical nerve symptoms finding a pharmaceutical combination can help calm things down and stop any central sensitisation progressing.
Take care,
Helen

[Erna]

You are very good women, I see you are in some struggles, but very hope soon you will come back to your activities and work. Appreciate. I will go to check the diagrams. By the way I was to my sister, she works in hopsital, so hope she will find some good specialists. Also I will stuck for a moment to my physical coach of olympics, anyway I dont thinks so diet is in involved in all that process. But we will go further. Yes I am on elavil and lamictal, before I was on nortriptyline. But those meds were for other things. I have come a long way to meet a right urologist. Spend real money. So I am on it,elavil, like a month. And symptoms so vary in that month. You know I was coming back to my home from sister, its a pretty 30 min walk, and in that time I was feeling aches or cold burning in my arms, fingers, legs, toes, a bit in cheeks, also chest and that feeling like after inoculation in my right buttock. Its interesting.

[janetm2]

Welcome Ernest,
Helen is giving all the good advice so I will just try to add a few notes. You mentioned pain after riding a bicycle which is a normal occurence for PN. Please stop riding if you have not already done so. Also stop anything when pain arises. I had levitor ani muscle spasms as well and it is hard to differentiate where the pain is coming from but hopefully your olympic guy can sort it out and get you some relief. Good luck
Janet

[Erna]

Hi Janet,
Yes as I've mentioned I will go to find something, but a little bit I am affraid, you know, to find those specialists is like looking for gold under rocks I think so. But yea , I've already changed my chair, cause the previuos one did more harm then good. Also I am waiting for a cushion from Ebay. I've already noticed when I sitting over 10 mintues, hurrey, symptomas are coming, probably some nerve are under pressure and cycle going on pressure and everything.. Now I am less paranoid, but I just pray that its not so serious and I will be better. Maybe I need to stay away form sitting ;D and nerves or tissues will recover. Just so stupid with that bike if that is a reason, I was like 4 hours riding for an exams. Thanks for support, thanks for understanding, really appreciate. I will stuck here, in this forum, in a positive way for a while ;D I bet.

By the way, Janet, as I see from your history, you was moving from one to another diagnosis, from one sympton to another, why it was like that ?

[janetm2]

Ernest,
glad to see we are helping. Why the many symptoms and diagnosis may be our biggest mystery or just the lack of full knowledge for the medical field. Also as others have said it seems that pelvic pain is a multiple set of problems. You resolve one but there are the others. Luckily for me once I hit the constant pain it was less than a year until surgery and the constant pain is broken. I am still mending but able to sit longer although it does seem best to get up every 20-30 minutes. Again fortunately my work is okay with me taking a hallway stroll so I can make it through the work day. I hope you can get this resolved maybe before having to find the rare doctor. Taking the steps to calm things down should help while getting the therapy. Take Care,
Janet

[Violet M]

Ernest, since you are getting better maybe it is wise to just continue with what you are doing to improve, but definitely avoid the bicycle. If you continue to have major problems you could try some nerve blocks to the genitofemoral, posterior femoral cutaneous, or pudendal nerve if you can find someone in your country to do them. But nerve blocks have some risks so as long as you are improving that's a good sign.

Violet

[Erna]

Hello, Vilolet
Yes, I am better, then summer. I will do everything is possible. I just want to be sure what is a problem. I am very nervous and could read 24 hours just to find something till I will be relieved. I will go tomorrow to check my physician. I wil try to explain him precisely the core problem you know if I won't, they will diagnose something else. I am serious, its important. You know everything so changes in that month, that I've got cought by past now by present symptoms and can't divide the possible reason, what is behind it. I can say this shortly, when my burning in genitals and anus have decreased after three months by elavil (maybe seconadary symptoms) I just have felt strained muscles, I have started not to sit on the right buttock or sleep on the right side, not for a pain only or generally, but of the swollen strained muslce (sense like) in the buttock, I have just felt something is strained it seems like after inoculation. It was uncomfortable. When suddenly in this week I got cold burning aching sensation through my all body, I mean all, cheeks and everything, especialy when I am walking, so at this point I have nothing to lose, I feel more protective probably by instinct when I am sitting, actually the whole summer I was sitting, cause I have felt so burning anus, all that peripenum, I was just tired and sitting.. Just this week i have gotten these clear and only symptoms, but cpps symptoms somehow decreased. I think maybe there is really something wrong with my muscles, probably they press or affect my nerves. It just confusing for real. Couple days before, as Hellen have suggested me to look for a place and nerve where is that burning, I have found out its more near lateral nerve and sometimes it can go everywhere, but as I have mentioned I feel something is pulled even when I bend sometimes and when I walk I try not put weight on my right leg.