Pudendal Nerve Entrapment or Dysfunction

Nerve blocks using many techniques, and medications - options discussed in detail
Elvis500
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Pudendal Nerve Entrapment or Dysfunction

Post by Elvis500 »

I’m currently experiencing numbness in Penis, Testicles ,Scrotum,Perineal and Erectile Dysfunction .

Can a pudendal Nerve Dysfunction or Entrapment causes numbness without any pain? I have seen several urologist they don’t seem to have any answer but always ask if I have any pain .I have done Lumbar MRI it was clean I’m quite stressed out now .
April
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Re: Pudendal Nerve Entrapment or Dysfunction

Post by April »

Hi Elvis,

I've definitely seen people post on here who report numbness, so I think so. Violet has more knowledge about this than I do so she may be able to chime in here with more information. Was there a triggering event that seemed to create the numbness?

April
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Violet M
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Re: Pudendal Nerve Entrapment or Dysfunction

Post by Violet M »

According to the Nantes Criteria article for entrapment here is what they say,

"Pain With No Objective Sensory Impairment
This is an essential clinical finding. The presence of a
superficial perineal sensory deficit is highly suggestive of a
sacral nerve root lesion, particularly involving the cauda
equina nerve roots, or a sacral plexus lesion. These proximal
lesions usually do not cause pain and present clinically with
sensorimotor deficits, especially sensory loss and sphincter
motor disorders."

You might want to read the rest of the paragraph in the article. https://www.pudendalhope.info/wp-conten ... iteria.pdf
However, this article was written a few years back, and it doesn't exactly address the possibility of whether pudendal nerve damage not caused by an entrapment could cause sensory deficits. Also, since the article is from a few years ago, it would make sense to have a phone consultation with one of the experienced pudendal nerve specialists to get their opinion on what the current thinking is as to whether an entrapment can cause sensory deficits.

I agree with April that if you know what triggered the event it could give you some possible insight into the cause.

Violet
PNE since 2002. Started from weightlifting. PNE surgery from Dr. Bautrant, Oct 2004. Pain now is usually a 0 and I can sit for hours on certain chairs. No longer take medication for PNE. Can work full time and do "The Firm" exercise program. 99% cured from PGAD. PNE surgery was right for me but it might not be for you. Do your research.
AL456
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Re: Pudendal Nerve Entrapment or Dysfunction

Post by AL456 »

Yes,

Sensory loss (numbness) can happen with compression/entrapment of the pudendal nerve. I have had persistent numbness symptoms as well after a traumatic injury 11 months ago and have had this information verified by two world leading pudendal nerve surgeons as well as other sufferers.
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Violet M
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Re: Pudendal Nerve Entrapment or Dysfunction

Post by Violet M »

AL456 wrote: ↑Sat May 31, 2025 5:31 pm Yes,

Sensory loss (numbness) can happen with compression/entrapment of the pudendal nerve. I have had persistent numbness symptoms as well after a traumatic injury 11 months ago and have had this information verified by two world leading pudendal nerve surgeons as well as other sufferers.
AL456, I think we had this discussion in a previous thread. I think by "sensory impairment" they mean something other than numbness in that article, but I'm not sure what. They do list numbness as one of the complementary diagnostic criteria later on in the article.

Violet
PNE since 2002. Started from weightlifting. PNE surgery from Dr. Bautrant, Oct 2004. Pain now is usually a 0 and I can sit for hours on certain chairs. No longer take medication for PNE. Can work full time and do "The Firm" exercise program. 99% cured from PGAD. PNE surgery was right for me but it might not be for you. Do your research.
stephanies
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Re: Pudendal Nerve Entrapment or Dysfunction

Post by stephanies »

Elvis,

I agree that sensory loss can come from injury or entrapment of the PN, however, it can also originate with an issue at the spine affecting the distribution of the PN. Have you had MRIs of both your lumbar spine and pelvis/sacrum? I think it is good to rule these types of issues out when seeking treatment for PN.

Stephanies
PN started 2004 from fall. Surgery in 2006 and 2007. Pain decreased by 85% in 2009, pain returned worse in 12/13. Pain reduced again in 2023.
Elvis500
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Joined: Tue Jul 23, 2024 6:11 pm

Re: Pudendal Nerve Entrapment or Dysfunction

Post by Elvis500 »

April wrote: ↑Tue May 27, 2025 6:00 am Hi Elvis,

I've definitely seen people post on here who report numbness, so I think so. Violet has more knowledge about this than I do so she may be able to chime in here with more information. Was there a triggering event that seemed to create the numbness?

April

Hi April,

Apologies for the late response.

I'm not sure what might have triggered this. I used to work in construction years ago, so it's possible that could have contributed, but I can't say for certain what trigger this .

Thanks
Elvis500
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Re: Pudendal Nerve Entrapment or Dysfunction

Post by Elvis500 »

Violet M wrote: ↑Wed May 28, 2025 12:45 am According to the Nantes Criteria article for entrapment here is what they say,

"Pain With No Objective Sensory Impairment
This is an essential clinical finding. The presence of a
superficial perineal sensory deficit is highly suggestive of a
sacral nerve root lesion, particularly involving the cauda
equina nerve roots, or a sacral plexus lesion. These proximal
lesions usually do not cause pain and present clinically with
sensorimotor deficits, especially sensory loss and sphincter
motor disorders."

You might want to read the rest of the paragraph in the article. https://www.pudendalhope.info/wp-conten ... iteria.pdf
However, this article was written a few years back, and it doesn't exactly address the possibility of whether pudendal nerve damage not caused by an entrapment could cause sensory deficits. Also, since the article is from a few years ago, it would make sense to have a phone consultation with one of the experienced pudendal nerve specialists to get their opinion on what the current thinking is as to whether an entrapment can cause sensory deficits.

I agree with April that if you know what triggered the event it could give you some possible insight into the cause.

Violet
Hi Violet,

Apologies for the late response.

I'm not sure what might have triggered this. I worked in construction years ago, so that might have contributed, but I can’t say for certain if any specific event caused it.

I read the article—thank you for sharing it. I live in Northern California; do you know of any specialists in this area? I came across Dr. Stephen Mann, but I’m not sure if he’s still practicing or retired.

Thanks so much for your help!
Elvis500
Posts: 9
Joined: Tue Jul 23, 2024 6:11 pm

Re: Pudendal Nerve Entrapment or Dysfunction

Post by Elvis500 »

AL456 wrote: ↑Sat May 31, 2025 5:31 pm Yes,

Sensory loss (numbness) can happen with compression/entrapment of the pudendal nerve. I have had persistent numbness symptoms as well after a traumatic injury 11 months ago and have had this information verified by two world leading pudendal nerve surgeons as well as other sufferers.

Hello,

Thank you for this. I've seen several urologists, but none have mentioned the pudendal nerve—until when I bring it up myself. Even then, they tend to dismiss the possibility, mainly because I don’t experiencing pain just numbness in same pudendal nerve area.

Did you regain the sensory now?

Thanks
Elvis500
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Joined: Tue Jul 23, 2024 6:11 pm

Re: Pudendal Nerve Entrapment or Dysfunction

Post by Elvis500 »

stephanies wrote: ↑Sun Jun 01, 2025 7:27 pm Elvis,

I agree that sensory loss can come from injury or entrapment of the PN, however, it can also originate with an issue at the spine affecting the distribution of the PN. Have you had MRIs of both your lumbar spine and pelvis/sacrum? I think it is good to rule these types of issues out when seeking treatment for PN.

Stephanies
Hello Stephanie,

Apologies for the late response.

I’ve had a lumbar MRI, but not a pelvis or sacrum MRI. According to three different orthopedic surgeons, my lumbar MRI came back clean. I’ll go ahead and try to schedule a pelvis/sacrum MRI as soon as possible just to see what they will find.

Thank you,
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