Pudendal nerve block scheduled for the first time

[Balenul]

This blocks kinda fail for urethral / urinary symptoms so i can t rule out pn or pne with them.I had 2 both useless but i am not convinced my pudendal nerve is fine.

[Balenul]

I have been scheduled for a pudendal nerve block for sitting pain and penal pain which occurred after a prostatectomy. I had pain prior to this for many years in the Perinium area that they thought may be prostatsis so I suspect the pudendal nerve was hypersensitive prior to my prostatectomy. I also have frequent urination feeling like I have to urinate all the time and urge. The pain is stopping me from driving long distances. Also I have awoken to tremendous pain throughout my pelvic area up through the bladder.
I am getting very little sleep and am depressed. I have tried pelvic physical therapy and cymbalta. I am getting the nerve block to see if it helps and also it can identify if it is the pudendal nerve. I think it is because I have experienced many different pains in the pelvic area. I have read many post that have not been positive but I have to try something. I would be happy if the pain could be lessened to a tolerable level. Do we have people on the forum who have been helped?

is your permanent urge to urinate located in urethra ?

[Balenul]

Hello April and Violet,

Thank you for your support and advice! The software therapy is painful only during the treatment, and the pain goes down from 6-7 to 4-3, but unfortunately, the pain relief is not prolonged. The doctor says that we need to focus on reducing inflammation and wait for the final result. I had 20-30 minutes of no pain yesterday at all, and it was so weird. and I was so happy!

My next steps are:
1. I will speak with my pain clinic about a new medication that was recommended by Violet. I have an appointment today.
2. I want to try dry needling therapy for my piriformis muscles, which are painful and get stiff very easily after the nerve block.
3. I have a scheduled appointment with my urologist about nerve stimulation because I am a good candidate for a trial.
4. All my MRIs don’t show any signs of damage or nerve entrapment, which leads me to think that I am not a candidate for a surgical procedure.
5. May try PT again
This is the link to the software therapy in case someone is interested in reading about it https://softwavetrt.com.

PS: I just spoke with my pain management doctor. She won’t prescribe me any opioids. She gave me amitriptyline 10 mg on top of my Lyrica 75 x 2.

I asked a few questions about the nerve stimulator, and she said that anyway we need to get a nerve block without steroids to be sure that my pain is nerve pain, not muscle pain.

Also, my bladder is a problem too. It's painful and overreacting. I wake up a few times during the night; it's hard to relax to pee.

The pain clinic doctor said that we need to make sure which stimulator will help.

I think I need to wait for my appointment with my urologist (Dr. Peters) and make a final decision about what I am going to do. If I can’t avoid the nerve block, I need to be aware of the upcoming flare-ups after the injection, and I will need heavy painkillers to get through that crazy pain. Any suggestions

a big hug from me.
Hanna

Dr Peters told me neuromodulation could help pelvic floor dysfunction also.What nerve block you talk about ( pudendal ? ) . For me the block did nothing.I have no sitting pain just severe urethral symptoms

[Camelote28]

Yes, before any of manipulations, my doc wanted to do a pudendal nerve block.
I didn’t, because I had a bad experience in the past.
I had a few weeks break from my pain. But now I am back to 6/10 unfortunately.

[stephanies]

Balnful,

It seems to me it would make sense to try Botox before neuromodulation if PFD is suspected. With the muscles relaxed you would be able to evaluate how much the tension is contributing to your symptoms. I also think MRIs of the lumbar spine and pelvis/sacrum are useful in ruling in or out any spine issues that could be the underlying cause of PN.

Stephanies

[JeanneJ]

Violet,
I never got an email that I had a message. I never had Chronic pelvic pain until my IC got very bad in 2022. I had a Cystoscopy, followed by 6 Bladder installations and internal PT. I believe all of that trauma in my pelvic area triggered it. I am using Gabapentin/Baclofen suppositories and getting Acupuncture. I was improving, pain level down to a 3. I had to stop the suppositories and have a Colposcopy at my GYN. After that my pain worsened so I think these internal procedures set me off. I went to PT again last year and we both agreed it wasn't helping. I tried it with another Therapist.

[Violet M]

Jeane, in order to receive an email that you got a message you would need to go to the User Control Panel, then to "Board preferences" tab, then to "Edit notification options". You can change the settings to receive an email if you get a message. To get to the User Control Panel click on your username in the upper right corner and instead of logging out, go to the User Control Panel.

The pudendal nerve innervates the external bladder sphincter so there can be some overlap with the symptoms of IC. All of those pelvic procedures could definitely play a role in triggering worse pain.

Sounds like you've been through a lot with all of those procedures. It can be exhausting. PT didn't help me either. It turned out I had a nerve entrapment that needed to be released surgically. I'm doing well now, 20 some years later.

Wishing you the best as you search for the right treatments. Sending hugs and prayers,

Violet