Health Organization for Pudendal Education

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Hi Aussie,

Yes, it sounds like a failed PN block since you had no loss of sensation in the distribution area of the PN. That's unfortunate.

The inferior rectal nerve can be tricky because of the variations in anatomy -- sometimes coming off the main trunk of the pudendal nerve above the ischial spine, so it doesn't always respond to a pudendal nerve block even if the block is given correctly. But still, you are sort of left with an unsatisfactory feeling about that nerve block since you didn't even get numb. Do any of your doctors recommend a second block since the one you had didn't seem to be adequate for a diagnosis?

Have you tried baclofen suppository?

Violet

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So I got PN from bike riding. But I’ve tried every common drug out there for this. The only thing that works is tramadol 50 mg lasts about 5 hours. I’ve had PN for .8 years. Only advice is to not chase pain. If tramadol works take At first sign of pain. I awake each day with minimal pain. Then it starts up from bending, sitting. Best of luck

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The extended release tramadol not in my formulary so I take regular 50 mg ones. If I didn’t need bowel movements I might be fine! It causes flares. I take only one day and hope it gets me through the day. I had 12 day run of no pain and took no tramadol. This six weeks after PN block. Just goes to show that you could get better. I don’t think it was the injection. Weird.

Also I had Pn for 5 years. Went away for 6 years. Now it’s back going on 3 years. It’s heart breaking.

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aussie_surfer wrote: ↑Mon Aug 04, 2025 12:31 pm Violet (or others), would you please happen to know, is the inferior rectal branch itself able to be decompressed or accessed surgically?

I haven't heard of it being done, but there is always a first......