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Having Pain In Testicle And Leg. Am I Having Pudendal Nerve Damage? What Is Going On?

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Posted on Sat, 3 Nov 2012
Question: Hello,
I am working with a Urologist right now and have been since having surgery on 08/29. Have usually pain in testicular area that is making me very uncomfortable. Working with Dr. Siegrist now whom has been very helpful but like to get more ideas on what is going on with me. In a great deal of pain and seeing all sorts of doctors.
WWW.WWWW.WW Not sure it's related but I have been competitive cyclist from age 18 to age 28 over ten years and did a great deal of running as well. Currently 44 with pain and having issues with left leg. Scheduled for MRI today to look at back and nerve related issues.

Found this information below.

Pudendal nerve damage
Pudendal nerve damage (neuropathy), also called "bicycle seat neuropathy XXXXXXX may cause numbness or pain. Pudendal nerve damage can result from the pressure of prolonged or excessive bicycle riding (e.g., competitive cycling), especially improper seat position or riding techniques are used. Special bicycle seats have been designed to decrease pressure on the perineum, potentially preventing or resolving this problem.

Pudendal neuralgia is the painful type of this nerve damage. Sometimes called "cyclist's syndrome XXXXXXX pudendal neuralgia is painful inflammation of the pudendal nerve. The pudendal nerve carries sensations to the genitals, urethra, anus, and perineum (area between the scrotum and anus), so the pain can be felt in any of these areas. Pain can be piercing and is more likely to be noticed while sitting.One thing I have been thinking about is having "exploratory surgery" to rule out anything but surgery is not always a good fit according to Dr. Siegriest. Just trying to fix all the is pain I am having. Request records from surgery but I would think after having several ultrasounds they would see something in the scrotum area to raise flags. Blood flow is good to testicular area and urine is clean. Just getting pulsating pain in the area. Pain floats back and forth to left and right testicular area.
Another question I have is since I had torsion on the right would this have anything to do with referring pain down the leg? Think this is truly a nerve pain from back? Sending link to MRI here. Let me know if you can see this information. Also urine has been clear but seem to frquency of urinating in more? Like 3-5 times a night is this normal?

WWW.WWWW.WW or you can try this one also
WWW.WWWW.WW
doctor
Answered by Dr. G.Srinivasan (16 hours later)
Hi,
Thanks for your query to XXXXXXX
I appreciate your time for the detailed history.
I understand that you have been an active and enthusiastic cyclist for a long tme.
Pain in the skin areas superficial to the testes are likely to be part of the pudental nerve problem.
If the pain is XXXXXXX seated - that is from the testes, needs to be evaluated by a urologist. Dr. Siegrist would be the best person.
Leg pain as you had rightly thought is usually nerve pain from the back.
Urination 3 to 5 times at night is not normal for your age. If there are associated symptoms like burning or blood in urine, Dr. Siegrist would be able to guide you.
If it is purely frequency, then try if water restriction after 6 pm helps.
Unfortunately i am not an expert in reading MRI, a report would be of help.
Surgical procedure without understanding the problem completely, can become more troublesome and hence not advisable.
Hope this helps, Kindly get back for doubts if any.
Regards
DR GS
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. G.Srinivasan (18 days later)
DR GS,
I have been to a Orthopedic Doctor this week and had a steroid injection my back but for some reason the left testicle is hurting even more now. Could be completely unrelated but wanted to let you know. I did speak to Dr. Siegrist today and he said as a last resort could remove the testicle but it may not solve the issue. Just want to get some relieve here I have had this since 08/21/12 almost 45 days and continue to take heavy meds to get by it's affecting my quality of life these day. I thinking about a second opinion my certain they will tell me the same thing here. The question I have is if they let's say blocked sperm to one testicle during surgery from the past would that surgery affect me now on the left side? Thanks for all your help.
doctor
Answered by Dr. G.Srinivasan (4 hours later)
Hi,

Welcome back.
Blocked sperms are not diagnosed during operation. It is usually diagnosed before surgery by scan or special XXXXXXX tests.
Testis removal- as he thinks - may not solve the problem.
Family factors need to be considered before the decision.

I feel PAIN THERAPIST WOULD BE OF SIGNIFICANT HELP. They usually follow a step ladder pattern and i have seen this useful in the united kingdom. Kindly speak to your doc on this and pls take a consult with the pain therapist.

Wishing you best health always,
REGARDS
DR GS
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. G.Srinivasan

Urologist

Practicing since :1991

Answered : 1412 Questions

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Having Pain In Testicle And Leg. Am I Having Pudendal Nerve Damage? What Is Going On?

Hi,
Thanks for your query to XXXXXXX
I appreciate your time for the detailed history.
I understand that you have been an active and enthusiastic cyclist for a long tme.
Pain in the skin areas superficial to the testes are likely to be part of the pudental nerve problem.
If the pain is XXXXXXX seated - that is from the testes, needs to be evaluated by a urologist. Dr. Siegrist would be the best person.
Leg pain as you had rightly thought is usually nerve pain from the back.
Urination 3 to 5 times at night is not normal for your age. If there are associated symptoms like burning or blood in urine, Dr. Siegrist would be able to guide you.
If it is purely frequency, then try if water restriction after 6 pm helps.
Unfortunately i am not an expert in reading MRI, a report would be of help.
Surgical procedure without understanding the problem completely, can become more troublesome and hence not advisable.
Hope this helps, Kindly get back for doubts if any.
Regards
DR GS