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Ask Dr. Bob Your Own Question
Dr. Bob
Dr. Bob, Medical Doctor
Category: Medical
Satisfied Customers: 5120
Experience:  20 Years in Internal Medicine, Neurology and Sports Medicine
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It feels like someone driving a needle into the back of the

Customer Question

It feels like someone driving a needle into the back of the head of my penis.II just had a cat scan done and a urinalysis by a urologist and he said everything was okay however, I still have this pain in my penis it's a constant pain just enough to aggravate the hell out of me. If I put a clamp on the base of my penis and squeeze the skin together the pain subsides quite substantially. Please Dr tell me what you think is wrong with me.
JA: How long have you been dealing with the issue? Is this your first time reaching out for information about it?
Customer: It's been going on on and off for a couple of years and I've been to a couple of doctors no one can find out what's wrong with me.
JA: Anything else in your medical history you think the doctor should know?
Customer: Not that I know of.
Submitted: 2 months ago.
Category: Medical
Expert:  Dr. Bob replied 2 months ago.

Is the pain worse with sitting? No you have normal urinary and sexual function?

Customer: replied 2 months ago.
The pain is better when laying down, hurts more when on feet.
Customer: replied 2 months ago.
Just had urinary pressure analysis at the doctor and says my pressure was fine. Sexual function is fine. Prostate is fine.
Expert:  Dr. Bob replied 2 months ago.

It sounds like you migh have pudendal neuritis. Have you discussed this with your doctor? Pudendal neuritis is an unusual problem with the pudendal nerve that can affect both men and women. The pudendal nerve runs through your pelvic region, including your genitals. The condition is also known as pudendal neuropathy, pudendal nerve entrapment, cyclist's syndrome, pudendal canal syndrome, or Alcock's syndrome. The cause of PN is unclear. The pudendal nerve can be compressed or entrapped. Numerous potential nerve compression zones exist.

Expert:  Dr. Bob replied 2 months ago.

MRI allows for PN to be classified, based on the entrapment site: type I, in the sciatic notch; type II, the ischial spine and sacrosciatic ligament; type IIIa, the obturator internus muscle; type IIIb, the obturator internus and piriformis muscles, and type IV, the distal branches of the pudendal nerve. Normal imaging findings do not exclude a diagnosis of PN.

Customer: replied 2 months ago.
Does this require surgery to fix?
Expert:  Dr. Bob replied 2 months ago.

Management includes the treatment of neuropathic pain (with gabapentin, pregabalin, duloxetine, amitriptyline), percutaneous posterior tibial nerve stimulation, physiotherapy, osteopathy and short-term psychotherapy. The effect of anesthetic infiltration of the pudendal nerve is limited. In refractory forms, transgluteal decompression of the pudendal nerve has been effective. In those where surgery has been ineffective, an implantable neurostimulator at the level of the terminal cone can be proposed.

Customer: replied 2 months ago.
No my doctor did not catch that he did not do a MRI. This condition will not kill me will it?
Customer: replied 2 months ago.
Dr. Bob, thank you very much for your time and you have a wonderful day.
Expert:  Dr. Bob replied 2 months ago.

PN greatly affects quality of life, but has no effect on life expectancy.

Expert:  Dr. Bob replied 2 months ago.

You're welcome. Hope all works out for the best.