perineal pain

[nvrsumr]

55 yo mva with perineal pain worse with sitting. No trauma to area. Pain on palpation of ischio pubic ramus and relieved with lifting testicles cephalad. No allodynia.

I know I can block/pRF every nerve under the sun but any specific ideas?

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[NOSfan]

Try blocking either the coccygeal or pudendal nerves.

 

[SSdoc33]

Ask ligament

Pudendal neuralgia comes to mind

 

[NEA]

Sounds like pudendal nerve to me. You can get an emg/ncv of the pudendal nerve too for supporting evidence but Nantes Criteria is the best.

 

[BobBarker]

Epididymitis

 

[nvrsumr]

Prudential and coccygeal sound good. Just seems more somatic. Ordered pelvis MRI.

I'm not doing that Emg haha

 

[Ligament]

R/o the usual crap first, if ruled out its likely pudendal neuralgia

 

[powermd]

Epididymitis

I was thinking about something along this line. Why would the pain improve with lifting the testicles otherwise?

 

[NOSfan]

Why would the pain improve with lifting the testicles otherwise?

Perhaps this is equivalent to a SLRT

 

[lobelsteve]

Why would the pain improve with lifting the testicles otherwise?

I feel better when someone lifts my testes.