4 months 13 days post op in Pudendal Decompression Surgery

Things to be grateful for
-Went out for a walk this morning despite the high humidity/ heat and increased pain
-Was able to talk to some more PN folks.
-Had a few good hours of the day early in the day
-So far the bladder pain is not out of control (knock on wood)
-I was able to rest my brain a lot today.
-I was able to shower
-I was able to do some reading

Bad things
-A lot more burning pain today than normal
-I can feel the digestive pressure causing me stinging and stabbing feelings.
-Last night I was horribly mentally distressed because of the pain.
-Mentally beating myself up, asking myself what I will be good for anymore?
-Sad that I can’t just appreciate the good parts of the day I have ( I do have them)..
-Worried that the kratom I am taking is flaring up my digestive system but its literally the only small amount of relief I get from this pain.
-Brain fog and tiredness seems to be an issue for me more so than normal.

What is pudendal Neuralgia?

PN is pain, discomfort or numbness in the distribution of the pudendal nerve. The pudendal nerve is a peripheral nerve that is the main nerve of the pelvis/ pelvic floor. The pudendal nerve emerges from the S2, S3, and S4 roots’ ventral rami of the sacral plexus. It carries sensory, motor, and autonomic fibers, however an injury to the pudendal nerve causes sensory deficits more than motor. These areas include the rectum, anus, urethra, perineum, and genital area. In women this includes the clitoris, mons pubis, vulva, lower 1/3 of the vagina, and labia. In men this includes the penis and scrotum. But often pain is referred to nearby areas in the pelvis. The symptoms can start suddenly or develop slowly over time. Typically pain gets worse as the day progresses and is worse with sitting. The pain can be on one or both sides depending on which nerve fibers and which nerve branches are affected. The skin in these areas may be hypersensitive to touch or pressure (hyperesthesia or allodynia). This is a chronic/ lifelong issue that does not have many treatment options.

What is pudendal nerve entrapment syndrome?

This is PN pain caused my a mechanical compression/ entanglement of the pudendal nerve between ligaments or scar tissue. Usually the sacrotuberous ligament and or the sacrospinous ligament. The only way to really definitively tell if you have a nerve entrapment is via surgery although some other specified imaging techniques which are able to image/ doppler where there is a hold up/ issue with nerve within scar tissue. This phenomenon is still debated and under studied. Pudendal decompression surgery is how this issue is diagnosed.