Hello,

My problem started just over six years with bilateral sit pain (warm/burning sensation) over the ischial tuberosity, this was felt one day sitting at work without any trauma. For the first 3 years with this condition if I stood up it was barely noticeable. Since my medical history is lengthy one I will try and capture the important info below in point form,

• After numerous tests including X-ray, MRI of pelvis/lower lumbar, CT scan, bone scan all findings were normal
• Various blood work showed normal
• Various types of physiotherapy yielded no relief
• During the 3-4th year I started to experience problems with my erection (not as prominent and longer time to achieve one) and also burning after ejaculation
• At this point I asked to be referred to a neurologist who was Pudendal nerve aware after doing some reading online. As part of his evaluation he gave me a rectal exam in which he was very aggressive, the following day I started to experience warm/hot sensation in my entire pelvis and in both legs. From that point forward this would be a normal occurrence mostly when standing (I also stated to experience IT band pain as I was standing at work as I could not sit)

• Had numerous nerve blocks, pudendal, Inferior cluneal, and hamstring. The pudendal showed some short term temporary relief.
• I had bilateral pudendal decompression surgery at the end of 2011. My erection and burning after ejaculation improved by 80-85% but my sit pain/burning and warm sensation in my legs are still present. My surgeon thinks it is related to central sensitization.

Any input or feedback would be greatly appreciated. Thank you.