Which Specialist to Consult for Perineal Nerve Pain?

For perineal nerve pain, you should consult a specialist in neurology or pain management?

Hello, doctor.
1.
I experience sharp pain in the perineal nerve when sitting, just after waking up in the morning, or after walking for a long time, but standing still does not cause discomfort.
2.
There is no pain during urination or defecation.
3.
After ejaculation, I experience sharp pain in the perineal nerve.
I have consulted both urology and neurology, and medications have not improved my condition.
The rehabilitation physician just suggested that I see a urologist again.
I found information indicating that my symptoms may be related to perineal nerve entrapment syndrome, but I am not sure if this is the correct diagnosis.
Which specialty should I consult for this condition? Thank you.

Hengzi, 20~29 year old female. Ask Date: 2019/06/28

Dr. Ye Qianyu reply Family Medicine

Hello! It is recommended that you consult the Pain Management Clinic for treatment.
Thank you for your inquiry, and I wish you a speedy recovery!

Reply Date: 2019/06/28

More Info

When dealing with perineal nerve pain, it is essential to consult the right specialist to ensure accurate diagnosis and effective treatment. Based on your symptoms, which include pain in the perineal region during sitting, after ejaculation, and prolonged walking, it is possible that you may be experiencing a condition known as perineal nerve entrapment or pudendal neuralgia. This condition can be quite complex and often requires a multidisciplinary approach for management.

1. Urology: Since you have already consulted a urologist, this is a good starting point, especially if your symptoms are related to urinary or sexual function. Urologists specialize in the urinary tract and male reproductive system and can rule out any underlying conditions related to these areas.

2. Neurology: A neurologist is another appropriate specialist to consult. They can evaluate your nerve function and determine if there is any nerve damage or entrapment contributing to your symptoms. Neurologists are skilled in diagnosing conditions related to nerve pain and can offer treatments such as medications, nerve blocks, or physical therapy.

3. Pain Management Specialist: If your pain persists, you might consider seeing a pain management specialist. These doctors focus on treating chronic pain conditions and can provide a variety of treatment options, including medications, injections, and alternative therapies.

4. Physical Medicine and Rehabilitation (PM&R): A specialist in PM&R, also known as a physiatrist, can help with rehabilitation strategies. They often work with patients suffering from nerve pain and can recommend physical therapy, which may include exercises to strengthen the pelvic floor and improve nerve function.

5. Pelvic Floor Physical Therapist: If your symptoms are related to pelvic floor dysfunction, a physical therapist specializing in pelvic health can provide targeted therapy. They can help with exercises and techniques to relieve tension in the pelvic area, which may alleviate your symptoms.

6. Multidisciplinary Approach: Given the complexity of your symptoms, a multidisciplinary approach may be beneficial. This could involve collaboration between urologists, neurologists, pain specialists, and physical therapists to create a comprehensive treatment plan tailored to your needs.

In summary, while starting with a urologist is appropriate, you may benefit from consulting a neurologist or a pain management specialist for further evaluation of your perineal nerve pain. Additionally, consider seeking out a pelvic floor physical therapist for targeted rehabilitation. It is crucial to communicate your symptoms clearly to each specialist to ensure they understand the full scope of your condition, which will aid in accurate diagnosis and effective treatment.

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