DEAR READER: Pudendal nerve entrapment occurs when a nerve in the pelvic area becomes compressed or trapped. It can be the result of post-surgical scarring, pregnancy or trauma. Activities such as riding a bicycle are known to trigger the condition.

Symptoms include pain when sitting that is reduced or eliminated by standing, lying down or when on a toilet seat; paresthesias in the buttock and genital areas; urinary hesitancy and/or urgency; constipation; impotence; sexual dysfunction; and a great deal more.

Treatment varies depending on the underlying cause and how long symptoms have been present. If you are a cyclist, that prolonged activity should be reduced. There are a number of medications — nerve stabilizers, antidepressants or anticonvulsants — that might reduce or alleviate the pain. When all else fails, treatments such as corticosteroid injections or nerve blocks may be appropriate.
Speak with your physician who knows your history and can recommend appropriate advice or medication. Then, if and when conservative measures fail, request referral to a top-notch surgeon for the problem.

To provide related information, I am sending you a copy of my Health Report “Managing Chronic Pain.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.