Underwent bilateral laparoscopic pudendal decompression in August 2025 where severe entrapment was found at Alcock’s canal/interligamentous region. I’m now about 8 months post-op. Recovery had been progressing slowly but steadily, with encouraging signs of glans nerve activity. Pre surgery symptoms were numbness in glans and anus with pain with sitting/lying down following a traumatic fall that broke my tailbone.
About 6 weeks ago after a particular event of sexual intercourse I developed a new issue with:
- ache at the scrotum–perineum junction
- intermittent perineal/scrotal stinging (has mostly improved)
- tightening/cramping in the perineum, especially with ejaculation
- random episodes of what feels like pelvic floor spasm.
- partial dip in some baseline residual sensation in glans.
The ache has remained fairly persistent since then, and I’ve had to stop sexual activity completely for weeks as ejaculation causes a significant tightening pain with pelvic contraction.
Surgeon said he felt it was a myofascial overcontraction of the superficial perineal muscles (ischio/bulbocavernosus/transverse muscles) which he described as very common after this surgery and that this had nothing to do with pudendal neuropathy itself. It’s clear that this particular sexual event triggered this issue post op.
I was wondering whether anyone with personal experience like this where it feels locked in and spasms randomly required other treatments other than pelvic PT such as muscle relaxants, diazepam suppositories, or Botox etc?.
I’ve had pelvic Botox before in the past pre surgery, but not in this context post surgery. I start back with my pelvic PT very soon where I will probably focus on down training the pelvic floor.
Only after comments from people who actually know about this or have experienced it and methods on how to treat this specifically, not spinning random misinformation.
Cheers 👍
u/Queasy-Stay5614 — 4 months ago
▲ 1 r/PelvicFloor
Some may be aware of my story.
8 months post bilateral decompression surgery for PNE where severe entrapment was found at Alcocks canal and ligaments (symptoms primarily numbness in glans, anus, and pain in seated and lying position). Things seemed to track fine. I was getting frequent internal nerve activity and promising signs of regeneration (in regards to the numbness in the glans I had).
Just over a month ago, I developed new symptoms during sexual intercourse of pain/stinging at the scortum-perineum junction. I was only partially erect using strong force and in less than ideal circumstances so I suspect this may have caused mechanical irritation of a still-healing nerve or sensitive tissue as I’m still quite early post op.
Since then, I have experienced:
- Intermittent stinging sensations in perineum/scrotum (which has settled somewhat)
- Ache or “mechanical” feeling at the scrotum-perineum junction (which may be described as a tight or pulling feeling)
- A tightening sensation in the perineum, particularly noticeable with ejaculation but also at rest.
I suspect that this may represent a flare related to nerve sensitisation, possibly with some secondary pelvic floor guarding. To be fair, I continued to have intercourse for many weeks after and pushed through pain. I abstained for a period of 8 days before resuming again to have the same problem. I have now abstained again and I’m at day 3.
Anyone experienced anything similar post op? Or in general? After a trigger.
Currently I’m considering if I engage with pelvic PT to relax the area, muscle relaxants etc.
Has anyone had that particular issue with random tightening and pain in the perineum, with a tightening squeeze and pain during ejaculation?
Never had this before this particular trigger post op. It feels like the area is stuck in a loop of frequent contraction now almost as if it’s guarding, or there’s some spasm. Not entirely sure.
I also note that sexual intercourse was mechanically fine for many months before this event.
-Positive and constructive comments only. No catastrophising, or talk of failures or negative stories. I don’t do that. This highly likely represents a flare, not a surgical failure or “scar tissue” complication as it’s linked to a direct mechanical event. I’m specifically looking for people who are realistic and helpful and actually know a bit about the topic in regard to the specific questions I’m asking.
Cheers ✌️
u/Queasy-Stay5614 — 4 months ago
Some may be aware of my story.
8 months post bilateral decompression surgery for PNE where severe entrapment was found at Alcocks canal and ligaments (symptoms primarily numbness in glans, anus, and pain in seated and lying position). Things seemed to track fine. I was getting frequent internal nerve activity and promising signs of regeneration (in regards to the numbness in the glans I had).
Just over a month ago, I developed new symptoms during sexual intercourse of pain/stinging at the scortum-perineum junction. I was only partially erect using strong force and in less than ideal circumstances so I suspect this may have caused mechanical irritation of a still-healing nerve or sensitive tissue as I’m still quite early post op.
Since then, I have experienced:
- Intermittent stinging sensations in perineum/scrotum (which has settled somewhat)
- Ache or mechanical feeling at the scrotum-perineum junction (which may be described as a tight or pulling feeling)
- A tightening sensation in the perineum, particularly noticeable with ejaculation but also at rest.
I suspect that this may represent a flare related to nerve sensitisation, possibly with some secondary pelvic floor guarding. To be fair, I continued to have intercourse for many weeks after and pushed through pain. I abstained for a period of 8 days before resuming again to have the same problem. I have now abstained again and I’m at day 3.
Anyone experienced anything similar post op? Or in general? After a trigger.
Currently I’m considering if I engage with pelvic PT to relax the area, muscle relaxants etc.
Has anyone had that particular issue with random tightening and pain in the perineum, with a tightening squeeze and pain during ejaculation?
Never had this before this particular trigger post op. It feels like the area is stuck in a loop of frequent contraction now almost as if it’s guarding, or there’s some spasm. Not entirely sure.
I also note that sexual intercourse was mechanically fine for many months before this event.
-Positive and constructive comments only. No catastrophising, or talk of failures or negative stories. I don’t do that. This highly likely represents a flare, not a surgical failure or “scar tissue” complication as it’s linked to a direct mechanical event. I’m specifically looking for people who are realistic and helpful and actually know a bit about the topic in regard to the specific questions I’m asking.
Cheers ✌️
u/Queasy-Stay5614 — 4 months ago