Cyclist’s Syndrome AKA Prudendal Neuralgia

[Spud1969]

Hi Everyone

About six weeks ago after riding my bike for 7 days in a row, averaging about 14 miles per day I developed a pain in my perineum. The pain switched from an ache, a throb and an electric shock type twinge shooting up into my lower stomach. I even had penile discharge (gross). I thought it was extreme 'saddle sore' but after a week or so, the pain got so bad I had to visit my doctor. I was checked for STIs and water infections, which all came back clear and even had the the doctor checking my prostate which was normal.
The doctor thought I may have prostatitis and gave me a 2 week course of antibiotics which did nothing really, but having done my homework I now think I may have Prudendal Neuralgia.

My symptoms are better than they were, but even after all these weeks I am still suffering a lot.

My question is has anyone else suffered from this and how long does it last. I'm scared that I will never enjoy riding my bike again. I have even bought a new saddle, an ISM PR2.0 to help me when I do (if) re-start cycling.

I have attached a link where it explains the condition, including its symptoms, of which I have many but it doesnt give a clear idea of how long it lasts. I will be making another appointment with my doctor shortly to see if she agrees with my self diagnosis.
Here's the link http://www.pudendalhope.info

 

[classic33]

Be wary of self diagnosis, making the symptons fit with what you've found out.
You may be wide of the mark, worrying yourself for no reason. Or you might be part right/all right in what you have found out. Let the tests give you some idea of what you're facing.

Hope your mind is soon put at rest.

 

[drummerbod]

When you say penile discharge - is that clear sticky fluid? I thought that was normal on occassions for cyclists (male obviously).

 

[Racing roadkill]

Sounds more like you've crushed up the nerves in the gooch. I don't know what the correct medical term for 'gooch' is, but it's the bit between nuts and buts. If they are just inflamed, they will settle down in a week or so, if you've trapped a nerve, that will need surgical intervention. Check for a hernia as well.

 

[machew]

cutting off the nose to save the penis. This may help

 

[fossyant]

Wait and see how things go, but certain saddles can cause issues. Everyone is different though.

You haven't hit a pothole or some such whilst sat on the saddle ?

 

[slamy]

I've seen to come up with this also. I was riding zwift on my trainer hard all through Jan and same type of symptoms. dr. didn't seem to concerned and gave me 12 days of a corticosteroid which seemed to help a little bit. My symptoms are much better but recovery seems slow. Has yours cleared up and how long did it take? I'm on my 6th week off the bike as well.

Hi Everyone

About six weeks ago after riding my bike for 7 days in a row, averaging about 14 miles per day I developed a pain in my perineum. The pain switched from an ache, a throb and an electric shock type twinge shooting up into my lower stomach. I even had penile discharge (gross). I thought it was extreme 'saddle sore' but after a week or so, the pain got so bad I had to visit my doctor. I was checked for STIs and water infections, which all came back clear and even had the the doctor checking my prostate which was normal.
The doctor thought I may have prostatitis and gave me a 2 week course of antibiotics which did nothing really, but having done my homework I now think I may have Prudendal Neuralgia.

My symptoms are better than they were, but even after all these weeks I am still suffering a lot.

My question is has anyone else suffered from this and how long does it last. I'm scared that I will never enjoy riding my bike again. I have even bought a new saddle, an ISM PR2.0 to help me when I do (if) re-start cycling.

I have attached a link where it explains the condition, including its symptoms, of which I have many but it doesnt give a clear idea of how long it lasts. I will be making another appointment with my doctor shortly to see if she agrees with my self diagnosis.
Here's the link http://www.pudendalhope.info

 

[kingrollo]

Pudendal neuralgia is an extremely rare injury - From what you describe I would say it isn't that - at the very most I would say trapped rather than damaged nerves,

I would rest until it eases - get a saddle with a cut out, decent shorts - and then get a bike fit.

 

[vickster]

If it doesn't get better with a sustained period off the bike, get the GP to refer you to urology (if you have private HC, go that route asap)

 

[Crackle]

Be cautious with online symptoms. Most of us can read up on anything and decide we've got half the symptoms but a doctor will know enough to recognise which are the key ones.

It may well be just your saddle. I recall my first long ride on an old plastic saddle on my Carlton in the 70's. It would be an understatement to say it caused me discomfort and was my first lesson in saddle shape and fit and bike setup.

 

[slamy]

Thanks for the replies. My personal history on riding long distances started in 1983 when I was in jr. high. I raced in the mid to late 1980's as a jr. and in 1988 went off to college and law school and got out of the sport until about 2000 where I picked the sport back up. I've always prided myself on being able to ride long distances with no problems regardless of my seat. The last 15 years I've been on a fizik allainte with probably over 30k miles on it. (replaced seat couple times same model.) A couple years ago I did 7500 miles in a year no problems. In Oct. I replaced my frame and set up the new one like the old one. However, I think my seat was a little tilted up than normal and the boys fell asleep a few times during ride but rather than take the time to adjust it correctly I just kept riding. In late Jan after a month where I rode all but maybe 3 days, in the middle of an interval I felt some sharp pains in the crease between the leg and groin. It felt like my bibs were pulling up so I kept pulling them down and riding through the pain. The next day I was sore so I decided that I'd just wear two pairs of shorts and did another hour on the bike. The following day I was in pain. It felt like I had to go to the bathroom all the time and there was just a general discomfort in the whole region. I decided to take a couple days off and I should be good to go. Well that ended up being about 3 weeks and I was feeling better and decided better get back on the bike. I road 2 days and symptoms came back so I took another week off and went to my Dr. He thought maybe i'd irritated my prostate and gave me 12 day pack of corticosteriod and within the first couple days I figured .. dang it's gone. But by day 8 there was still discomfort. On a pain scale maybe a 2; not severe pain but annoying and it's worse when sitting at work. Anyhow, I was wondering if anyone has had this issue before? I plan on visiting my urologist next week .. fun fun but I'm staying off my bike until this gets sorted out.

 

[kingrollo]

Thanks for the replies. My personal history on riding long distances started in 1983 when I was in jr. high. I raced in the mid to late 1980's as a jr. and in 1988 went off to college and law school and got out of the sport until about 2000 where I picked the sport back up. I've always prided myself on being able to ride long distances with no problems regardless of my seat. The last 15 years I've been on a fizik allainte with probably over 30k miles on it. (replaced seat couple times same model.) A couple years ago I did 7500 miles in a year no problems. In Oct. I replaced my frame and set up the new one like the old one. However, I think my seat was a little tilted up than normal and the boys fell asleep a few times during ride but rather than take the time to adjust it correctly I just kept riding. In late Jan after a month where I rode all but maybe 3 days, in the middle of an interval I felt some sharp pains in the crease between the leg and groin. It felt like my bibs were pulling up so I kept pulling them down and riding through the pain. The next day I was sore so I decided that I'd just wear two pairs of shorts and did another hour on the bike. The following day I was in pain. It felt like I had to go to the bathroom all the time and there was just a general discomfort in the whole region. I decided to take a couple days off and I should be good to go. Well that ended up being about 3 weeks and I was feeling better and decided better get back on the bike. I road 2 days and symptoms came back so I took another week off and went to my Dr. He thought maybe i'd irritated my prostate and gave me 12 day pack of corticosteriod and within the first couple days I figured .. dang it's gone. But by day 8 there was still discomfort. On a pain scale maybe a 2; not severe pain but annoying and it's worse when sitting at work. Anyhow, I was wondering if anyone has had this issue before? I plan on visiting my urologist next week .. fun fun but I'm staying off my bike until this gets sorted out.

Whats your generally flexibility like ? - If its all getting tight in the groin area - then you are going to get the irritation and your bits are pulled as you pedal.
Check your hamstrings as a starting point - or just start a stretching regime.
I was cycling for years any set up, any saddle - then pretty rapidly this groin pain and tightness came on - like yourself I rode on - eventually I was ridding in total agony - and just had to stop - I then couldn't sit down on any surface for 6 weeks !
Eventually (like 3 years !!!!!!) - I finally got to see someone who was an expert in hamstring pathology. He injected local anaesthetic around the point where the hamstring joins the pelvis - then did 2 rounds of dry needling - then with lots of core and eccentric hamstring exercises - I got back on my bike.
What he said to me is that as you get older things change - he reckoned the one hip joint was showing minor wear which meant the hamstring was overworking and pulling on the groin area - so although those saddles\set up may have been fine for you years ago you might need something a bit more specialised now.

I noticedafter one particular ride - I could see an indentation on my plastic saddle - I was digging into the saddle - even through padded shorts - I tried an ISM saddle which was better - but the brooks leather really did the trick - looks a bit daft on a CF bike - but at least Im out there !