Hi,
Thank you for posting your query at DoctorSpring.com.
You have undergone detailed investigations to diagnose the neuropathy and I agree with the findings, your doctor's observations and recommendations.
At present, no further tests are available to localise the neuropathy any further or establish its cause.
Also, the location is not amenable to nerve biopsy (as we would do for neuropathy in other locations).
Other causes of erectile dysfunction have been excluded by doing penile doppler, MRI limbo-sacral spine and psychological assessment.
I also agree with your current treatment plan.
I hope it helps. Please get back if you have any further queries.
Best wishes,
Dr. Sudhir Kumar MD (Medicine), DM (Neurology)
Senior Consultant Neurologist
Patient replied :
Thank you for your quick reply. I have 2 follow up questions:
- I reckon neuropathy due to compression is a possibility. In this case is there physical therapy or specific care that can be useful ? I encountered references to a phenomenon called "pudental nerve entrapment". Can this be excluded?
- Lifestyle changes: Should I refrain from cycling, get special orthopedic cushioned seats for working? Does moderate drinking worsen the problem ?
Thank you for getting back.
Back extension exercises would be useful.
Pudendal nerve entrapment would have been excluded by nerve conduction studies.
Cycling for short distances is fine. Prolonged cycling may cause more pressure in the perineal area leading to some nerve damage.
Similarly, moderate alcohol intake may adversely the nerves. However, occasional or small amounts of alcohol is fine.
Best wishes
Patient replied :
Dear Sir . The MRI report, which I haven't shown to any doctor yet, refers "stenotic dimensions of the raquidian channel". Could this be the cause? How would it have been excluded ?
Thank you for getting back.
I am not sure of this finding. If possible, please upload the complete MRI report, then, I can give my opinion.