Ganglion Impar Block

[WS1234]

Hey Guys - going in to discuss a nerve block with the pain clinic I work with in a few weeks. The other day I received a message from a fellow CPPSer who I keep in touch with saying they had experienced some major relief from a Ganglion Impar Block. His symptomatic profile is very similar to mine (inflamed meatus, urethral discomfort), and he said that both of these systems resolved shortly after the NB. Obviously its too early to tell if it will have a lasting impact, but still kind of interesting.

I am wondering what you guys think of this approach, and what the potential downsides are. I can see there's a few posts from 7+ years ago regarding this type of NB but was wondering if anyone had more recent experiences or opinions.

[Chriss]

In my point of view, nerve blocks are not only waste of time but also it may has a unpredictable side effect. I have done ganglion block with no improvement, read my story.

[scotcan]

Let me know if you go ahead with this, and if it's successful WS.

I have similar symptoms to you and also chronic coccyx pain, so I'd be interested to find out of this works.

[prostate454]

I'm the one who has had now two ganglion impar nerve blocks. Both brought a significant reduction in symptoms (pain). I am considering a ganglion impar ablation at this point for a longer lasting effect. My symptoms are currently very much reduced at this point so I'm holding steady for now though.

I previously tried a pudendal nerve block with no impact to symptoms (including some embarrassing side effects the day of the block lol).

[scotcan]

I'm the one who has had now two ganglion impar nerve blocks. Both brought a significant reduction in symptoms (pain). I am considering a ganglion impar ablation at this point for a longer lasting effect

So I take it the effects of the nerve block are temporary and the pain comes back? Does it come back with the same intensity or reduced? What does a ganglion impar ablation consist of? Burning the nerve to kill it?

[prostate454]

Scotcan, the idea is to:

A) Dull the pain in the short term...yes. I'd rather have a single injection than have to take a bunch if antibiotics or other pain killers. But it can also help to disrupt the pain channel to the brain. There's quite a bit of info about that on this site and others - how constant pain begets more pain as more and more bandwidth is devoted toward transferring pain signals to the brain. If that cycle can be broken then it can help to heal.

B) Yes my understanding is that an ablation basically damages the nerve temporarily and disrupts the pain signals. Since nerves take a while to heal, the results can last for months in some cases.


All that said, I'm still 100% sure my problem is chronic prostatitis (inflammation of my prostate) as a result of a specific sexual encounter back in 2015 and is pathogenic in origin. Randomly I developed hip bursitis early this year from running and it has been chronic ever since. About 1.5 months ago I was prescribed diclofenac as an anti-inflammatory. About 3 weeks into that my prostate pain was 80% gone. I can ejaculate daily and there's no flare-up (unheard of now for two years). If I don't masturbate then my pain is gone almost completely. That's huge having been in pain 24/7 for 2.5 years now. While I'm hoping that it was just chance that the pain level dropped so much following diclofenac...I'm a little apprehensive on what will happen when my script runs out. We'll see...

[HCR123]

Hey prostate,
I had a similar situation early where I took antibiotics and they didn't do anything for me but I was also working out. Just like you I developed hip bursitis. Never had this in my life but got it during circuit training. I took prednisone steroid to help with the bursitis pain. And all my pain disappeared! I was thinking it was the antibiotics. But as soon as the two weeks of steroids ran out, I got IBS and all my CPPS symptoms came back. I was despondent. But I later learned it was the steroid that basically numbed the nerve pain. Wouldn't it be nice if we could get steroids on a monthly basis to help interrupt the pain? Sigh.... Anyway, hope things work out well for you. I'm dealing with a flare up myself originating somewhere in my levator ani. Had some pt done on the puborectalis and hoping that alleviates a bit of the spasm pain. I think I've gotten it the past couple times after ejaculation.

Freaking sucks but have to be patient from what I'm learning. Everyone heals at different paces. Wish there was a medication that was consistent with dulling the pain. I may try Elavil or pregablin.

[scotcan]

What type of pain does the hip bursitis cause?

The reason I ask is because for the last 10 months I get unbearable pain in my left buttock and tail bone when sitting. I can run/exercise ok and standing is fine, only when I sit do I get the pain. Could this be the same thing? I was thinking it's been caused by all the stretching I've been doing since the CPPS started.

[HCR123]

Scotcan
It would be on left and right side of buttock. It's where the hip socket is. I have it flare up when doing squats or exercising lower body for long periods in hitt classes. At times it has also irritated my sciatica. I've recently been getting the tailbone pain and have not exercised as much. I think that is just nerve pain in that area. I'm trying to stretch and have my pt show me how to try and massage the area on my own. Have to be careful cuz of sacrum and nerves there.
Fit the buttock pain try using a tennis ball or lacrosse ball. Lay or sit on it and see if that helps.

[scotcan]

HCR123
I don't get pain in the side of the buttock, it's more in the sits bone and only on the left side. Also my tail bone gets excruciatingly painful at times and is very tender to touch when sitting for long periods. What you describe sounds like Trochanteric bursitis, based on what I've read on it. I also read there is Ischial bursitis where the pain is more in the buttocks, I'll look into that and see if the Doctor can check it out - Clutching at straws here but desperate for a fix!

I've tried the tennis ball, and think that's what caused the buttock/tail bone pain in the first instance. It only materialized at the beginning of this year when I started really stretching and working on TPs after a really nasty bout of CPPS last Christmas. I fear I damaged/trapped a nerve or have done some irreversible tissue damage as it won't go away now.

[prostate454]

My bursitis pain is generally in the sides up my hips, either right above or right below the trochanter. It's like a burning and an aching feeling, a little bit tender to the touch like it's sort of bruised. The trochanter itself doesn't hurt in my case. It's maddeningly stubborn too, I've had it for about 9mo now and it refuses to go away. I have no idea why it suddenly appeared when I started running again earlier this year (I used to run a ton and never had any problems - took a couple years off from that though). And the fact that it's in both hips identically is rather odd. But MRIs of hips and back just show bursitis and no arthritis or spine issues aside from some normal ontogenic degeneration of L4-L5. I've wondered if it could somehow be linked to the prostatitis but can't really figure out how that would be.

In sad news, my diclofenac was causing bad constipation and I started getting hemorrhoids, so two days ago I stopped it in an effort to get things healed up down there. And right on cue, my prostate has blown up and started hurting badly again. I guess it's a double-edged sword, it's nice to know there is a NSAID that almost eliminates my symptoms, however it comes with side effects and really isn't a long-term solution. I'd almost rather have not tasted freedom again. I'll take this intel to my urologist in January during my next visit and see if he has any bright ideas - maybe there's a more mild NSAID that would help some. But it does once again reinforce that in my case it's the prostate itself that is inflamed and irritated. Who knows maybe after this initial flare-up post-NSAID it will die back down a bit.

[scotcan]

prostate454
Have you tried a stool softener, like Restoralax? That might help you keep taking your NSAID medication. Probably best to talk this through with a doctor, but I know people who take stool softeners every day.

[prostate454]

prostate454
Have you tried a stool softener, like Restoralax? That might help you keep taking your NSAID medication. Probably best to talk this through with a doctor, but I know people who take stool softeners every day.

I have some stool softener but unfortunately the firm stools caught me off guard and it was too late before I developed haemorrhoids. I will wait til they go away before I restart the diclofenac again. Even then I'm not sure what the end game is, I'm only 37yo so I can't see taking NSAIDs indefinitely. But arthritis sufferers do it so...

I'm going to discuss with my urologist, pain doctor, and GI doc to see what options I have. I can't believe how good it made things feel, even better than steroidal anti-inflammatories. Heck I have IBS-D and the minor constipation actually had me making what most ppl would consider "normal" stools for the first time ever in my life (no joke). Maybe i could do a month on and one month off or something like that. At least it would be something to look forward to when in pain. Or maybe there are other types that would be almost as effective but are easier on the stomach (though I didn't have any stomach problems after 5wks). We'll see either way.

It's just so frustrating that one tiny body part can be chronically inflamed and painful for years on end. I don't see living a particularly long and fulfilling life in 24/7 continual pain so even the risk of side effects of NSAIDs might be a worthwhile trade-off in the end.