Dear Brad, I know your post is quite old so you may have already gone down the surgery path. I have severe pudendal nerve entrapment and have for almost 20 years. I am about to turn 58. I, along with my neurologist did the home work to find me a surgeon. I ended up having bilateral pudendal nerve entrapment surgery. I had to travel from KY to Minnesota to get it done. I had to make three or four trips there prior to the surgery. Keep in mind that the pudendal nerve is quite long and wraps around other parts of your body. Looking back I don't know how a determination was made as to where to actually go in on both sides. I spent a week there and had a five hour surgery. It was a total failure. All that hope I had was gone and I still had to recover from a major surgery. I'd be interested to know if you had surgery and if it worked. I do have an implanted Medtronic pump system and have for about ten years. It has a compound of morphine and marcaine and is just delivering a small dose into my spine that helps block the pain signals being sent to my brain. It hasn't fixed my pain but it has done enough to keep me from jumping off of a bridge. Over time, I have learned that stress is a big flare inducer and I have worked hard to train my brain to push the pain to the back of my mind. For many years it was all I could think about. I hope you have made some progress since you posted. Believe me when I tell you I feel your pain and sympathize. Joan