Posted by lowth21 @lowth21, Mar 1, 2017

I was diagnosed with prostate cancer 4 years ago. Biopsy advised one agressive cancer and 2 not as agressive. Had a prostatectomy. Woke up from surgery with severe burning pain in and around my rear. This continued in my 3/4 days in hospital. Worst hospital stay ever. As soon as I left hospital for home, I had difficulty sitting due to the burning pain in my buttocks and down the back of my thighs.My cancer was advanced prostate cancer due to it being outside the prostate. Following radiotherapy, my PSA levels have been stable for 12 months at .04. The nerve pain down my thighs have not diminished and has radiated down under my feet. When I sit I have burning pain down the back of my thighs and burning pain under my feet when I walk. I am currently on 450mg of Lyrica a day but does not appear to be helping. As the nerve pain is bilateral (ie in both legs and feet) my doctor believes my sciatic nerve was damaged in surgery in my lower back.Urologist advised that it has never happened before. Just lucky I guess. I was wondering if any man out there has had a similar problem following prostate surgery and what treatment has worked/not worked for them as I am desperate to get this fixed.

I may not be of much help, @lowth21, but I’m prompted to mention a couple of possibly pertinent experiences. For background, my cancer was in the bladder, not the prostate, but was discovered after a TURP procedure to alleviate benign prostatic hyperplasia. Another difference for me is that PSA tests are of no value in cases of bladder cancer. A total of 12 small, low-level malignant, epithelial polyps were later removed from my bladder by a TURB procedure.

First a question: What can you tell us about the “doctor (who) believes your sciatic nerve was damaged?” About a year after my bladder surgery, I developed pain in my pelvis, buttocks, and thighs. My primary care physician (PCP) sent me to spinal pain specialists, who quickly pointed to my sciatic nerve as a prime suspect, ordered an MRI, suggested I get ready for spinal surgery, and told me to start taking steroid shots to alleviate the pain. All of these fit into the daily routine advice from the spinal pain unit. But first, I needed six weeks of physical therapy, they said.

During that time, I did some research and talked to my PCP a couple of times about possible diagnoses. We settled on trying an anti-inflammatory therapy that only becomes a diagnosis if it works! Looking for a root cause, we assumed it might be inflammation of one or the sacro-iliac joint where the spine connects to the pelvis — perhaps an after-effect of either the TURP or the TURB surgical procedures. She arranged for injecting one joint with an anti-inflammatory medication, and within a few days, the pain was gone. A second injection was never needed.

This result may be coincidental rather than causative, but I thought you’d like to have it as one of the ideas to discuss with your “doctor.” Keep us posted so we can learn from your experience and, hopefully, find other questions you can put to your medical team.

Thank you Martin for replying to my post. I did not respond immediately as I was fortunate to obtain a referral to a top Neurosurgeon who also teaches neurosurgery at university. I was very interested in your response as regards “inflammation of the sacro-iliac joint”. I read the results of my pelvis MRI which stated “No accute sacroilitis is demonstrated”. I spoke to the neuro surgeon and he has ruled that out at this stage.
My Nurosurgeon has now ordered a new MRI from a new MRI machine which apparently provided a much clearer picture of the nerves. He has ordered:
– MRI – whole spine and GAD
-MRI of the pelvis
-MRN of the sacral neurography PLUS
-Nerve Conduction test of LL inc Perineal
The surgeon mentioned he has been involved in some research of PFCN (involvement of the posterior femoral cutaneous nerve (PFCN), including its perineal and inferior cluneal branches to the symptom of “sitting pain.) which he believes “could” be a cause of my pain possible caused by the epidural durin my prostatecomy some 4 years ago.
I will continue to post here when I get further results.
Thank you so much for your reply to my post

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