Penile numbness (Next steps?)

20, Male. I have been suffering with sudden, persistent penile numbness only on the underside of my penis that began during ejaculation several months ago.

Since then, I have had greatly reduced penile pleasure, no morning erections, weaker erections when standing, delayed pelvic-floor contractions during the last time I orgasmed, and occasional perineal heaviness or stinging. The numbness is even more slightly worse when erect, but strange sensations sometimes return slightly when I lie on my stomach.

Pelvic-floor therapy found a tight pelvic floor. I completed multiple sessions involving internal release, breathing, stretching, and pelvic relaxation. I can now relax the pelvic floor somewhat better, and this can improve erection quality while seated, but the penile sensation has not returned.

I also experience lower-back pain, tailbone and buttock stings, burning in my toes, one foot sometimes feeling colder, and intermittent leg twitching. More recently, prolonged standing at a standing desk caused much worse lower-back and posterior hip pain, shooting sensations toward my tailbone, leg paresthesias, and spasms in my inner and posterior thighs. External hip-rotation exercises also triggered abnormal lightness, itching, pinching, and stabbing sensations in my groin and inner thigh.

My lumbar MRI was described as fairly normal, although it showed an L5–S1 disc bulge/protrusion with some foraminal narrowing. But, the doctors are dismissing it as a culprit because they claim the pudendal nerves can only be compressed from an S2-S4 problem.

I also received a bilateral pudendal nerve block, but it did not restore penile sensation. Some of my recent leg twitching and paresthesias became more noticeable around the time of the block, standing desk use, and new pelvic therapy exercises, so Im not sure what aggravated what.

My bladder and bowel control are normal, and I can feel my bladder filling and urine passing. I have not had definite leg weakness or loss of walking ability.

I am concerned that a sacral nerve root, pudendal or dorsal penile nerve, pelvic-floor, coccyx, or L5–S1 issue is being overlooked. I have not yet had a complete neurogenital workup such as penile sensory testing, biothesiometry, dorsal penile nerve evoked potentials, bulbocavernosus-reflex testing, pelvic neurophysiology, penile Doppler, or pelvic MR neurography.

Has anyone had similar penile numbness with back, tailbone, hip, and leg symptoms despite a mostly unremarkable MRI? What specialist or test finally helped identify the cause? What are my next steps?