Turp Surgery: Still in Chronic Pain 6 Years Later

I have had pelvic pain which would come and go for many years and only figured out it was pudendal nerve when the nerve became active continuously around March of last year.
Back in the late 1990s I had a TUMP prostate surgery (microwave). I started to have pelvic pain in the area above the penis on the left and right side. I had MRIs and many ultra sounds, placed on antibiotics for months, many blood and urine tests with 5 different urologist and they could not figure what was causing the pain. I had retrograde ejaculation after the tump and when I ejaculated I would be in much pain. I also had a burning at the tip of the penis. They told me there were a lot of clogged vessels and debris and told me they would go in and remove some of the debris. They did the surgery and the pain came back. I gave up and learned to live with the pain. It would come and go. Then about four years ago when it became active I had urinary incontinence, frequency, telex/urge and some passive fecal incontinence. I also would get electrical spikes in my rectum area, tingling of the skin in the pelvic area and other new pains.
In March 2022 the nerve became active and has stayed active. I got a new sensation which was burning in the rectum area. My psa was high and I had an mri and it showed a high probability of prostate cancer. At this time my front Pelvic area became inflamed and tingling. The urologist said I did not have an infection and it was nerve pain. They were more interested in the prostate cancer. I had the pain after ejaculating and the pain did not go away and it was getting so bad I did not do my walking some days. I had a prostatectomy for the cancer and I felt I would get rid of the pain which I thought was pressure in the seminal vessels.
The pain went away after surgery and I got pain in the rectal area and the urinary sphincter area. The rectal pain got so bad I could not sit and I had pain feeling I had to make a bowel movement even after going. Then when I really had to go the pain would feel like a gas pain through my whole body and it would come out. This pain was off scale. The pain would then drop. The pain in the urinary sphincter area made me feel I had to go all the time. I was having bladder spasms with the catheter in and when it was taken out. When I coughed there felt like electrical jolts down my right leg, it was jarring. I went for pelvic pt and the pains have gotten much better. I still have some pain sitting, I use a donut and a feeling/ burning in the urinary area, tingling of the skin area and a feeling I done too many sit-ups in the front pelvic area. These pains are minimal and just remind me the nerve is active. I feel fantastic, the best in 15 years. I can not believe how much the pain was affecting me and my energy and mood. I am still wearing heavy protection to manage the urinary urge/reflex//stress incontinence having almost no control which is frustrating but in the scheme of things having minimal pain everything is great.
My nerve seems to magnify small pressures into large pain, it is hypersensitive. Everybody nerve pains are different and it depends on the nerve which has been hurt. I do not know what is affecting the nerve but am trying to manage it. I am on cymbalta which helps pain some and reduces anxiety. The pudendal nerve can have many things happen to it like scar tissue around it, muscle tension, entrapent.
If the pain your husband has came immediately after the surgery I would think it was damaged by the turp. I am not a doctor but if they figure out which nerve it is some people use nerve blocks or have ablation. I was in a car crash and had nerve pain in my arm due to the ligament damage in my shoulder. I was on extremely high doses of Lyrica and it did almost nothing for the pain then they put me o cymbalta and the pain went away. I still have to be careful not to aggravate the arm.
I wish your husband the best and hope something can be done. Living with nerve pain is horrible. I fear that something else will happen in my pelvic area to set the nerve off. Best wishes to all

Have you considered seeing a pain doctor? Many are anesthesiologists are the most knowledgeable doctors in pain treatment. I would guess the procedure hit a nerve that is causing the pain. Has he ever addressed this with the surgeon who did the procedure since it is not normal?

The only thing that has helped my husband is using a tens unit and we put the patches on his lower abdomen once or twice a day. He has balance issues after a stroke 13 years ago and the lyrica helped for a month but stopped working and it also made his balance worse. He uses a walker. He has seen a pain Dr and tried spinal injections but can't find the right nerves. He was going to try a spinal stimulator but they said he would have to be off his blood thinners too long and would be dangerous for him and may not provide relief.

Consider acupuncture since you most likely haven’t tried this previously.