hazemMemberNovember 18, 2011 at 9:43 pmPost count: 3
I have a 15 years old Disc prolapse at L5-S1 which is causing numbness in my left foot from time to time. Five month ago I started having pain in anus and penis as well as my right foot. I had an MRI which states “Disc degeneration and broad based disc prolapse with left predominance at level L5-S1. Slight compression of the left S1 nerve root”. Accordingly doctors say that the pain i feel is not related to the L5 S1 disc. would you please let me know if L5 S1 disc can cause pain in penis and anus and if so can this improve by time or it is necessary to have a surgery. I can see from the MRI that the disc is touching the spinal canal (white colour)but not the nerves (the black dots ).Donald Corenman, MD, DCModeratorNovember 19, 2011 at 12:55 amPost count: 8468
You report a disc prolapse at L5-S1 which causes effacement but not compression of the left S1 nerve. You report relatively new symptoms of anus and penis pain. We can look at these complaints two ways- what causes anus and penis pain and what compression of the S1 nerve would cause.
The perineum and penis are innervated (nerve supply) from the sacral plexus. That is S2,S3 and S4. These originate from the sacrum and are rarely compressed as there are no open discs in the sacrum. The L1 nerve can occasionally cause penis and testicle pain as there is sensory nerve supply to these structures from this nerve. There would be no anus pain generated from L1 as the anus is strictly an S2-4 nerve supply.
The S1 nerve, if irritated and symptomatic (and with a small bulge that is only effacing the nerve- this is less likely to cause significant symptoms) will cause posterior buttocks pain and pain radiating down the back of the leg to the foot. Therefore, this nerve will not cause anus or penis pain.
Don’t forget that there are local diseases that can cause this pain such as infections or neoplasms.
Normally- if caused by nerve origin, anus and penis pain would be caused by a sacral plexopathy.
Dr. CorenmanhazemMemberNovember 19, 2011 at 7:06 amPost count: 3
Thanks Dr. Corenman, just to confirm what I understood is that there is a possibility that the penis and anus pain is related to the L5 S1 disc if it is pressing on the sac of nerves affecting the nerves going further down to S2-S4.
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