This topic is about someone experiencing persistent right-sided anal pain following pelvic surgery. The pain began eight months after the surgery, which left them with a rectal stump that needs regular irrigation. Their surgeon suspects a pudendal nerve injury, but the exact cause is still uncertain. They are looking for others who might have similar experiences and seeking advice on effective treatments. Here are some insights and suggestions shared by others:

1. There are no signs of infection like fever or elevated white blood cell count, and antibiotics are not prescribed without clear evidence of infection. The person has had to strongly advocate for antibiotics in the past for a small abscess.

2. After trying two pudendal nerve epidural blocks with only temporary relief, they are considering requesting pudendal nerve ablation if the second block is ineffective.

3. The pain lessens when lying on the right side or using a heating pad, but it worsens with prolonged standing, necessitating frequent changes in position.

4. There is frustration with the challenges of obtaining adequate care within the U.S. healthcare system.

Advice and insights from others include:

- Topical anesthetics like lidocaine gel can be applied to the anal canal to help dull the pain during activities such as flying or driving.

- Anti-inflammatory rectal steroids, such as steroid foam, can be applied using a finger if the applicator is difficult to insert. It's advisable to consult a gastroenterologist for equivalent products available in the U.S.

- If a bacterial component is suspected, swab cultures of the anal canal can be requested. A combination of Metronidazole (Flagyl) and Ciprofloxacin (Cipro) has helped some individuals by eliminating pain and discomfort.

- Structural issues like mucus build-up or internal anorectal prolapse might be causing intermittent pain. In some cases, prolapse is only visible during specific examinations, such as standing or squatting on a toilet rim.

- Heat and positioning, such as using heating pads and lying on the side, have been effective in reducing symptoms for several people.

- Some anecdotal dietary and topical alternatives include consuming fresh pineapple and using herbs and spices with anti-inflammatory properties. A topical cream called "Living Well Rub On Relief – Fast Acting" has provided temporary relief for some.

- Persistence with healthcare providers is crucial. Many have found that some physicians may dismiss the pain, so finding a specialist experienced in pudendal neuropathy or complex anorectal issues is important.