Has anyone possibly had an ultrasound or MRI(or EMG) to specifically show the pudendal nerve and check for some form of entrapment. I have no idea if this is any kind of cause, I am just throwing out suggestions and trying to investigate all potential avenues. I've been doing physical therapy for over a year, stretches, and had trigger point injections intrarectally into the pelvic floor muscles without much success or relief(I probably am worse). I also have certain symptoms that would seem to point to a neurological dysfunction of some kind like intense tingling down the legs and in the feet which is correlatively triggered when having bowel movement especially, but sometimes just sitting. From a paper published in April of this year on 'Pudendal Nerve Entrapment Syndrome' in the NCBI journal:

"Anatomy of the Pudendal Nerve:

The pudendal nerve emerges from the S2, S3, and S4 roots' ventral rami of the sacral plexus. It carries sensory, motor, and autonomic fibers; however, an injury to the pudendal nerve causes sensory deficits more than motor. It courses between two muscles, the piriformis and coccygeus muscles. It departs the pelvic cavity through the greater sciatic foramen ventral to the sacrotuberous ligament. It passes medial to and under the sacrospinous ligament at the ischial spine level to re-enter the pelvic cavity through a lesser sciatic foramen. The pudendal nerve then courses in the pudendal canal, which is also called the Alcock canal. The three last branches of the pudendal nerve terminate in the ischioanal fossa. These are the inferior rectal branch, perineal branch, and dorsal sensory nerve of the penis or clitoris. However, there are case reports which have shown variability in the anatomy of the pudendal nerve.[2][3]"