Any dorsal nerve decompression successes?

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A's Mommy
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Re: Any dorsal nerve decompression successes?

Post by A's Mommy »

Additionally, for all that have inquired. My dorsal branch was not a problem. I have the operative report although it is in German so I can't really make it out. However, based on what Prof. told me my nerve was entrapped in scar tissue as it exited Alcock's canal. When my nerve was injured, the perineal branches especially became trapped in a neuroma. The neuroma is what happens when a damaged nerve tries to regenerate but it regenerates into scar tissue. He removed the neuroma and some of the regenerated branches had to go with it. He left the perineal branches that are most important for sensation in the vagina and functional (to urethral sphinctor, anal sphincter, etc). It was described to me as a huge glob of scar tissue. He did explore both sides although the right side never had pain but since I came all that way he wanted to explore it (I was fine with that). There was only pathology on the left. I am 5 weeks out and experiencing painful regeneration symptoms but there are things that are better. The incisions are lateral to the perineum, about 6 cm in length each.

My pathology was very clear. The Potter MRI combined with Bodner ultrasound and my history explained it very well. I am only regretting that I did not see Prof. Aszmann 3 years sooner. But, of course, I was led along the path of misdiagnosis for those years.

Additionally, some have asked about the whole of the Alcock's canal. Yes, he explored it all the way to the proximal end. He explained it is very easy to do on women as comnpared to men due to the infrapubic angle. Especially in women who have given vaginal birth. The area that Dr. Hibner reached via my TG was healed just fine.

Regards,

A's Mommy
Daughter grew completely on left side of pelvis
Multiple uterine surgeries to fix uterine adhesions, septum, and endo
Had all the conservative workups done, 3Tesla (Potter), recovering from L sided TG (Hibner) 11/10, Botox 6/11 failed, bilateral anterior PNE decompression (distal Alcock's/perineal branch), Aszmann, Vienna, 10/11; dx'd with CRPS Type 2, 12/11, Ketamine @ CCF 2/12, doing 75% better PRAISE JESUS!
http://fighting-pne.blogspot.com
http://www.thepelvicmessenger.org
flyer28
Posts: 244
Joined: Fri Mar 25, 2011 11:29 am

Re: Any dorsal nerve decompression successes?

Post by flyer28 »

Hallo A´s mommy
congratulation and wishing you successful recovery.
I am from Bratislava, Slovakia, which is a city 60 km from Vienna (one hour driving).
I hope that ultrasound of Dr. Bodner will solve my diagnosis.
Matt
summer 2009 - episodic post ejaculatory pain,
early 2010- major flare-up, chronification
february 2011 - ESCW wave. major flare-up, lasting 5 months
february 2012 - diagnosed CPPS with irritation of pudendal nerve, hypog. plexus block
june 2012 - dorsal nerve block, no relief
2013 - starting PT with moderate results
2014-2017 better periods interchanging with heavy flare ups
2018 first long remission (several months)
2019-2023 most of the time almost assymptomatic with cca 2 flare ups yearly
AliPasha1
Posts: 739
Joined: Fri Sep 17, 2010 2:35 pm
Location: New Orleans,Louisiana

Re: Any dorsal nerve decompression successes?

Post by AliPasha1 »

Hi Matt,

Please make sure that Dr. Aszmann is ready to explore your inferior and posterior Alcock's Canal in addition to the dorsal nerve decompression.I believe that he is ready now to do the PNE surgery although I need further confirmation.

Take care,
Ali
Diagnosed for PNE by Dr. Jerome Weiss in June 2007.Started PT with Amy Stein in NYC.
PT for almost 3 years now without any results.
Pudendal Nerve blocks in August,2007 by Dr. Quesda left me with sitting pain.
Unilateral TIR approach with Dr. Bautrant on 18 Febuary,2010 with no major improvements and sitting is much worse.
MRI By Dr. Potter reveals nerve entrapment in the ST,AC and DN.
Dorsal Nerve Decompression surgery on April 8,2011
Redo surgery by Dr. Hibner on July 18,2011
susibee
Posts: 60
Joined: Wed Mar 16, 2011 4:12 am
Location: New Hampshire

Re: Any dorsal nerve decompression successes?

Post by susibee »

A's mommy,

I do hope you are feeling better today; I know you've had a rough go of it lately. I read what you wrote about the neuroma found by Dr. Aszmann. I'm curious, was this seen on MRI? When was your MRI relative to the surgery?

Sending you best wishes for your continued recovery!
Vulvodynia diagnosed '01; symptom was occassional vulvar itching/rawness after sex.
Autumn '10, localized clitoral and left labial burning after sex
March '11, new left buttock pain, worsened clitoral/left labial pain/burning.
May '11, increased sitting pain.
Summer '11, pain decreased/plateaued to 0-4/5.
Treatment: 75 mg nortriptyline nightly, definitely helps; PT x 4, didn't really help.
Consults with Hibner and Dellon, left me with questions.
Next step: MRI in NYC or VT.
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shawnmellis
Posts: 227
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Location: Concord, NC USA
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Re: Any dorsal nerve decompression successes?

Post by shawnmellis »

It is important to note, that with the Dorsal Nerve Decompression , which is the Anterior (Front) Pubic Ramus approach done with Dr. Aszmann and Dr. Dellon, that other branches of the Pudendal Nerve can finally be reached, which were previously not able to be reached well, ,such as the Distal Alcock's Canal (Part furthest away from the origin at the Sacral Roots), and also the Deep and Superficial Perineal Branches, as well as the Dorsal Branch. These are all areas of the Pudendal Nerve, which we need more PNE surgeons to be able to access and decompress.
Bringing Help Awareness Education to Patients & Doctors about PNE through Videos at http://www.YouTube.com/PudendalNerve & PudendalHope.com Please tell Dr. Oz to cover topic of PNE by going to http://www.doctoroz.com/contact Started 1/2010. Initial urinary tract infection in 1/2010. Medication: Diazepam, Tramadol. 4 nerve blocks. physical reinjury 8/2010. 7/2011 Potter MRI Varices dorsal branch 8/23/11 Diagnosis Entrapment of Dorsal Branch Dr. Lee Dellon There's Always Hope!
flyer28
Posts: 244
Joined: Fri Mar 25, 2011 11:29 am

Re: Any dorsal nerve decompression successes?

Post by flyer28 »

So does it mean that dr. Aszmann is able to reach all parts of Alcock canal with his approach?
Also in men?
M.
summer 2009 - episodic post ejaculatory pain,
early 2010- major flare-up, chronification
february 2011 - ESCW wave. major flare-up, lasting 5 months
february 2012 - diagnosed CPPS with irritation of pudendal nerve, hypog. plexus block
june 2012 - dorsal nerve block, no relief
2013 - starting PT with moderate results
2014-2017 better periods interchanging with heavy flare ups
2018 first long remission (several months)
2019-2023 most of the time almost assymptomatic with cca 2 flare ups yearly
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A's Mommy
Posts: 447
Joined: Fri Sep 17, 2010 12:46 pm
Location: Pennsylvania
Contact:

Re: Any dorsal nerve decompression successes?

Post by A's Mommy »

Dear flyer

Prof Aszmann told me that it is much easier to reach the whole of the Alcocks canal on women due to a wider infrapubic angle. It is not so easy on the male due to the anatomy. I will see of I can find his email and post it on the forum.

To all: wish me luck and prayers as I'm headed to a pain specialist who deals with CRPS/RSD. This has gotten out of control and I believe I would benefit tremendously from the 10 day outpatient Ketamine that NYT is currently having. The pain has spread since my surgery 7 wks ago. This is common with CRPS and NYt told me that many with it are afraid of surgery for fear of it spreading. Well, surgery was warranted for me and I truly believe that if I can get this nervous system under control that my decompression will deem successful. However the widespread burning is now overtaking my mind.

As Mommy
Daughter grew completely on left side of pelvis
Multiple uterine surgeries to fix uterine adhesions, septum, and endo
Had all the conservative workups done, 3Tesla (Potter), recovering from L sided TG (Hibner) 11/10, Botox 6/11 failed, bilateral anterior PNE decompression (distal Alcock's/perineal branch), Aszmann, Vienna, 10/11; dx'd with CRPS Type 2, 12/11, Ketamine @ CCF 2/12, doing 75% better PRAISE JESUS!
http://fighting-pne.blogspot.com
http://www.thepelvicmessenger.org
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shawnmellis
Posts: 227
Joined: Sat Dec 04, 2010 8:42 pm
Location: Concord, NC USA
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Re: Any dorsal nerve decompression successes?

Post by shawnmellis »

A's mommy,
You are still in my thoughts and prayers every day, and I hope that the Ketamine treatment will help with your RSD. Keep us updated and Happy Holidays!
Shawn
Bringing Help Awareness Education to Patients & Doctors about PNE through Videos at http://www.YouTube.com/PudendalNerve & PudendalHope.com Please tell Dr. Oz to cover topic of PNE by going to http://www.doctoroz.com/contact Started 1/2010. Initial urinary tract infection in 1/2010. Medication: Diazepam, Tramadol. 4 nerve blocks. physical reinjury 8/2010. 7/2011 Potter MRI Varices dorsal branch 8/23/11 Diagnosis Entrapment of Dorsal Branch Dr. Lee Dellon There's Always Hope!
donstore
Posts: 463
Joined: Mon Nov 08, 2010 6:13 am
Location: San Francisco

Re: Any dorsal nerve decompression successes?

Post by donstore »

Wishing you all the best, AM. Hope you find some relief.

Don
Mild to moderate PN for 5 plus years, pain controlled by lyrica and opiates.
Nerve block (unguided) 9/10 Dr. Jerome Weiss - sciatica for 5 months but got numb in painful perineal/scrotal area - he diagnosed entrapment - but no more cortisone for me
Potter MRI 5/11 - rt STL entrapment of PN at Alcocks
Consult with Dr. Hibner Feb. 2012
Bilateral inguinal hernias diagnosed by dynamic ultrasound - surgery on 6/20/13
Feeling a little better, a few more months will tell
susibee
Posts: 60
Joined: Wed Mar 16, 2011 4:12 am
Location: New Hampshire

Re: Any dorsal nerve decompression successes?

Post by susibee »

A's Mommy,

I just want to let you know I am thinking of you and wishing all good things for you and your family.
Vulvodynia diagnosed '01; symptom was occassional vulvar itching/rawness after sex.
Autumn '10, localized clitoral and left labial burning after sex
March '11, new left buttock pain, worsened clitoral/left labial pain/burning.
May '11, increased sitting pain.
Summer '11, pain decreased/plateaued to 0-4/5.
Treatment: 75 mg nortriptyline nightly, definitely helps; PT x 4, didn't really help.
Consults with Hibner and Dellon, left me with questions.
Next step: MRI in NYC or VT.
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