Did labral tear surgery reduce your PN/pelvic/perineal pain?

[Elmwood]

That is good news. I'm keeping my fingers crossed for you.

Has anyones doctors told them how hip issues cause PN issues? I understand that the nerve goes relatively close to the hip joint but how does a tear (or arthritis in my case) effect the nerve?

Thanks and good luck to all

[pregmom]

I just had my hip injection on Friday 9/14. Not sure yet if I have improvement. My hip pain is more on the outer hip and with lifting leg up to my chest have discomfort and can feel the impingement. Anyway, hoping to 'feel' something to make my decision about surgery a little easier .....

Beverly I am so happy to hear you are doing better! Finally some good news

Jax, what is the status with your hip pain...did you see improvement over the course of the 2 weeks? enough such that you will move forward with the surgery?

Diane

[Lernica]

Brief update: Still recovering from scope surgery on my left (PN) side. I'm 52 (much older than Beverley, I think) and I have had pelvic pain for ten years. So it's going to take longer for me. Walking is still very difficult, and I'm still on one crutch. Also, I've developed vulvodynia since the surgery, so sitting is very uncomfortable and intercourse is out of the question. My obturator internus is still in knots. Still doing pelvic PT once weekly and hip PT twice, swimming 30 minutes daily, doing hip exercises 30 minutes daily at home. Still on disability.

I am, however, still hopeful that my bad hips are a big part of my pelvic pain problem, and that getting them fixed is part of the solution. But it looks like it is not going to be a quick fix.

In articles written by Dr. Deborah Coady, gynaecologist, about the connection between pelvic pain and hip pathology, she says it can take up to one year for pelvic pain symptoms to resolve after hip surgery. So, as always, patience is key.

Warm wishes to everyone!

[Faith]

Sorry your recovery has been slow, Lernica, but your attitude is great (as always). I'm sorry to hear you developed vulvodynia after the surgery. I was curious...with your initial PN symptoms you didn't have vulvodynia? I thought most every woman with PN had vulvodynia....generalized vulvodynia is called pudendal neuralgia. Or was your PN only rectal? Hang in there....keep up the patience! Thanks for updating us.

I have an appointment next week to see a hip specialist and get a hip MRI and make sure my hips are not a possible factor in my PN/SIJD pain. I've had so many MRIs (including the Potter), but they are saying I need an MRI with attention to the hip itself...is this typical? Or do they usually do an MRA of the hip? Maybe that is what they will do. I'm not sure as I am traveling a couple of hours to see the Dr. and then they will order the MRI while i am there (so I've been told).

[Lernica]

Faith,

Before the hip surgery I had mostly rectal pain, not vaginal. Now it's vulva pain all the way. There's a perineal post that they put between your legs during the surgery in order to dislocate the hip. So I could be recovering from that. My hip PT thinks that it's just my pelvic nerves being refired up in response to the post-op pain. Either way, I hope it will settle over time. I'm just starting a course of Elavil now to help things along . . .

I'm glad to hear you're exploring the hip pathology possibility. I never had an MRA since my pathology was evident with a regular MRI. An MRA usually involves the injection of die into the hip joint which could result in some discomfort for a few days. Evidently the pressure from the increased fluid in the hip joint can cause some pain for some people. They will also inject some lidocaine in the hip as a diagnostic tool. If you feel some transient relief after the procedure, it may provide evidence that your hip is the source of your pain. An MRA is the gold standard for detection of labral tears, but not for bone issues such as FAI or dysplasia, in which case an MRI is sufficient.

The ladies I've been in touch with who have both hip and perineum pain report that the lidocaine injection does reduce their hip pain for a bit but has no effect on their perineum pain.

Warm wishes and best of luck.

[sneetch]

Hi all!

I am scheduled for hip surgery to repair my labral tear on the 30th of October. Very nervous, but I guess that's all pretty normal!
Argh! ... I don't like the sound of that "perineal post" Lernica! I have vulval stinging and burning, anal pain, clitoral pain and sensitivity and increasingly, lots of sensitivity of the pubic symphysis. I also have plenty of hip pain, as well as clicking and catching. The clicking is constant with every step I take and I have to be very careful doing particular activities like getting in and out of bed. If I'm not careful, the leg/joint can get 'stuck', especially if I stretch out the leg and then rotate it externally. It's excruciating, so I try to avoid it!
Just wondering, Berverly & Faith, having had the surgery ... What have you done in terms of physical rehab? I have been seeing a physio for my hip issues for a few months now, but I've found that I am completely unable to do many of the exercises/stretches she gives me for the hip because they invariably cause terrible flares of my other symptoms. The information that my surgeon gave me regarding rehab says that riding a stationary upright (or recumbent) is excellent rehab. It also mentions water walking. I honestly don't thinky that I could do either of these. The upright exercise bike is definately out because of the pressure it puts on the perineal area. I have tried a recumbent bike, but unfortunately, like all seated positions, for me it induces horrible sensitivity in the clitoris and the area over the pubic symphysis. A swimming pool is not a option either because my skin is very sensitive to chlorine ... Always has been! It all sounds a bit like excuses, I know! I know I have to do something for rehab. I certainly don't want to go through the pain and stress of a hip operation only to drop the ball with the rehab!

Any thoughts?

[Jax87]

Hi,
First, Faith, I'm so glad you are getting a hip MRI! Yes, you definitely need one that specifically looks at your hips. Like Lernica, I did not have an MRA either. I had the MRI, and then after the diagnosis I had a CT scan and x-ray to look at different measurements. It will definitely be worth it either way to know if you have a hip issue. Good luck! I'll be thinking about you.

Pregmom, I had the injection and I did have significant relief in the first 8 hours or so, but no long term relief. I think that my pelvic floor may have even relaxed some during that time, but its hard to tell since it was so short. My doctor says I have so dysplasia, so he wants to take a closer look at my scans and has sent me to orthopedic pt for 6 weeks to strengthen everything. I may have to have a PAO instead of a scope. So I will keep you updated. I am still hopeful that I can have a scope, but I will do what I need to do for long term success.

Sneetch, I haven't had the surgery, but I think there are lots of ways to do rehab. I know I just saw the ortho PT and he was super careful not to do anything that might flare up my pelvic pain, so you might find one that is more flexible. I don't think Lernica and Beverley have been doing any biking. Some women put vaseline or some other protective substance like zinc oxide on their vulvas before swimming to protect themselves from chlorine. Also, I have heard of women talking to their OSs before their surgeries to cover the post and make other allowances so that there is not too much trauma. Creativity seems to be the key. Good luck!

Lernica, you are absolutely right that it can take up to a year to recover from the hip surgeries and heal your pelvic floor, I have heard that from my doctor and PT. Your positivity is an inspiration. Hang in there!

Hugs to all,
Jackie

[Lernica]

Re: Perineal post during surgery:

Discuss this with both your OS and the anaesthetist who is assigned to watch over you during the surgery. Ask that they make sure that the post is WELL PADDED and that they pay special close attention to your genitals during the surgery because of your history of PN. If the surgery is lengthy, some OS's will release the traction every half hour to give the body/perineum a rest. But a good scope surgeon needs no more than 40 minutes to perform the scope so that's how long pressure will be applied to your perineum. It would be like a 40-minute bike ride: not good, but not fatal for PNers.

Re: PT after scope surgery:

Absolutely no stationary bike-riding unlike most OS protocols. But there are plenty of hip strengthening exercises that can be done without aggravating the pudendal nerve: e.g. clamshell, hip adduction, hammy stretches (keeping at 90 degree angle), calf raises, etc. I have had no problem with hip PT, though it is taking me longer than usual to regain my strength given how disabled I was before the surgery.

Re: Swimming:

I have been swimming 30 minutes daily since three weeks post-op, with a pull-buoy between my legs. And Jackie is right: I do coat my vulva with vaseline beforehand and make sure it is well lubricated afterwards (with, e.g. olive oil) so it doesn't dry out. But zinc oxide is an even better idea, since it soothes as well as protects! (Thanks, Jackie!) Might try this next time as my vulvodynia is killing me right now. But I will NEVER give up swimming since it's the only aerobic exercise I can do right now (until the hips get stronger).

Sneech, best of luck with your upcoming scope! Who is your OS? Have you joined the excellent website Hip Chicks Unite yet? There you will get tons of great advice about your upcoming hip surgery, what to expect and how to prepare for it. You have to pay a small fee but it's a small price to pay for great info and NO SPAM!

[beverley]

I'm 12 weeks post op. I am down to 20 mg of Elavil. I have no hip pain and no PN symptoms unless aggressively provoked (like very tight jeans). Although, i can now wear underwear and jeans that i haven't been able to wear in 12 months!! I can have sex and sit without pain. i can take long walks, do gentle yoga and have no pain. To answer a couple of questions: I'm 47 but I was in very good shape before the surgery so my recovery has been pretty easy. I was very active prior to the PN but i think i injured my hip when i fell straddle on a jungle gym when i was 6 and then age and overuse pushed it over the edge -- but who really knows how these things happen. I have spent every single day since my surgery trying to get better including:

Drugs: vaginal valium, lydocaine and Elavil
PT: I recently switched PT and the new one was much more aggressive internally -- although it made me flare -- i think i made some real progress
Chiro: my SI joint and pelvis were really misaligned after surgery and before -- i have been adjusted almost every week
Massage: i found that my adductors were really tight and causing some vulvydynia -- massage has been great
Foam Roller: rolling out tight muscles
Anti - inflamatory vitiamins: curcumin, Omega 3, B12 for neuropathic pain

I ride a recumbent bike every day for 30 minutes - i was worried this would aggravate my PN but i put a pillow on the seat and lean back and the pressure is on my lower back and tailbone and it doesnt bother my PN. I also do all the exercises my PT has given me as well as meditate and do relaxation techniques to help with general sensitization. I feel that this nightmare is behind me and feel so emotional that i have made it this far. Good luck to everyone and I will keep you posted.

[Violet M]

Wow! Awesome news, Beverly!

Violet