Dr Dellon

[gorenje]

Dr. Aszmann gave me the email address to one of his former patients. Here is his reply. (I have removed his name):

Hello,

my problems began in the fall of 2009. It started with genital and perineal pain, it was unbearable. I think it was a result of the accident and took me inside the scar. After two months the pain lessened a bit, but it was still unbearable. I could not sit. Seating was the most painful. I felt it also when walking and standing. From pain I could not escape. Pain soon began to spread to the buttocks, back and legs. I had the same pain in the feet as a perineum, I could not stand for a long time, it was unbearable. My genitals were downloaded in spasm and very insensitive. It seemed to look pretty ugly. I often had a cramp in the legs. Genitals was very dry and started to deteriorate the quality of pubic hair. (pain was hot and biting)

Before Aszmannem treated me another doctor. He was investigating me per rectum. He said that I have there stiff and it does not hurt and there I have muscle knots. He gave me some injections to perineum. I heve also rehabilitation. I did physical therapy per rectum, and I had too stimulating electricity per rectum. They said something about trigger points.

To decompress, I was at the beginning of summer 2012. Convalescence was very slow. Is February and I'm still not okay. But I feel much better. Pains are much smaller. Genitals are slowly released and restores the sensitivity. With the erection I had problems especially after surgery. After half a year, and sexuality started to improve. Because it still is not healed, after sex it hurts. Sex causes the back spasm and numbness, especially at the beginning of treatment.

I had a compression on the left branch of pudendus. Nerve were pathologically enlarged to a width. Aszmann suspected to compress after seeing the MRI, and he was right.

Aszmann and I think that I'll be perfectly fine. It probably wants some time.

Good luck!

[ezer]

Thanks for sharing. Do you know what was the accident that person suffered? I mean if there is a direct trauma to the area from an accident, there can be certainly consequences.

[gorenje]

No, I don't know what kind of accident it was but I can email him back and ask.

[mikette]

Apart from dorsal nerve surgery, anybody knows if are more the patients who underwent surgery with dr aszmann and improved their condition than the ones who didn't?

[Griff522]

In general, surgery doesn't work for this issue. That's why there are not a whole lot of doctors doing it. My advice would be to rule out every possible cause of your pain. See a urologist, and an orthopedic dr or surgeon. Consult with a pelvic floor physical therapist and have them check you out. All kinds of problems can cause pudendal nerve pain. In my case it is two hernias and a labral tear in my hip. But none of the 9 doctors that I saw in the last 3 years ever mentioned the word hernia or labral tear. I had to research and finally find a doctor who was willing to help me find the source of my pain. And believe me, those kind of doctors are hard to come by. But keep searching because they are out there.

If you do have scar tissue, it can be addressed and relieved through PT and ART (Active Release Technique) done by a chiropractor. I did develop scar tissue as the result of my surgery with Dellon, and I could actually feel the ropey tissue that was bothering me. My chiropractor felt it as well, and focused on that area and after about 2 or 3 sessions with him last summer it was gone. Don't have surgery to remove your nerve from scar tissue because the surgery itself will just create more!

[gorenje]

Griff522, I'm happy to hear that PT and ART are effective treatments against scar tissue around the nerve - and that your chiropractor was able to help you. For some reason scar formation seem to be more of an issue with dorsal nerve decompression surgery than with the other surgeries - I wonder why? From what I have read about other people on this board who had dorsal nerve decompression they generally seemed to have an improvement the first few weeks post surgery before their condition worsened. Maybe the two treatments you mentioned (PT and ART) done post-op would improve the long term success of this surgery?

[ezer]

Gorenje,
I had plenty of PT after dorsal decompression and that did not improve the outcome of that surgery. Please consider also that they have to cut through some small muscles like the ischiocavernosus to get through to the dorsal nerve. It is delicate and it is not risk free.

[gorenje]

ezer, I see. I'm sorry it didn't work for you. I thought I was on to something - but I guess maybe not. Assuming there had been no scar formation causing problems post-op, would you then consider this surgery to be justified or would you basically see it as of no use - no matter what?

[ezer]

I am not sure scar tissue is such a big deal. I am more concerned about what they had to cut to get to the dorsal nerve. But I really question the premise of a new undiscovered entrapment at the pubic ramus to be honest.

[flyer28]

it is difficult to state final judgement about the dorsal nerve decompression surgery. This surgery is somehow more safe than the classic TG approach with shorter time of recovery, especially the time immediately after operation. On the other hand, the results are mixed. What makes me scare that operation in even some cases which seemed the "classic" ones (pain, numbness, tinel sign in dorsal nerve area) did not delivered relief. ON the other hand, some others were succesful.
I am suffering with chronic pain in the area of ischiocavernosus/base of penis but still dont favour that operaion, despite dr.Aszmann found some fibrotic thickening in my right dorsal canal. Somebody stated that dr.Aszmann is colleting big survey about all of his operation. Maybe that would be interesting, not all of his patients publish here their results. Anyhow, results from dr. Aszmann seem to be much better than results of dr.Dellon.