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

[shana]

Hi Folks
I just wanted to check in regarding the labral tear surgery I had in 2009 with Dr Struan Coleman at HSS in NYC.
Dr Coady my pelvic pain gyn at the time, was doing a study in which they found that some womens' vulvar and pelvic pain improved after the surgery. Im sure you are familiar as this has been discussed a lot. Quite a few of us had this surgery. I had no hip pain or clicking etc. when Dr Coleman did the pre-surgical check,so this made me quite skeptical about doing it.
My main symptoms at the time were IC/ urinary urge/pressure and urinary hesitancy and sit bone and mild right side perineal pain that was gradually worsening. Since IC protocol treatments hadn't helped and PTs couldn't seem to find any reason why my sit bones hurt (other than a "skinny butt"), I was anxious for pain relief and
I had the surgery reluctantly. The surgeon said he found significant damage to my labrum and that I had really needed the surgery. He also lengthened the psoas muscle
How I had gotten a labral tear in the first place I'll never know (unless its just from the natural wear and tear one's body sustains by middle age.
THe recovery was pretty easy... I was mainly on 1 crutch and soon I really didn't need one.
I did the necessary PT protocol for recovery (a few months of weekly visits and in between I did all the exercises.) I healed fine.
But I saw no improvement in my issues.. I wasn't told about what actually happened during the surgery; I didn't know about the traction, you guys are discussing, but would like to know more?
I hope that this traction didn't worsen my PN issues ;If I knew there was any risk from that I would've probably not done it.
I had the surgery in Nov 2009. By Spring 2010 around the time I finished post-surgical PT,
the sit pain had become bad enough that I was cutting back on driving ..
From then on things gradually got worse etc.
BTW Ive heard from the surgeon's office this year. They wanted to re-examine me and see how I was doing and possibly get an MRI of the other hip. I explained how much pain I was now in and said that unless this exam could do anything to help me find the source of my pain and reliev it, then I saw no point in coming in. They were basically doing a follow up on those who had been in the study I assumed..

Was anyone else part of this study?.. and did you go back recently for a re-check?
I think Dr Kelly is Dr Coleman's colleague, but I'm not sure.
Thanks.

I wasn't in the study but I had surgery with Dr Coleman in Jan '11, basically the same surgery u described. I did evrthng post op as prescribed my hip felt better for some time then in the middle if 2012 my hip pain started up again. I've now seen Dr Coleman abt 4 times since Feb '13 had another MRI and CT scan and cortisone injections to try to figure out what's causing my pain. Everything looks fine do now he wants to go back in bec my symptoms indicate its prob scar tissue and the bone prob needs to b shaven down more. He also wants to repair the tear in my other hip. Before he operates he wants mr to go for a second opinion w Kelly but Dr. Kelly doesn't want to see me so now I've been waiting almost 2 wks for Dr. Coleman to spk to Dr. Kelly and ask him to take a look and see if he finds anthng that was overlooked.

I'm not sure how I feel abt hvng another surgery but I do trust Coleman. He's always been honest with me, he's the one that suggested I get a second opinion and I've been to my fare share of top top specialists and usually when I say I want a second opinion then get all offended so I thnk it says anthng abt Coleman that he suggested it. He also never dismissed my pain which to me is a big deal. I've seen many drs who've told me its nthng or its in ur head or whatnot. He's always believed me and never pushed me away which is a big deal for me...

Shana

[Jax87]

Elmwood, good to hear your report even though you haven't had too much relief yet. It's good to hear a man's perspective. What was your left side buttocks pain like before surgery if I may ask? I know Lernica has had both her hips done with a good amount of pain relief, but I haven't seen her on here in a few months and I can't get in touch with her. Hopefully she's somewhere pain free.

Shana, I think you are right to trust Dr. Coleman. I think it's great that he is positive about seeking a second opinion, I think really confident doctors are willing to do that. I'm hopeful that he will figure out what's going on with your hips. It sounds like maybe he just didn't take care of everything the first time or there is scar tissue. It's so frustrating, but hips are pretty important and you are in great hands.

I started seeing the pelvic floor PT again for the first time since my surgery, and she is very happy with my progress. I am actually able to contract and release my pelvic floor, which I wasn't able to do last July when she saw me last. Some of it is due to surgery, some to ortho PT, and some to the meds I think. But whatever it is, it's a success for me. She's hopeful I will be able to have pain free sex eventually. I have heard that before, so I'm a little skeptical, but I can't argue with the fact that my pelvic floor is slowly improving.

[Elmwood]

The pain in my buttocks was/is (still have it on the right side) an aching type of pain. If I sat normal my whole buttocks would ache. If I slouched forward my tailbone would ache. If I leaned on one side than that side and my hip would ache. It was never excruciating just bothersome and frustrating. Long car or plane rides are still difficult but hopefully having the second hip done will help a lot.

[pudendalpt]

Thanks for the www.pelvicguru.com reference. I am a Pelvic PT and I can't tell you how many times people are misdiagnosed with PN or PNE when they have hip issues or other diagnoses all together. Even then, the right diagnosis and treatment must be ascertained. Is it just an obturator internus or piriformis muscle issue? Is it a problem with a "gliding" of the hip and/or labral tear? Is it actually another superficial pelvic floor muscle, for example the bulbocavernosis that can get compressed an cause irritation of the pudendal nerve at the perineal branch.

I have seen many get unnecessary labral AND PNE surgeries. Continue to seek help from physicians and pelvic PTs who specifically understand the pelvic floor, pudendal neuralgia and hip/pelvis anatomy and function (not just any PT and not just any pelvic PT).

This is a great site for messaging. All the best to you!!
Tracy Sher, MPT, CSCS
www.sherpelvic.com
www.pelvicguru.com

[beverley]

HI all: I want to update this thread as I am about 11 months post op from FAI and Labral repair surgery. I was pain free and off meds for a couple of months. But, I am having a mild flare. I am not having any hip pain but some mild labial pain. I think it was caused by over doing it with exercise, stopping pelvic floor PT and thinking I could sit for long periods of time! Also, I have some scar tissue - which I am doing ART therapy for. This might sound really random but both times that I have the PN symptoms start up I have had neuropathy on the PN side and off the charts mercury blood levels -- heavy metal toxicity. I recently had 3 immunizations and got the neuropathy immediately afterwards and the pn flared. I always thought the mercury was related to the pn but none of the doctors that I saw gave it much credibility so I have never mentioned it on this site. The mercury clearly started an inflammatory response in my body. My PT says my pelvic floor had some tight spots as well. I will keep you updated and wished that I was 100% cured!!

[beverley]

So, my flare got worse and my hip started to hurt as well. My OS (dr stuan coleman) suggested that i get my hip injected with cortisone -- which i did a few days ago and it has made my hip pain better but my PN worse. Has anyone else had this experience?

[Elmwood]

I seem to recall (maybe on this very thread) that somebody was bothered by the cortisone. Cortisone never bothered my PN but it never much helped my hips either. Sorry to hear that you're having a flare but I guess the whole process is a two steps forward one step back type of thing. Keep us updated though. I'm 6 month post op for a labral tear on my left side and I haven't noticed any difference. I plan on starting Pelvic floor PT next week with somebody who is supposed to be pretty good.

[Griff522]

Hey I just wanted to post and see how everyone is doing post scope surgery. I read Beverly's post about her flare and I hope things are improving for you. I am scheduled for scope surgery to repair my labrum on August 16th. I'm having it done at HSS with Dr Coleman. To be honest, I'm a bit anxious about it. I'm worried about how much pain I'm going to be in afterwards. I know I have hip issues, but I worry too that the surgery won't help my obturator internus pain/spasms. Anyone want to give me a pep talk and tell me everything is going to be okay?

[shana]

I'm scheduled Sep 10 for my second surgery with Dr. Coleman. I had my right hip done Jan 11 at first it was good and then it started getting real bad again to the point where I can barely walk or stand or sit without being in pain. So they are going back in to clean out the right hip and shave the bone down more and there's possibly another tear. Then they are doing the full surgery on the left. I'm actually looking forward to having surgery. Its my only hope to hopefully getting pain free. I don't know how my recovery will be this time as I'm having both hips done but by my last surgery I took pain meds the day of surgery and the day after that was it. I took it easy the first couple weeks and then I was back at work and did what I had to do with limitations. For me the hardest part was the 12 weeks of PT twice a week. That for me was the hardest part. Relax you will be fine and HSS is one of the nicest hospitals I've ever been in. I had great care and I have no complaints.
Good luck

Shana

[alexm]

Hi Griff,

I'm about 3 weeks post-op for fai and labral tear. I'm doing the other side later in the year. The operation isn't that bad at all. I had a one week honeymoon period with very little pain followed by two more difficult weeks and now things have calmed down some. I too was pretty worried before the op but hey, it's only normal. Just keep positive and look long term, as the recovery does take time.

Best of luck!
Al