You are really out of touch even with your own advocator Professor Robert.
Please check the the following post by Zacho.
1)
http://www.pudendalhope.info/forum/view ... f=17&t=629
pudendal or obturator nearve?
by Zachco » Thu Dec 23, 2010 7:54 pm
hollow , I'm new hear and I am right now in my diagnosis period. I have had my first pudendal nerve block about 3 months ago. I would like to ask a few questions and I will also be happy to share my experience of almost 6 years of suffering .
My block was preformed in Nantes by Dr Riant after a consolation with him and another consultation with Dr Labate . Dr labat made an Interview and tested me physically for sensory abnormalities and trigger points, which in my case was very hard to find. I must mention I had many trigger points in the past, (mostly in the prostate and icheal spine area , but they had all gradually disappeared after 3 different curses of physiotherapy. Unfortunately the Pain is still with me , although I did have an improvement and benefit from this past treatments). Dr Labat did not preform any EMG OR other test. he Explained to me that this test appeared non-beneficial and that it was proved that a person might be damaged in the nerve according to this test but feel no pain at all, while others show the complete opposite therefore they don't use it any more. Dr Riant asked me many questions regarding to my pain the way it acts and his location and it seam by his reaction like he have seen many cases very similar to me . He explained that when we'll meat again in the day after to preform the infiltration I should be as much painful as possible , so I can tell for sure if my pain disappear as a result of the block for a complete diagnosis. This was very important information to me because my pain is located in 4 different places in the pelvis and it's nature is to move from one place to another, and so it might disappear from a spot or being very light in the morning hours.
The nerve block was preformed at the ligaments and it was very well tolerated by me. honestly I had expected it to be in a lot more pain. in this specific day when I came before the infiltration I was at pain level3 in the scale of 0 to10 and it was located mostly at the groin area left and right and some uncomfortable pain, sensation of a lump near my rectum only in the right. I also had some discomfort /light pain in my perineum and penis ,but nothing like the strong urethral ,perineal or rectal pain I had in so many other days during the last years. The block shut all pain down in the Penis perineum and rectum but left me with a heavy feeling of a swollen foreign body right to my rectum . the left perineum and rectum was completely free. After 10 minutes I have noticed that I am still feeling a burning sensation in both sides of my groin , similar to the filling of a very tight underwear. Dr Riant told me that the swollen sensation of a foreign body is common with this procedure. What is bothering me more, is the pain in the groin. I knew this area is not usually related to the pudendal nerve , and so I asked Dr Riant in the interview, if this is a sign for an ilioinguineal or a cutaneus nerve pain as I red in some articles before, but he related it more to be a hint for an obturator nerve. When I come back to my hotel later in that evening my pain had became a lot worst while walking to a restaurant for 1 kilometre and another one back my legs became very weak and I finally could barely keep my self standing. in that night the pain climbed up in bed to 7/8 and woke me up from my sleep . It had spread down to my inner thighs , an area I have felt very uncomfortable in the past but never painful like this . I continued to have strong pain in this area for weeks after this filtration and had a strong weakness in my legs . I have red some article about the obturator nerve later that describes a very similar situation to what I have. The pain I had in the last 3 months was more goring pain than rectal pain , unlike in the past. another different is that this pain is rising mostly after long walking and standing unlike the rectal/perineal pain that is activated by sitting or after sex. I can also happily tell that this kind of pain had started to decreased 1.5 month after the block and today I can sit for a lot more time than before , but this is steal pretty painful .
My next infiltration is in February and it supposed to be in the alcock canal .
I wonted to ask if anyone hear had nerve block in the obturator nerve and if there is entrapment in the obturator nerve, where is it's location and how can it be treated?
Should I inform the Dr's in advanced ? any comment on this subject will be very appreciated.Zachco
Posts: 4
Joined: Thu Dec 23, 2010 11:45 am
Private message
2)b]And also from TIPNA and you can see Celeste’s response to that.[/b]
http://www.tipna.org/forum/viewtopic.php?f=16&t=6912
AliPasha1
Joined: Sat Aug 22, 2009 12:07 pm
Posts: 74
Nantes and Bautrant aren't using PNMLT or EMG Testing anymor
This Post is especially for Celeste and Greg T as I have been stating for months after my trip from France that none of the French teams are using EMG or PNMLT testing anymore.That leaves the old fashioned Houston team still using PNMLT for diagnoses .Following is the proof.
http://www.pudendalhope.info/forum/view ... f=17&t=629
hollow , I'm new hear and I am right now in my diagnosis period. I have had my first pudendal nerve block about 3 months ago. I would like to ask a few questions and I will also be happy to share my experience of almost 6 years of suffering .
My block was preformed in Nantes by Dr Riant after a consolation with him and another consultation with Dr Labate . Dr labat made an Interview and tested me physically for sensory abnormalities and trigger points, which in my case was very hard to find. I must mention I had many trigger points in the past, (mostly in the prostate and icheal spine area , but they had all gradually disappeared after 3 different curses of physiotherapy. Unfortunately the Pain is still with me , although I did have an improvement and benefit from this past treatments). Dr Labat did not preform any EMG OR other test. he Explained to me that this test appeared non-beneficial and that it was proved that a person might be damaged in the nerve according to this test but feel no pain at all, while others show the complete opposite therefore they don't use it any more. Dr Riant asked me many questions regarding to my pain the way it acts and his location and it seam by his reaction like he have seen many cases very similar to me . He explained that when we'll meat again in the day after to preform the infiltration I should be as much painful as possible , so I can tell for sure if my pain disappear as a result of the block for a complete diagnosis. This was very important information to me because my pain is located in 4 different places in the pelvis and it's nature is to move from one place to another, and so it might disappear from a spot or being very light in the morning hours.
The nerve block was preformed at the ligaments and it was very well tolerated by me. honestly I had expected it to be in a lot more pain. in this specific day when I came before the infiltration I was at pain level3 in the scale of 0 to10 and it was located mostly at the groin area left and right and some uncomfortable pain, sensation of a lump near my rectum only in the right. I also had some discomfort /light pain in my perineum and penis ,but nothing like the strong urethral ,perineal or rectal pain I had in so many other days during the last years. The block shut all pain down in the Penis perineum and rectum but left me with a heavy feeling of a swollen foreign body right to my rectum . the left perineum and rectum was completely free. After 10 minutes I have noticed that I am still feeling a burning sensation in both sides of my groin , similar to the filling of a very tight underwear. Dr Riant told me that the swollen sensation of a foreign body is common with this procedure. What is bothering me more, is the pain in the groin. I knew this area is not usually related to the pudendal nerve , and so I asked Dr Riant in the interview, if this is a sign for an ilioinguineal or a cutaneus nerve pain as I red in some articles before, but he related it more to be a hint for an obturator nerve. When I come back to my hotel later in that evening my pain had became a lot worst while walking to a restaurant for 1 kilometre and another one back my legs became very weak and I finally could barely keep my self standing. in that night the pain climbed up in bed to 7/8 and woke me up from my sleep . It had spread down to my inner thighs , an area I have felt very uncomfortable in the past but never painful like this . I continued to have strong pain in this area for weeks after this filtration and had a strong weakness in my legs . I have red some article about the obturator nerve later that describes a very similar situation to what I have. The pain I had in the last 3 months was more goring pain than rectal pain , unlike in the past. another different is that this pain is rising mostly after long walking and standing unlike the rectal/perineal pain that is activated by sitting or after sex. I can also happily tell that this kind of pain had started to decreased 1.5 month after the block and today I can sit for a lot more time than before , but this is steal pretty painful .
My next infiltration is in February and it supposed to be in the alcock canal .
I wonted to ask if anyone hear had nerve block in the obturator nerve and if there is entrapment in the obturator nerve, where is it's location and how can it be treated?
Should I inform the Dr's in advanced ? any comment on this subject will be very appreciated.
_________________
Mild PNE symptoms
Last edited by AliPasha1 on Fri Jan 07, 2011 2:10 pm, edited 1 time in total.
Fri Jan 07, 2011 11:14 am
Celeste
Joined: Tue Mar 23, 2004 4:13 pm
Posts: 2704
Doctors can do what they want to do, Ali, and you making your freakshow attacks on me changes nothing.
I don't know what's wrong with you, and I don't care. I just think you need to move on with your life and leave me alone. You're making yourself look more disreputable by the moment.
_________________
PNE from childbirth, 5/2002. Left side PNLMT 5.2, left side TG surgery 6/30/04, Houston.
Thickened SS and ST ligaments were grown together, encasing the nerve.
I'm cured. I hope you will be, too.
Fri Jan 07, 2011 12:34 pm
3)Another Post by an italian member Mikette on the European Forum and Judy's B reply to her whom I believe is the European Surgical Co-ordinator just like you are the North American co-ordinator for Professor Robert or the Nantes team.mikette
Joined: 23 Jun 2010
Posts: 42
Location: italia/ bologna
Posted: Sun Jan 09, 2011 8:36 pm Post subject: EMG/PNMLT Testing
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on pudendalhope and tipna someone has stated:
The French doctors Professoor Robert of Nantes,France and Dr. Eric Bautrant of Aix En Provence who were the pioneers of EMG/PNMLT testing and used them for diagnostic purposes have totally disgarded the EMG/PNMLT testing alltogether in the last two years.Their reasoning being that it is an unreliable tool for diagnostic purposes.
does anybody have some more informations about that or different opinions?
_________________
francesca
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judyb
Joined: 23 Oct 2007
Posts: 809
Location: poole
Posted: Tue Jan 11, 2011 12:37 pm Post subject: EMG/PNMLT Testing
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Hi,
It was in fact G Amarenco who started using this and the others followed.
They held several consensus meetings and agreed based on the results that it was only useful for providing supplementary information in some cases. For example it is unreliable in women who have had children as this in itself affects the nerve response. The test is also carried out lying down which means that the nerve(s) are not under pressure as they are in a sitting position.
As a result of this data and papers that they have published jointly it is not a major part of the diagnostic criteria that have been agreed.
Our information leaflet on pudendal neuralgia which includes this should be published soon. We submitted for an evidence check for the Information Standard accreditation. Their report has come back and is very positive
Hope this helps
Judy
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