Health Organization for Pudendal Education

angioletta wrote:Ciao Gabriel, may I ask you who is your doctor presently? Dr .porru (Pavia) once excluded Ic Or any other bladder desease left me down with the advice to refer to phisiatric expert first and then to a pain management centre. Basically I do not have any expert taking care of me at present. Thank you!

I live in Siracusa, I haven't a doctor actually. I consulted many specialists in the past but now I have only to chose if to go on surgery (as dr. De Bisshop - Aubagne - suggest) or not.
I think there is no much choise for me, I can do some attempt for Scrambler therapy but I do not have much confidence...

Thank you Violet and Gabriel for answering.
@Violet: I had at least 10 sessions. The urinary frequency improved. Muscles are less contracted now. The uretral spasms are better, however the urine flow is slow. I have no pelvic pain during day presently, generally not even sitted. it comes out during night ( Related to the position. My back pain is awful during night and after a couple of hours sleep I wake up with a pain referred in a deep part of the vagina, the feeling is that it is evoked by the pressure on the side of the body .
@Gabriel: I found you in the Italian forum. I am waiting to have a visit with Dr. Pesce in Italy, waiting list is so long!

Angiolitta, it's unusual to have pain at night and not in the day. It sounds like your problems are positional though. Do you have pain along the course of the pudendal nerve with a pelvic exam?

Violet

Hi Angioletta,

Welcome to the forum. It a bit tricky to comment on the cause of your conditions is related to pelvic floor or nerve related. Yes the magnetic resonance will answer many questions.

Good Luck!

Hi, last week I went to Aix I managed to have a visit with Dr. Bautrant. he excluded pudendal neuralgia, diagnosis is miofascial syndrome of internal obturator and piriformis. He put me on Lyrica, so far no improvement. For pain at night I am taking tramadol. I cannot lye down since after a few minutes pain on the sacrum area or right is So high. Tolerable pain on my left Side. This is why I am writing at 4 am ... Dr. Bautrau said it is is the insertion of muscles on the sacrum, but I am no so convinced. Has anyone had a similar experience?

Forgot to mention that if I stand up I have no back pain at all. It is the pressure against the mattress causing me the horrific pain. Heat on the sacrum worsens the pain. in addition, Dr. bautrant diagnosed an hypertonic uretra. Actually I feel spams that are treatable with heat and relaxation.

I wonder if Dr. Bautrant did a pelvic exam and found that you did not have pain along the course of the pudendal nerve and that may be why he said it's not PN. Is that right? Also you said you don't have pain with sitting which is not typical for PN patients. If you are having sacral and back pain as you say, then it sounds like maybe there is something else going on. You mentioned that physical therapy was helping, so maybe it would be smart to continue with it. If your pain is primarily from the muscles rather than the nerves, maybe some vaginal valium would help relax those muscle. Some women insert valium pills directly into the vagina -- it is cheaper than the suppositories and you don't get as many systemic side effects as you would if you took it orally. You could also try a TENS unit. I had very good success using a TEN unit for the piriformis and obturator internus muscles.

If heat doesn't help -- try a gel ice pack, or you can even insert frozen water balloons vaginally.

Violet

Thank you Violet. Yes Dr. Bautrant performed a vaginal and rectal examination before concluding that it was not PN. I have some pain with sitting but not in the perineal area but on the buttocks predominantly. I had no pain at the visit with the exception of obturator internally and buttock and sacrum Area. I understand he has two check list criteria (Aix and Nantes) for the diagnosis
in Italy we only use Valium capsules since we do not have vaginal dosage forms. Thank you, I will try the tens and keep on doing Pt. Thanks for the ice advice!

You could also try the hot/cold sitz baths to relax the muscles.