Health Organization for Pudendal Education

Faith wrote: I worry that you are right that maybe my ligament instability rubbing the PN somehow. And if that's the real cause of all my pain then PN surgery probably wouldn't help me.

That's exactly what Dr. Bautrant thought was the problem in my case. I had chronically strained ligaments and pelvic misalignment causing pain primarily on one side. I don't know if I would have gotten better by just waiting but after 8 months of doing almost nothing and living on the couch I was not getting better so I opted for surgery. It turned out to be the right thing for me.

I have sacral pain at times -- I'm pretty sure it's from the ligaments.

my sacral pain developed few months after my pn symptoms had started, its on both sides, not too bad when I am lying down but very bad by the end of the day when I am on my feet all day. Its more mechanical kind of pain, hurts when I move by back and it clicks on movements. PT says it all started because i dont sit properly but I think its related to PN. Now it bothers me more than PN. Does anybody have the similar symptoms?
Thanks

Violet M wrote:

Faith wrote: I worry that you are right that maybe my ligament instability rubbing the PN somehow. And if that's the real cause of all my pain then PN surgery probably wouldn't help me.

That's exactly what Dr. Bautrant thought was the problem in my case. I had chronically strained ligaments and pelvic misalignment causing pain primarily on one side. I don't know if I would have gotten better by just waiting but after 8 months of doing almost nothing and living on the couch I was not getting better so I opted for surgery. It turned out to be the right thing for me.

I have sacral pain at times -- I'm pretty sure it's from the ligaments.

So were you still out of alignment post surgery?? What kept you from going right back where you were if alignment was a real contributor to the pain? This stuff is so confusing.

Faith, yes, I was still out of alignment after surgery -- probably still am.

OK, now this is just my theory.....If you are out of alignment and one leg is shorter like mine was, one side of your pelvis is sagging. This could cause a tighter space than usual between your ST and SS ligaments and cause the nerve to become compressed between those two ligaments. If you cut one or both of the ligaments the nerve is released from the compression -- even if you are still out of alignment. Or, if one side of your pelvis is sagging and there is a tight space between ligaments it could cause a stretch injury to the nerve. Remember, this is just my theory but it makes perfect sense to me because most of my pain was on one side.

Violet M wrote:OK, now this is just my theory.....If you are out of alignment and one leg is shorter like mine was, one side of your pelvis is sagging. This could cause a tighter space than usual between your ST and SS ligaments and cause the nerve to become compressed between those two ligaments. If you cut one or both of the ligaments the nerve is released from the compression -- even if you are still out of alignment. Or, if one side of your pelvis is sagging and there is a tight space between ligaments it could cause a stretch injury to the nerve. Remember, this is just my theory but it makes perfect sense to me because most of my pain was on one side.

That sounds like a pretty decent theory Violet. So what do you think about Dr. Hibner's procedure where he uses a cadavar ligament? Could it cause a re-entrapment?

I have scoliosis. My theory about my pelvic instability is that it wasn't really an issue until I got pregnant and my ligaments were lax. Then I had this agressive PT who manipulated my SI joint several times and kept irritating and overstretched/lax liagment. Just my theory

Faith wrote:

Violet M wrote: So what do you think about Dr. Hibner's procedure where he uses a cadavar ligament? Could it cause a re-entrapment?

I don't think we know for sure yet. I have heard the replacement is smaller than the original.

wouldn't the neurowrap Dr. Hibner uses around the nerve prevent the re-entrapment? It may still rub, but it wouldn't get encased in scar tissue.

The Neurawrap is highly effective for preventing scar tissue to re-form around the nerve, but he decompresses the entire length of the PN during the surgery, regardless of where the "entrapment" is found. For me, since my entrapment was at the Alcock's canal, he wrapped the nerve where it was entrapped, but did not wrap the entire length of the pudendal nerve where it was not entrapped. However, he still frees it from all fascia and surrounding connective tissues and then finally, severs the sacrospinous ligament and transposes the nerve forward of the ischial spine so as to avoid re-entrapment in the sacrotuberous ligament. Hope this helps.

A's Mommy wrote:severs the sacrospinous ligament and transposes the nerve forward of the ischial spine so as to avoid re-entrapment in the sacrotuberous ligament. Hope this helps.

A's Mommy, so does he use the cadavar ligament for the SS ligament or the ST ligament?

Lernica wrote: I have ALL your symptoms. I have been diagnosed strictly has having PN.

Lernica, do you have pain in your sit bone area at all? Is you pain mostly vaginal or rectal or both. And is everything all one sided?

Lernica wrote:I should know better than to use words loosely on this forum of PN experts! I mispoke. I have not been diagnosed with PNE, just PN, but it IS on the left side.

By the way, I wasn't trying to be hateful or anything. I am by NO means a PN expert. I am so happy that you found a doctor who believes you and is willing to help you get your pain under better control. I have not set in many a doctors' office, but they didn't think I had PN.