Health Organization for Pudendal Education

Dear Violet,
What Dr. Dellon is practicing is called “boutique Medicine”. The boutique medicine targets a well-to-do clientele who basically are millionaires or billionaires for that matter. It has a small number of clients in Manhattan and the west coast and doctors who practice boutique medicine range from 800 to 5,000 doctors and most of them are either family practice doctors or in internal Medicine doctors. It is not meant for poor or middle class American patients and especially those who are suffering from chronic illness such as PNE and have lost everything.However,if the family doctors do charge for their consultation ,it is usually US$50-150 dollars and not US $600 or US $1,100.

“Health insurance is certainly necessary to guard against financially catastrophic illness like PNE.etc because without health insurance, it can easily lead to bankruptcy. I found a very interesting article from the web and I am pasting it as follows.
"Medicine used to be a cash-only business, and there were certainly many people who didn't have the cash," said Caplan, the medical ethicist. Doctors who insist on cash also have an ethical obligation to help people who can't afford the fee, he said — even if it means accepting chickens.
Cash crusaders acknowledge the need for some type of insurance. Without it, expensive surgery or hospitalization would force most people into bankruptcy. But they think health insurance should work more like car insurance: you pay for the routine maintenance and little dings yourself, and insurance pays for more expensive repairs.

The last line of the paragraph is what baffles me about Dr. Dellon which is”insurance pays for more expensive parts”. He on the other hand is demanding money not only routine maintaninance but also for more expensive parts. That is why it becomes unethical.

This doesn't mean that I don't appreciate Dr. Dellon's effort to jump into this PNE enigma to solve it and his skills as a surgeon,but he shouldn't think that we are some rich cliental and he can charge us what ever he likes and lead us into bankruptcy when we are hanging on to our last penny and most of us are either on Social Security and the rest are trying to get on one.

The ball is in his court whether Dr. Dellon starts taking insurance to help PNE patients in the USA. He can still keep his rich cliental like his offices in Switzerland or Dubia,UAE where he can easily charge the rich Europeon clientele or the filthy rich Arab Shiekhs in the Middle East as he desires.

Kind Regards,
Ali

I take it that Dr. Dellon refused the chickens you offered him, Ali.

You ae absolutely right Celeste.lol! Now,I am so broke after my trip to Vienna tha I am putting my car for sale. If Dellon had taken insurance,this could have easily been avoided.

Regards,
Ali

Oh, I'm sorry, Ali. I hate to see you lose your car.

Hi Everyone

I live in South Africa and am a male. In 2007 I was diagnosed with PNE and had bilateral surgery in Nantes done by Pr Robert. All excruciating pains disappeared after the op. However, 5 months later I started to get a slight pain on the right when I sat. The pain was not the sharp, stabbing entrapment pain I experienced prior to the op. But with prolonged sitting the pain got worse. I've traveled four times to Nantes to have nerve blocks but to no avail. In order to help me sit I used a tens machine. This enabled me to sit for close to 4-5hrs per day.

Suddenly a week ago I started to get those excruciating pains coming on again. I have stopped sitting altogether both because the pain is unbearable and because I feel like the nerve is entrapped again and don't want to injure it. I require urgent re-assessment and may require surgery again. My dilemma is, which doctor? After surfing the net I have narrowed down my choice to two doctors - Dr Bautrant (France) or Dr Dellon (USA). Problem is I cannot decide. I would like folks to share their thoughts on this. Thanks

Linkey

Linkey, sorry to hear your pain is back. Do you have any idea where your entrapment is? Is there any way you could have a 3T MRI from one of the experts first? Not that they are 100% accurate but might provide you with some valuable info.

Dr. Dellon is new on the scene so we don't have a lot of stats on his results. Depending on where you are entrapped, he may require more than one surgery. As with all of the PNE docs, some are having good results with Dellon, some are not. Dr. Bautrant has done many more PNE surgeries than Dellon but may not deal with all sites of entrapment such as the dorsal nerve or some of the other pelvic nerves. So, really there are advantages and disadvantages to each doctor.

I would go to NYC and get a 3T MRI from Dr. Hollis Potter to see where you are entrapped. It will cost you $3000 US plus airfare and hotel. Dr. Bautrant does the TIR approach and Dr. Dellon does TIR and TG. Dr. Bautrant has had some successes (Violet for one) while no one who posts here has found success with Dr. Dellon so far. He has a lot of successes in his online book on his website, however. If you are entrapped in an area that Dr. Bautrant can reach with the TIR approach, he will cost a lot less than Dr. Dellon. Dr. Hibner has had a lot of experience with the TG approach and has added some of his own innovations. Don't know what his cash price is but I"ll bet it's less than Dr. Dellon but I can't say for sure.

Thank you Donstore and Violet for your valuable inputs. Dr Bautrant uses the doppler ultra sound technique plus the EMG to pinpoint entrapment. Would it then be necessary to go to NY for the 3T MRI. Is the latter more accurate than Bautrant's methods. Violet, I don't know where the entrapment is but the pain is similar to the ones I had before, a deep pain in the perineum (made worse upon sitting) and sometimes around the anus. Sometimes pronounced on the right side laterally alongside the perineum. We do not have the expertise here in SA to do any tests. Pr Roberts said the original entrapment was severe on the right side, being both in the Alcocks canal and between the ST and SS ligamnets. He did cut one of the ligaments to release the nerve.

Its quite a difficult situation; if I go to Bautrant and its the dorsal nerve, then there would be no hope. The flight to NY from SA is 17hrs.If Dr Dellon does not get it right and its means another op, that would make things very difficult for me in terms of the pain of travelling,it's cost, Dr Dellon's high fee, etc. If I opt to go to Nantes they would give me nerve blocks again and that is no solution. Dr Dellon's method of diagnosis doesn't seem so thorough - I may be wrong? He seems be highly qualified and experienced and yet some patients have given him a bad rating. But he seems to know his stuff. He's promptly replied to my email inquiry and is prepared to answer any questions.

Violet, how accurate is Dr Bautrant"s doppler US and EMG? If its the dorsal nerve does he advise the patient to go elsewhere? What is the best way to contact him. I e-mailed him last week but got no reply yet. I phoned his clinic and they told me he will be in tomorrow (Thursday). Will he take my call because surely he will be consulting?

Thanks Donstore and Violet.
Linkey

Linkey,
There is a French paper that claims a correlation of about 60% between the compression of blood vessels (thus an altered doppler measurement) and a compression of the adjoining nerves found during neurolysis. So it is like the PNMLT, it helps in the diagnostic but there is absolutely no guarantee.
Dr.Aszmann in Austria is also a specialist of the dorsal nerve.

Dr. Aszmann is quite a bit cheaper than Dellon also, isn't he? Ali could answer that question. But if it's the dorsal nerve wouldn't the pain be primarily in the penis?

Sorry Linkey -- none of the diagnostic tools are 100% accurate and I doubt anyone knows for sure which is the most accurate.