Health Organization for Pudendal Education

Had a CT guided Alcock's canal block today bilaterally. I will post results in a few days. Dr. Antolak is my pudendal doctor.

kone

Ouch. Those are not fun. I hope it helps but don't be too alarmed if you have a flare-up for a month or so.

Best,

Violet

Actually, it did not hurt more than a mild bee sting. It was very tolerable. I have had 5 injections now, and have never had any flares or adverse outcomes. The last time my Alcock's canal was injected n(in January), my urinary urgency and frequency went away completely. I am hoping for more improvement this time too. The steroid injections seem to be a hit or miss proposition, but I want to avoid surgery if at all possible.

Question in regards to surgery: Due to the nature of how my PN started (trauma in perineum due to a bike ride), I am fairly certain my pudendal nerve was bruised and subsequently fixed my scar tissue (or perhaps developed a neuroma), in the area just anterior to the rectum (between the rectum and the perineal floor). I see no reason why the "clamp" area needs to be "freed" adding much more bilateral trauma to the procedure, and of course the cutting of the ST and/or SS ligaments. Is there a surgeon who will only open this area and not venture into the SS/ST area?

kone

This isn't a procedure I have had to look into as my problems are higher up but I know there are surgeons who do decompression in that area.
Dr Dellon and Dr Aszmann spring to mind. Saw you were on line so thought I'd respond although I hope that others who have researched this will add more info and put me right if I'm wrong.
Take care,
Helen

What about Dr. Conway? Does he do a limited approach? My doctor does the trans-gluteal approach and I don't want that approach unless I know with 100% certainty that there is an obstruction in that area. Why operate on an area, cutting ligaments and muscles if it is not blocked there? I may have to get one of those Potter MRI's. My doctor does not believe they show the areas of entrapment, but I may do it just for my own knowledge to make the best possible decisions should surgery be an option in the future. Right now I want to avoid it, but if it will take surgery to get my life back, I will consider it. But it will have to be done with certainty of the areas of obstruction.

kone

Can someone with knowledge of the surgeons for PN please list the surgeons, where they are located, and which approach they use? It also is helpful to know if they accept insurance plans. Thanks.

kone

It should be here kone http://www.pudendalhope.info/node/54. . . .although no insurance info.
I looked on the lists and saw that Dr Dellon and Dr Aszmann do the dorsal surgery which is distal to Alcocks.
Take a look at Dr Dellon's chapter 12 which explains the area and approach of this surgery http://www.dellon.com/ps/chapter12.pdf
Take care,
Helen

Conway can do the TIR approach sparing the ST ligament but I don't know if he would agree to.

Dellon does not accept insurance but you could check with the insurance company to see how much they would pay if you file the claim yourself but my understanding is that he does not feel it is necessary to spare the ST ligament.

Violet

Violet M wrote: Dellon does not accept insurance
but my understanding is that he does not feel it is necessary to spare the ST ligament.

Violet

Yes, forgot about that Violet . It is detailed in his chapter 12 kone
hope this helps
Helen

I have found a direct relationship with my dose of Clonazepam (Klonopin) and my discomfort level. Whenever I tried to reduce the dose, I had more pain. This week I began taking a slightly higher dose, and I have significantly less pain when sitting, standing, bending, etc. For those of you who have tried the conventional neurontin, Cymbalta, anti-depressant combo without success, I'd invite you to speak to your MD about a trial dose of Clonazepam. My dose is 1 mg per day. It REALLY helps my symptoms.

There are drawbacks to using Clonazepam, so it is not to be entered into lightly. It is physically addictive. It may be hard to get off of, and one cannot go off of it cold turkey. It makes one tired. And there are other side effects too. But it substantially increases the quality of my life, so I am more concerned about living a productive life than be concerned about addictive issues. I don't have an addiction personality, so I know it is safe and beneficial for me to use right now until I can get therapy/surgery/heal, etc.

Thought I would mention this to anyone who is desperate to try something different.

kone