Health Organization for Pudendal Education

Minor intervention meaning easy to do. He is the only one that does it

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Missingmylife42 wrote:Minor intervention meaning easy to do. He is the only one that does it

I think it can be an outpatient surgery. I don't know if he is the only one but you should try a nerve block and see if it resolves your problem..

Thought I'd post my report by Dr. Bautrant. 3 years after surgery I still have pain in the right side at the site of surgery, I was very careful to diligently massage the piriformis muscle regularly to prevent piriformis syndrome.. I have no idea why I'm still experiencing pain in this area but I'm so much better than I ever was before surgery. It has taken a very long time for me to get to this point but I'm not cured entirely. Right side sit pain escalates when sitting, right at the very area where surgical decompression was carried out. Between the sacrospinous and sacrotuberous ligaments. I sometimes have the odd flare in the rectum but very seldom. Sacrum is tight and painful but I get great relief in this area when I use the TENS unit for an hour or so each day. In the years leading up to surgery, I had no improvement of symptoms whatsoever. I had tried every other treatment available to me and felt I had no other choice but to see Dr. Bautrant. My only medication now is 25mg Lyrica at night. I rather try and cope with the 30% of pain which still remains without being drowsy throughout the day but I know I need to get a good sleep at night. See below report.

TYPE OF SURGERY .. Surgical Treatment of right pudendal nerve entrapment at the Alcock canal and the inter-ligamental clamp by the trans ischio rectal approach with endoscopic control.

Indication- Right Pudendal neuralgia due to tight Alcock canal and inter ligamental clamp entrapment.

Medial and posterior colpotomy. Entry was through the right ischio-rectal fossea and dissectioned until reaching the sacro-spinous ligament.
Opening of the pudendal canal at the inferior edge of the sacro spinous ligament.
Liberation of the inter ligamental grip by sectioning very tight fibers of the lower part of the sacro-spinous ligament which constitutes the effect of a clamp with the sacro-tuberous ligament. This ligament was conserved and liberation was necessary by sectioning the lower third of the sacro-spinous ligament.
Entry in the Alcock canal was obtained by sectioning hard fibers of the Falciporous ligament.
Progressive section, after haemostasis with the ultrasound energy, of all the pathalogical and sclerosis fibers of the Alcock canal until there was total liberation.

Degree of entrapment at the Interligamental Grip: 4 (1-4)
Degree of entrapment at the Alcock Canal: 3 (1-4)

Careful haemostasis with bipolar energy.
Large antisepsis. Drainage. Closure with resobers stitches.

Duration of surgery : 1 hour and 15 minutes.

Hi Catherine,
That is the whole problem with TIR approach by Dr. Bautrant.He never access's the Sacrotuberous ligament where the nerve is entrapped many times .When I had my MRI with Dr. Potter ,I made sure that she looked into the Sactrotuberous ligament and to my shock and amazement,I was entrapped in the Sacrotuberous ligament as well as I got re-entrapped in the scar tissue in the Alcock's Canal left after surgery.
You can look at my MRI results which I have posted.

Best Regards,
Ali

AliPasha1 wrote:Both Sacrotuberous and Sacrospinal Ligaments especially the Sacrotuberus ligament are very important for Pelvic stability.I can see proof of my friend who had surgery in Nantes that left him with sitting pain as well as inability to lift even objects like grocery bags.
Ligament repair is imperative for Pelvic stability.

Ali,

Didn't know that you'd actually met someone who had the surgery in Nantes. Can you give his first name and when he had the surgery?

Greg