Health Organization for Pudendal Education

I brought my mri's from Dr Potter and also had one done here his radiologist sees no scar tissue or entrapments But. Dr Potter sees everything. I flew way out here for.nothing. there is no hope

I'm so confused...I saw on Facebook that he did an exploratory surgery on you and didn't see any scar tissue?

What is Dr. Hibner recommending? Botox, pelvic floor PT, pain pump? Did the MRI from Dr. Potter show scarring?

Us Dr Potter showed trapped in alcocks nerve and dorsal nerve to the cliyoris he does not believe hers. I have q pump on left side and I'm done the first time after five blocks this is cat scan guided that's how They all should have been. Now my right side is burning is on fire. He wont put two pumps in he never has afraid of too much marxaine cause I hallunciated with lidocaine. I'm so upset Dr kalaklon MRI is not showing nothing. I also had this MRI the day laproscopic surgery. I don't want to leave arizonia until I am numb on both sides. I'm so upset that Dr hibner does not want to listen to Dr Potter. And Dr Potter emailed Dr hibner and was actually upset I had another MRI by someone else. Well I wanted to and SR hibner wanted yo compare reports. So here I lay still in the hospital Just. Not knowing anything. Its very hard to get a word in when Dr hib is talking. I know he does not want to jump into surgery but would the. Pump work qnays if I didn't have entrapmns Croesus It work on everyone

Are you sure he said he wouldn't operate at all? I'm also seeing Dr. Hibner, and he is very cautious about sending people directly to surgery. He wanted me to try the pain pump and then botox and a PT eval before surgery, but after explaining ( and crying) that I really didn't want to want for surgery any longer, he agreed to just do the botox and PT eval. He also sent me to have an MRI at St. Josephs's and like yours, mine apparently came back normal. This hasn't affected his treatment plan (including surgery) though. I think he just really want people to go through all the treatment options first before having the surgery.

yes, he will still operate. he bases the reason to operate on your clinical presentation (ie: symptoms, feelings... that you hurt there) not on the MRI.

He always does the pain pump first... but that doesn't mean no surgery.

He always tries pain pump, pt and botox before surgery. If they don't work then he does surgery.

at least your pain pump went in. Mine didn't.

I forgot your name that had the MRI here dud u also have it with dr potter. Also question if they were to put a pain pump in anyone would it numb them too. I am numb on my left side would that happen to anyone. Does this prove I am entrapped. Also if this works would a intrathecial pain pump work

No, I wouldnt think it proves that you are entrapped...at most, it proves that the pudendal nerve is most likely involved in some way but people can have neuralgia from other causes than entrapment. Yes, the pain pump *would* causes numbness for anyone not just for those with pudendal symptoms (basically, if you hooked up someone completely asymptomatic they would still have numbness).

I think you need to clarify with Dr. Hibner exactly what his treatment plan is for you. I think it is wise of him not to jump into surgery given the variation in cause of pudendal pain...if you have pudendal neuralgia due to other causes and not due to entrapment than all the surgery in the world to release an entrapment will not work. You also have to remember that the 3T MRI and Dr. Potter are not infallible and it is not yet a recognized or widely acceptable means of diagnosing pudendal nerve entrapment....keep in mind that there have been no studies done to compare asymptomatic people against symptomatic people and what the results would ultimately show in each group. I am definitely not saying that the results are not accurate...I'm just saying it makes no sense to base an entire treatment plan on something that hasn't been proven *enough* at this point.

sgrandy,
You stated that if pudendal neuralgia is not caused by the nerve being entrapped, then all the pudendal release surgery in the world would do no good. Do you know if when a surgeon opens up the sacrotuberous ligament, (TG approach), and finds that the nerve is not entrapped in the ligament, does he still cut the SS ligament? It seems that even if PN was caused by something like tight muscles, cutting the SS ligament would give the nerve some extra room. What do you think?

Sorry, Paulette...I wish I could answer that question but I honestly don't know. I have not had surgery nor have I consulted with anyone for surgery so I'm not sure what an individual surgeon might do with the SS if no entrapment at that level can be seen...I suppose it depends on each individual's protocol. I guess it is always possible that cutting the ligament could give the nerve some slack but I'm not sure how much of a difference it would really make if the cause of neuralgia was solely overly tight muscles (which is a component in my case). I'm assuming that if the the ligaments are overly tight for some reason and irritating the nerve that severing the ligaments might help with that even if the nerve is not "officially" entrapped...this seems logical to me at least.