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Cryoablation and RF Ablation

Posted: Tue Jun 11, 2024 1:21 am
by jon
I've been scheduled for cryoablation on 6/27/24, with a nerve block the day before.

I've had two nerve blocks done by Dr. Lawrence Poree, who is now at UCSF in San Francisco. He did them at the ischial spine using fluoroscopy for visualization and a needle probe with a speaker on it that could pass a bit of current through the nerve to verify location. It was interesting to hear my pudendal nerve continually firing for no reason.

I've also had 2 pudendal nerve blocks, by different doctors, that did absolutely nothing. I don't know the location those doctors used.

I'm very curious as to why the Interventional Radiologist is planning to do the nerve block at the Alcock's Canal. And it seems very inappropriate that most ablation procedures are also done there.

The ischial spine is proximal to the Alcock's Canal. That means it's closer to the spine. Usually, but not 100% of the time, a nerve block only affects more distal portions of the nerve. The ischial spine is where the sacrospinus and sacrotuberous ligaments cross, and that's the most common entrapment location. Why in the world would you do a block, or, God forbid, an ablation procedure that leaves out the most common problem area?

I really have to get this answered before I have my procedure.

In theory, at least in what's left of my mind after Gabepentin, is that I DON'T want a block at the canal to work. That way I'd know I have an entrapment before the Canal and after the ischial spine.

That would be crucial to know before having decompression surgery, because the transrectal approach cuts your entire buttock open so the entire nerve can be traced. There are now minimally invasive options that have a MUCH shorter recovery time than transrectal, which can take up to two years to fully recover from.

Re: Cryoablation and RF Ablation

Posted: Wed Jun 19, 2024 1:47 am
by Violet M
Sounds like you have done your homework, Jon.

Did the nerve blocks by Poree give you any temporary pain relief? It seems like you would want to have a successful nerve block at the site of the cryoablation prior to the procedure. Is that what they recommended?

Wishing you the best with your procedure.

Violet