Any dorsal nerve decompression successes?

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susibee
Posts: 60
Joined: Wed Mar 16, 2011 4:12 am
Location: New Hampshire

Any dorsal nerve decompression successes?

Post by susibee »

Hi all!

I've been away from the board recently, and wow, there's a lot new going on here. I'm still not caught up reading everything. But I'm just wondering... do we know of any successful dorsal nerve releases among the members of this board? Anyone?

I'm still confused as to how a person can be sure their dorsal branch is causing a problem. There's MRI. As far as blocks -- it doesn't seem anyone isolates the dorsal branch with a block. Is that correct? And then there are symptoms/location of pain -- but those really don't seem like absolutes in terms of localizing an area of compression.
Vulvodynia diagnosed '01; symptom was occassional vulvar itching/rawness after sex.
Autumn '10, localized clitoral and left labial burning after sex
March '11, new left buttock pain, worsened clitoral/left labial pain/burning.
May '11, increased sitting pain.
Summer '11, pain decreased/plateaued to 0-4/5.
Treatment: 75 mg nortriptyline nightly, definitely helps; PT x 4, didn't really help.
Consults with Hibner and Dellon, left me with questions.
Next step: MRI in NYC or VT.
AliPasha1
Posts: 739
Joined: Fri Sep 17, 2010 2:35 pm
Location: New Orleans,Louisiana

Re: Any dorsal nerve decompression successes?

Post by AliPasha1 »

Hi Susibee,

I can only answer your question as far as a male is concerned.Dorsal Nerve in a male is the culprit when one has a numb Penis as well as scrotum pain.It isn't gping to address your sitting pain,bowel issues sacrum pain,Urinary frequency,Painful Urinary Urgerncy etc.Those are all PNE symptoms.

I hope that it helps.

Kind Regards,
Ali
Diagnosed for PNE by Dr. Jerome Weiss in June 2007.Started PT with Amy Stein in NYC.
PT for almost 3 years now without any results.
Pudendal Nerve blocks in August,2007 by Dr. Quesda left me with sitting pain.
Unilateral TIR approach with Dr. Bautrant on 18 Febuary,2010 with no major improvements and sitting is much worse.
MRI By Dr. Potter reveals nerve entrapment in the ST,AC and DN.
Dorsal Nerve Decompression surgery on April 8,2011
Redo surgery by Dr. Hibner on July 18,2011
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shawnmellis
Posts: 227
Joined: Sat Dec 04, 2010 8:42 pm
Location: Concord, NC USA
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Re: Any dorsal nerve decompression successes?

Post by shawnmellis »

Hi,
I think I may have a dorsal nerve compression based on my pain location and symptoms, and based on a visit with Dr. Dellon. I am still unsure though if all this is the only branch I have affected, or if is another branch compressed in addition to the dorsal branch or if another branch is mimicking the symptoms that resemble a dorsal compression. I am unsure because some people report having penile numbness and erection problems which I do not have. I mainly have urination problems, some scrotal pain, and pain in my upper perineum, but I also have some pain in the middle of my perineum and a light amount to my left perineum. I don't think there is a definitive test as to whether you have dorsal or not, but I think if you exclusively have the symptoms Ali mentioned such as penile numbness, penile pain, and erection problems and no other problems or similar problems for a female, then you probably exclusively have dorsal branch entrapment. I think that not a lot of doctors do dorsal nerve blocks, but I would think that would be a great test for it. I heard that Hibner has done a few of these dorsal block tests, and one was a male I think, so I may get one done when I see him in November. There have not been too many cases I am aware of of not only people being diagnosed with this, but also having surgery for this to give you the best opinion and facts on this though. I am going to email Dr. Dellon to ask him some of these questions, and will let you know what he says later.

Shawn
Bringing Help Awareness Education to Patients & Doctors about PNE through Videos at http://www.YouTube.com/PudendalNerve & PudendalHope.com Please tell Dr. Oz to cover topic of PNE by going to http://www.doctoroz.com/contact Started 1/2010. Initial urinary tract infection in 1/2010. Medication: Diazepam, Tramadol. 4 nerve blocks. physical reinjury 8/2010. 7/2011 Potter MRI Varices dorsal branch 8/23/11 Diagnosis Entrapment of Dorsal Branch Dr. Lee Dellon There's Always Hope!
flyer28
Posts: 244
Joined: Fri Mar 25, 2011 11:29 am

Re: Any dorsal nerve decompression successes?

Post by flyer28 »

I was also almost sure that I have dorsal nerve entrapment, having the pain in the upper part of penile shaft and around the base of penis. No urinary problems, no erection problems, no numbness, no sitting pain, only dull ache in the base of penise.
On 20th July I had an exam by Dr.Aszmann in Vienna, he was very kind and communicative, we spend more than one hour talking about my problems and examining the issue. Basically he said after the exam he can 99,9 % exclude pudendal nerve entrapment, even dorsal nerve entrapment is highly improbable (I have no sitting pain, no perieum pain, no anal pain, only pain at the base of penis). He thinks that it is related to microtrauma to penile crura ligaments or maybe some autoimmune inflammation of adjacent structures. My pain was always provoked by some mechanical irritation: sex, heavy lifting, tennis playing etc. He said that I am not a candidate for dorsal nerve decompression and my condition requires conservative treatment.
I felt some relief that I dont have neither PNE nor dorsal nerve entrapment. Whatever it is, it is easier to fight than PNE.
All the best
Matt
summer 2009 - episodic post ejaculatory pain,
early 2010- major flare-up, chronification
february 2011 - ESCW wave. major flare-up, lasting 5 months
february 2012 - diagnosed CPPS with irritation of pudendal nerve, hypog. plexus block
june 2012 - dorsal nerve block, no relief
2013 - starting PT with moderate results
2014-2017 better periods interchanging with heavy flare ups
2018 first long remission (several months)
2019-2023 most of the time almost assymptomatic with cca 2 flare ups yearly
nyt
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Joined: Sun Oct 31, 2010 3:24 am

Re: Any dorsal nerve decompression successes?

Post by nyt »

Far as I know Dr. Hibner is the only one doing dorsal nerve blocks. I do not know how many he has done to date but his associate Dr. Castellanos (not sure I spelled his name correctly) told me they are done ultrasound guided under anesthesia, they have gotten quite good at them and are happy with the results for diagnostic purposes. I do not know if anyone has been cured yet. I am scheduled for one with Dr. Hibner in October.
2/07 LAVH and TOT 7/07 TOT right side removed 9/07 IL, IH and GN neuropathy 11/07 PN - Dr. Howard
6/08 Obturator neuralgia - Dr. Conway 11/08 Disability, piriformis syndrome - Dr. Howard
4/09 Bilateral obturator decompression surgery, BLL RSD - Dr. Howard
9/10 Removed left side TOT, botox, re-evaluate obturator nerve - Dr. Hibner
2/11 LFCN and saphenous neuralgia - Dr. Dellon 2/11 MRI with Dr. Potter - confirmed entrapment
5/11 Right side TG - Dr. Hibner 2012 Left side TG - Dr. Hibner
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helenlegs 11
Posts: 1779
Joined: Fri Sep 17, 2010 9:39 am
Location: North East England

Re: Any dorsal nerve decompression successes?

Post by helenlegs 11 »

Dr Hibner recently said that [b]entrapment[/b] is often caused by some trauma, a fall,problem with surgical procedure etc and will be associated with a sharp onset of symptoms.
Nerve irritation and or intermittent compression would usually have a slower onset. Would the slower onset of symptoms be true of your situation Matt?
I hope that the conservative treatments work, let us know how you progress.
Fall 2008. Misdiagnosed with lumber spine problem. MRN June 2010 indicated pudendal entrapment at Alcocks canal. Diagnosed with complex variant piriformis syndrome with sciatic, pudendal and gluteal entrapment's by Dr Filler 2010.Guided piriformis botox injection 2011 Bristol. 2013, Nerve conduction test positive; new spinal MRI scan negative, so diagnosed for the 4th time with pelvic nerve entrapment, now recognised as Sciatic, pudendal, PFCN and cluneal nerves at piriformis level.
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shawnmellis
Posts: 227
Joined: Sat Dec 04, 2010 8:42 pm
Location: Concord, NC USA
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Re: Any dorsal nerve decompression successes?

Post by shawnmellis »

Hi, I just wanted say that since my last post, I have learned that someone can have the dorsal branch of the pudendal nerve compressed and not have erectile dysfunction or penile numbness and still have pain at any area of the penis,scrotal pain, or female genital area for women, and or pain at some other part of the perineum, but not usually any rectal problems unless you have both dorsal and another branch affected. It is possible to have both dorsal and another branch of the pudendal nerve compressed also. If you have a pain that you can duplicate any time of day by pressing on any part of your male or female genitals or a constant pain there, it is possible after you have ruled everything else out that you could have dorsal branch compression. Dr. Hollis Potter's MRI can also sometimes show scar tissue around the dorsal branch, varices, and or compresssion of this area. The only surgeon in the U.S. who does dorsal nerve decompression is Dr. Lee Dellon in Baltimore, Maryland.

Shawn
Bringing Help Awareness Education to Patients & Doctors about PNE through Videos at http://www.YouTube.com/PudendalNerve & PudendalHope.com Please tell Dr. Oz to cover topic of PNE by going to http://www.doctoroz.com/contact Started 1/2010. Initial urinary tract infection in 1/2010. Medication: Diazepam, Tramadol. 4 nerve blocks. physical reinjury 8/2010. 7/2011 Potter MRI Varices dorsal branch 8/23/11 Diagnosis Entrapment of Dorsal Branch Dr. Lee Dellon There's Always Hope!
AliPasha1
Posts: 739
Joined: Fri Sep 17, 2010 2:35 pm
Location: New Orleans,Louisiana

Re: Any dorsal nerve decompression successes?

Post by AliPasha1 »

Hi guys and girls,

My scotrum pain,Penile pain and urinary burning is back with a vengeance. :cry: :cry: :cry: :cry:

Ali
Diagnosed for PNE by Dr. Jerome Weiss in June 2007.Started PT with Amy Stein in NYC.
PT for almost 3 years now without any results.
Pudendal Nerve blocks in August,2007 by Dr. Quesda left me with sitting pain.
Unilateral TIR approach with Dr. Bautrant on 18 Febuary,2010 with no major improvements and sitting is much worse.
MRI By Dr. Potter reveals nerve entrapment in the ST,AC and DN.
Dorsal Nerve Decompression surgery on April 8,2011
Redo surgery by Dr. Hibner on July 18,2011
calluna
Posts: 1058
Joined: Mon Sep 27, 2010 11:57 pm

Re: Any dorsal nerve decompression successes?

Post by calluna »

I'm so sorry to hear that, Ali.
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Karyn
Posts: 1655
Joined: Fri Sep 17, 2010 12:59 pm
Location: Lowell, MA

Re: Any dorsal nerve decompression successes?

Post by Karyn »

Ali,
I'm so sorry you're hurting! Do you think you're having a flare from PT or perhaps the nerve block? I certainly hope this subsides for you soon!
Hugs,
Karyn
Ultra Sound in 03/08 showed severely retroverted, detaching uterus with mulitple fibroids and ovarian cysts.
Pressure and pain in lower abdomen and groin area was unspeakable and devastating.
Total lap hysterectomy in 06/08, but damage was already done.
EMG testing in NH in 04/10 - bilateral PN and Ilioinguals
3T MRI at HSS, NY in 09/10
Bilateral TG surgery with Dr. Conway on 03/29/11. Bilat ilioinguinal & iliohypogastric neurectomy 03/12. TCD surgery 04/14.
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