Health Organization for Pudendal Education

Well, not sure what to make of the progress or lack thereof from my guided bilateral pudendal block I received this past week. Since this was my second block they increased the epinephrine/steroid content. After the block, my perineum region was fully numb including both butt cheeks, I also felt that some epinephrine leaked over into the sciatica on the right side as I had pins and needles all the way down my leg as well as some numbness which lasted for more than 14hrs.

Now for the results,

My baseline is normally around a 6, this increases with prolonged sitting as well as standing (Left side seems to be a little worse on some occasions)

The left side dropped from its normal level to about a 3 for approximately 2hrs then jumped to a 4 after 4hrs then returned to normal levels. As for the right it dropped to about a two for about 4hrs. Last night I experienced increased burning which I still have today.

What are everybody’s thoughts? Would this block be considered successful? Will this additional burning go back to normal levels?

I do not know about all PN surgeons, but Dr. Hibner considers any relief of pain for any amount of time to be a "successful" block as referenced in his 2010 article in The Journal of Minimally Invasive Gynecology

Yes, post-block "flares" are normal for most people. It typically took 1-2 weeks for me after a block to get back to baseline. I never had any long term relief from blocks.

Faith wrote:I do not know about all PN surgeons, but Dr. Hibner considers any relief of pain for any amount of time to be a "successful" block as referenced in his 2010 article in The Journal of Minimally Invasive Gynecology

Yes, post-block "flares" are normal for most people. It typically took 1-2 weeks for me after a block to get back to baseline. I never had any long term relief from blocks.

The thing I don't understand is if my whole perineum area was numb wouldn't that mask most the nerves in the area therefore not pin pointing the exact nerve?

I think the point is that if blocking the pudendal nerve gives pain relief, then that indicates that the problem is with the pudendal nerve, and not with anything else. The pudendal nerve innervates the whole of the perineal area, so there won't be any other nerve involved.

With regard to which branch(es) of the pudendal nerve might be affected, that's another thing. The symptoms give a clue, but as pain can be felt both proximal and distal to the problem area of the nerve, it is hard to tell for certain - also, anatomy can vary a lot.

I'm glad your block was successful, and I do hope that the flare settles down soon.

Hi, I am new to this website

I am looking for information to help my mum, she has suffered severe pudendal nerve pain for the last 3 years, and she has and is on huge amounts of medication, which has not made any difference at all, This effects her life hugely, Yesterday she had her first x-ray guided nerve block in london, she is now in severe pain and tears, we were told it could get worse but this is ridiculous, she is in immense pain on sitting ,i feel so sorry for her, only relief she has has is when she is lying completely flat or stood upright, but she is 71 and gets tired,has anyone any idea how long this extreme pain will last for??

Thanks Paula

Paul,

Just wondering how you're feeling now after your second block.

Redsukita wrote:Hi, I am new to this website

I am looking for information to help my mum, she has suffered severe pudendal nerve pain for the last 3 years, and she has and is on huge amounts of medication, which has not made any difference at all, This effects her life hugely, Yesterday she had her first x-ray guided nerve block in london, she is now in severe pain and tears, we were told it could get worse but this is ridiculous, she is in immense pain on sitting ,i feel so sorry for her, only relief she has has is when she is lying completely flat or stood upright, but she is 71 and gets tired,has anyone any idea how long this extreme pain will last for??

Thanks Paula

Hi Redsukita,

Sorry to hear about your mom, hopefully the pain starts to diminish soon!

With my first guided nerve block I had no ill effects whatsoever, with the second I did experience increased burning in my buttocks and thighs for 5-7 days at which time I returned to my normal levels. If you read through some of the posts regarding blocks you will see that some people have had both good and bad responses, I think it all depends on the person. Please keep us up to date.

Lernica wrote:Paul,

Just wondering how you're feeling now after your second block.

Back to my normal pain levels with no change unfortunately!

Thanks for asking! How are you making out these days?

Paul,
At least you got some diagnostic information from your blocks. As far as I can tell, they are rarely if ever a cure. What are you thinking about for your next move ?

Best Wishes,

Don

donstore wrote:Paul,
At least you got some diagnostic information from your blocks. As far as I can tell, they are rarely if ever a cure. What are you thinking about for your next move ?

Best Wishes,

Don

My pelvis floor specialist is confident that I have Pudendal Neuralgia by the fact that she can move the nerve among other tests she has done and seen positive results. That being said, I have worked with a few therapists before with little success but I have to have faith. I have set a timeline for November at which time if I do not see any improvement I will make plans to see Dr. Beco who I am already working with.