Health Organization for Pudendal Education

On my second surgery they found that the nerve was:

1. Entrapped in both allcok's canal, called the pudendal canal above, by the sacrospinous ligament. My understanding is that this is the "typical" entrapment.
2. It was also caught up in the falciform process.



Has anyone else had this? If so how has recovery been, and what have you done for follow-up therapy.

Thanks

Carl

Hi Carl,

I had entrapment in Alcock's canal, falciform process, and at the ST/SS ligament grip at the ischial spine on both sides -- 3 places on each side I guess.

I guess the best word I can use to describe recovery would be "slow". I think follow-up therapy would depend on the underlying cause. I did a bit of PT at almost a year post-op. A tens unit helped the muscles to get back to a more relaxed state. I also did some prolotherapy to strengthen the ligaments and stabilize the pelvis. For pain relief in the early months post-op I did alternating hot/cold sitz baths. I think rest and avoiding aggravating activities is really important.

Violet

Thanks Violet,

Violet M wrote:Hi Carl,

I had entrapment in Alcock's canal, falciform process, and at the ST/SS ligament grip at the ischial spine on both sides -- 3 places on each side I guess.
...

Looking at the post I said entrapment on the SS ligament, but actually the SS had scarred onto the PN; Dr. Conway had to remove the remains of the SS completely.

Excerpt from Dr Conway Operative Notes May 2012 wrote:
we were able to identify a portion of the falciform process, which appeared to infuse with the sacrospinous ligament near the ischial spine and appeared to be directly compressing the pudendal nerve. ... which was flattened in this area.

We then traced the nerve ... and found it affixed in another area to the remnant of the sacrospious ligament near the ischial spine.

There was also some tangling of the third branch in the vascular bundle.

There were a couple of Good things that came from this surgery.

1. There was definite entrapment and scarring that required surgery that the previous surgery could not have fixed.
2. Surgery prevented even further nerve damage that would have occurred.
3. This was clear documentation of nerve entrapment and nerve damage in separate locations.
4. Confirmed that I was not Crazy, I know it sounds funny, but after a while with PN you wish it was in your head and that there was a fix for it.

So as bad as it is right now at least I know there was something wrong that caused this.