Health Organization for Pudendal Education

Hi all! I am scheduled to have a nerve block to the dorsal nerve to to clitoris to see if that nerve is the one causing the rest of the pain to the pudendal nerve. Dr Castellanos is doing it on June 17th. I'm questioning just having the anesthesia and not the steroid which will cause a flare in pain. I have not had any relief from other nerve blocks but had severe pain lasting a long time. I know its diagnostic so wouldn't the anesthesia be enough for that? My PGAD is constant. I have a neurostimulater implant by Dr Peters but it does nothing for PGAD. I feel like in going mad! Any input would be so appreciated. Blessings to all of you!

I am not sure what you mean by just the anesthesia. They usually use bupivacaine in the block plus a steroid. Are you asking them just to use the bupivacaine or similar medication without the steroid? I am assuming in the past when you have had nerve blocks the steroid has caused a flare for you. I know it can happen even though it is rare.

Yes, sorry I do mean bupivaine and yes I had a severe flare from the steroid and see no reason to go thru that again!
If its for diagnostic reasons I should be spared. They said i can decide the morning before the procedure. In also having botox to the pelvic floor muscles. Just wondering if anyone has had this nerve block?

proudpam, did you have PNE surgery with Dr. Conway in March? I had a steroid block about 3 months after surgery and that was a complete disaster.

I had both the dorsal nerve block and botox done at the same time. This was a couple of years ago. I do quite well with botox but I know not everyone on the forum has had the same experience with botox that I have. I still get botox to the pelvic floor. With the dorsal nerve block it was the first time I had no clitoral pain, it was glorious and then the block wore off . Dr. Hibner wanted to do dorsal decompression surgery on me but I declined. Told him I was done having surgeries. I have Complex Regional Pain Syndrome (CRPS) and when he did my left side it moved into there and even though I have improvements from the left sided surgery it added new problems from CRPS spread. I told him I just didn't want to risk the CRPS spreading again into a new site. He was quite understanding and told me if I ever changed my mind to let him know and we would consider ways to try and not have my CRPS spread after surgery.

nyt, how can you have so many nerve entrapments? How can it even possibly happen?
If I remember correctly Dr. Dellon wanted to decompress 10 nerves or so. Then you had obturator decompression. Bi-lateral pudendal decompression and then Dr. Hibner wanted to decompress the dorsal nerve.

What is the pathology that makes 12 or so nerves in your body become entrapped? Do you really believe what you were told by those surgeons?

Hi nyt...I did not have surgery with Dr Conway! My gut was not at peace with that decision. Gotta go with the gut.
Dr Castellanos thinks possibly just my dorsal nerve is entrapped due to my competitive biking on the wrong seat.
Because of that theory we are tackling that. I did not know they could do decompression surgery to just the dorsal nerve. I did ask him if the nerve could be "killed off" and he said it could be cut!? I fear the steroid will make things worse than they already are. In 60 years old and honestly want to retire at 65 with full benefits from my work so I need to continue working. It has been so difficult. My last block flared me for months. Continued input from all of you friends in pain will be so helpful even though I have to make the final decision.
Blessings to all!

proudpam, I had dorsal nerve surgery. Completely useless.

Ezer, I am not going change the subject of this thread by going into my history especially since I posted much of what caused my problems in previous threads. I think it is wiser to stay on subject within the threads.

nyt, you are the one that chose to go off topic with describing your own surgeries with Dr. Hibner when the topic was nerve blocks, not me.

I was surprised that you were offered yet more surgery from Dr. Hibner. This is in addition to the suggestion to get decompression of an extra 10 nerves plus a fasciotomy (from a surgeon that has a spectacular 100% success rate --a number that you fully accredit from what I recall).

It sounds farcical on the surface but what do I know. As you implied multiple times when you were lecturing me, It is a very complex subject and it would be too difficult for a layperson like myself to comprehend.