MRI and scarring

[Faith]

I've noticed that most MRI's from Dr. Potter show scarring at some level indicating PNE most likely. Did anyone who had an MRI by her (or otherwise know) if it's possible for normal people (without PN pain) to have an pelvic MR showing scarring, but obviously not have PNE. I am just trying to understand since I know they can't use the MRI as diagnostic for PNE what the reasoning would be.

[AliPasha1]

Faith,
That's the question that should be addressed by Dr. Potter herself.As you can read from my MRI report that I am scarred but I am also entrapped in the scar tissue.

Regards,
Ali

[Pelvis Stressly]

Did anyone who had an MRI by her (or otherwise know) if it's possible for normal people (without PN pain) to have an pelvic MR showing scarring

This has been my main question re. the value of Potter's scans in diagnosing this condition ever since I went to see her close to a year ago. I'm not at all questioning the accuracy of the images she gets, just wondering if the scar tissue she seems to find in almost everybody is always necessarily indicative of entrapment/compression.

The guys I went to see in Cornwall (& my pelvic floor PT) certainly don't seem to think so. The RMT in Cornwall said he can randomly grab any muscle in just about anyone's body & easily find scar tissue (often just based on life's normal wear & tear). That doesn't automatically indicate a problem though, and he won't treat it unless it's actually in a location with corresponding symptoms.

[AliPasha1]

Hi PS,
Happy New Year my friend!You have brought a very good point.So far her findings have proven to be correct as far the scarring of the PN in two patients is concerned.i.e Athena's mom & RJR.But as you said,the pain symptoms correlated with the findings.Isn't it rare to have a scar tissue in the Alcock's Canal or the ligaments since they are so deep in the Pelvis.

Regards,
Ali

[Pelvis Stressly]

To you too Ali.

Yeah, think the point is clinical findings (ie. symptoms) have to take priority over any imaging. So an MRI can be helpful if it confirms & narrows in on what the patient's actually experiencing, but otherwise it's not uncommon to see unrelated anatomic anomalies (that aren't actually causing any problems).

And I think we'd both agree that it's obviously way too soon to start jumping to any conclusions based on only two patients (although it's a promising start). I'm just worried that people might now prematurely jump into surgery based strictly on Potter having turned up a bit of scar tissue, when it might not actually be responsible for the offending symptoms.

Relatively speaking, don't think the pudendal nerve is actually so deep Ali, which is why it's subject to damage (& scar tissue).

Take care, PS.

[PN-SufferVT]

My two cents on this topic....

First we have to remember that you can have damage or trama to a nerve not fill it in the location of the of the damage. For example this is why some not all but some feel pain in the rectum or penis when their issue is at the level of the ischial spine or elsewhere. Nerves are like electric wires pulses can follow either way.

Secondly, my wife (Anesthesiologist) says there are other forms of a previous injectable called Wydase that are on the market, but lesser known. But in some cases could treat scar tissue.

I will try to get the names of those for everyone.

[AliPasha1]

Hi PS,
It should be the other way around,since the Pudendal Nerve is so deep in the Pelvis and surrounded by ligaments, muscles,and tissues for proteting it, that it should be a rare thing to have the scar tissue around it expecially in the Alcock's Canal.That would also expain why the PNE is a rare condition and has been so difficult to visualize.

Regards,
Ali

[AliPasha1]

Happy New Year PN-Suffer VT,
I would really appreciate if you can kindly provide the names.Maybe,it is possible to break the scar tissue around the dorsal nerve.

Regards,
Ali

[Pelvis Stressly]

Well I said "relatively speaking" Ali because, although it may still be a rare condition, compared to the small nerves in the hypogastric plexus for example, the pudendal nerve is more exposed and at risk of damage through activities like cycling.

Comparing the two nerves, Dr. Aszmann had the following to say...

"these [nerves in hypogastric plexus] are embedded in loose connective tissue far away from bones and ligaments. Cycling only presses on the pudendal nerve, since there the inferior pubic ramus opposes the saddle and the poor nerve gets traumatized."

[AliPasha1]

PS,
But the nerves to the hypogastric plexus are very close to the male prostate and any issues with the prostate can effect these nerves as well.That's why most people become impotent after prostate cancer surgery and chemotherapy treatment.

Regards,
Ali