A couple of months into my weightlifting program I noticed some twinges of pain that felt kind of like a toothache in the right posterior vaginal wall. My doctor passed it off as hemorrhoids so I thought, “OK, lots of people have hemorrhoids so I’ll just live with it.” Over the next year the pain became more persistent until I had to stop the exercise program and start the seemingly endless search for a doctor who could provide a diagnosis. Finally the pain became knife-like with diffuse burning and pelvic floor muscle spasms, forcing me to lie down most of the day. Except for my religious faith and my love for my family I had no reason to live.

My chiropractor “fired” me because my pelvis was so unstable it wouldn’t hold an adjustment for five minutes. My physical therapist (my second one), a pelvic floor specialist, pressed on the pudendal nerves and said, “It looks like your worst pain is right on the pudendal nerves.” Talk about a pain flare afterward – it was so bad my physical therapist wasn’t sure how to proceed during my next visits. My pelvis was so unstable she was shocked and said, “I’ve never seen anything like this before!” After seeing that physical therapist, I googled “pudendal nerve” and read for the first time about pudendal nerve entrapment and pudendal neuralgia. As I read I kept saying over and over again, “That’s me! That’s exactly how I feel! This is not all in my head!”

With only minor, temporary improvement from physical therapy and nerve blocks I was faced with the decision of whether to lie in bed indefinitely or go for pudendal nerve decompression surgery. Due to the chronic strain and laxness in my pelvic ligaments I did not feel comfortable with the transgluteal approach that severs the sacrotuberous (ST) ligaments. My research led me to the conclusion that the ST ligaments are important in pelvic stability, specifically in preventing excessive rotation of the pelvis. I opted for the trans-ischio-rectal (TIR) approach because it spares the ST ligaments.

My surgery was in 2004 in Aix-en-Provence, France. I had six points of entrapment – bilaterally at the ischial spines, falciform processes, and Alcock’s canals. The sacrospinous ligaments were very hardened and had to be completely sacrificed on the right and partially on the left. Dr. Bautrant was unable to achieve a normal PNMLT during surgery, possibly because the myelin sheaths of the nerves had been damaged.

The first six months of recovery were quite painful, to the point where I wondered whether I had made the correct choice regarding surgery. By the ninth month I experienced significant improvement in  pain and activity levels. Now I am completely off  medications and I can be up and around all day doing light housework, gardening, and other activities I used to enjoy.  After losing several years of my life to the couch, I have even gone back to work!  I have to be careful not to get too rambunctious or sit too long, but my quality of life is 80% better than it was before surgery and I am extremely grateful to the physicians who helped me get my life back.

June 2018 — Here is an update to my story.  It’s been almost 14 years since PNE surgery from Dr. Bautrant.  I work as a nurse, sit many hours at a time,  take 16 mile hikes in the mountains,  lift light weights, and do landscaping and gardening in my yard.  In short, I have a very active, great life.  There are certain activities such as jogging and cycling that I avoid because they tend to flare-up the pain.  Otherwise, I hardly have any PN pain.

Wishing everyone less pain!