I am a little confused. After reading numerous posts, I believe it is accurate to state that entrapment in the distal alcock's canal is difficult, or impossible, to treat with the TG method. So how is it treated surgically?
Is the dorsal nerve in the distal alcock's canal?
Also, what are the specific symptoms of entrapment in this area? I can pretty much pinpoint my area of pain, but I don't know how to describe it. The pain seems to lie medial to the ishial tuberosity, on the inside of the posterior thigh, or the right side of the perineum. I know it would help to get a MRI from Dr. Potter, but the money just isn't there. I am scheduled for surgery with Dr. Conway using the TG method, but if I am entrapped in the distal alcock's, it will be a waste of time, (I guess).
Finally, does anyone know why the sitting pain becomes worse after some surgeries????
Thank you for any and all answers. There are lot of people who understand this wretched disease much better than I do.
Entrapment at Distal Alcock's
Re: Entrapment at Distal Alcock's
I believe that dorsal entrapment is often characterized by clitoral (or penile) pain. Increased pain after surgery is due to aggravation of the nerve during surgery. What does Dr. Conway say about your symptoms ? There is a long discussion of this area here: http://www.pudendalhope.info/forum/view ... f=17&t=448
Don
Don
Mild to moderate PN for 5 plus years, pain controlled by lyrica and opiates.
Nerve block (unguided) 9/10 Dr. Jerome Weiss - sciatica for 5 months but got numb in painful perineal/scrotal area - he diagnosed entrapment - but no more cortisone for me
Potter MRI 5/11 - rt STL entrapment of PN at Alcocks
Consult with Dr. Hibner Feb. 2012
Bilateral inguinal hernias diagnosed by dynamic ultrasound - surgery on 6/20/13
Feeling a little better, a few more months will tell
Nerve block (unguided) 9/10 Dr. Jerome Weiss - sciatica for 5 months but got numb in painful perineal/scrotal area - he diagnosed entrapment - but no more cortisone for me
Potter MRI 5/11 - rt STL entrapment of PN at Alcocks
Consult with Dr. Hibner Feb. 2012
Bilateral inguinal hernias diagnosed by dynamic ultrasound - surgery on 6/20/13
Feeling a little better, a few more months will tell
Re: Entrapment at Distal Alcock's
Thank you, Don. I haven't seen Dr. Conway yet. Since I live so far away, he will do what he calls a "one stop shopping." I will see him one day and have surgery the next. But you have already helped me a great deal. I don't have clitoral pain, so I am hopeful that Dr. Conway will be able to reach the area of entrapment. I will check out the link you provided.
Re: Entrapment at Distal Alcock's
Paulette, distal alcock's is a difficult area to reach. Ali has probably studied into it more than most of us -- you could PM him.
PNE since 2002. Started from weightlifting. PNE surgery from Dr. Bautrant, Oct 2004. Pain now is usually a 0 and I can sit for hours on certain chairs. No longer take medication for PNE. Can work full time and do "The Firm" exercise program. 99% cured from PGAD. PNE surgery was right for me but it might not be for you. Do your research.
Re: Entrapment at Distal Alcock's
Thanks, Violet. I will.
Re: Entrapment at Distal Alcock's
Hi Violet,
Thank You very much for the compliments.
Hi Paulette and Don,
At the moment,Dr. A Lee Dellon in Baltimore and Professor Aszmann in Vienna,Austria are the only two surgeons who can reach the distal Alcock's Canal by means of the dorsal ,Perineal nerve to the entrance of the distal Alcock's Cnal.They can both put a finger and see if there is any tightness there.
All other surgeons can access the Posterior end of the distal Alcock's Canal.
None of the other PNE surgeons including Robert,the Houston team,Bautrant,Conway and Hibner can access it by either means TG,Modified TG or TIR approach.
It is done by means of the dorsal nerve decompression surgery only.
Dr. Hibner was supposed to start doing dorsal as well as perineal and the distal Alcock's Canal surgery after his trip from Vienna,Austria in Febuary but it seems that he isn't ready as yet.
Kind Regards,
Ali
Thank You very much for the compliments.
Hi Paulette and Don,
At the moment,Dr. A Lee Dellon in Baltimore and Professor Aszmann in Vienna,Austria are the only two surgeons who can reach the distal Alcock's Canal by means of the dorsal ,Perineal nerve to the entrance of the distal Alcock's Cnal.They can both put a finger and see if there is any tightness there.
All other surgeons can access the Posterior end of the distal Alcock's Canal.
None of the other PNE surgeons including Robert,the Houston team,Bautrant,Conway and Hibner can access it by either means TG,Modified TG or TIR approach.
It is done by means of the dorsal nerve decompression surgery only.
Dr. Hibner was supposed to start doing dorsal as well as perineal and the distal Alcock's Canal surgery after his trip from Vienna,Austria in Febuary but it seems that he isn't ready as yet.
Kind Regards,
Ali
Last edited by AliPasha1 on Wed Aug 03, 2011 4:57 pm, edited 2 times in total.
Diagnosed for PNE by Dr. Jerome Weiss in June 2007.Started PT with Amy Stein in NYC.
PT for almost 3 years now without any results.
Pudendal Nerve blocks in August,2007 by Dr. Quesda left me with sitting pain.
Unilateral TIR approach with Dr. Bautrant on 18 Febuary,2010 with no major improvements and sitting is much worse.
MRI By Dr. Potter reveals nerve entrapment in the ST,AC and DN.
Dorsal Nerve Decompression surgery on April 8,2011
Redo surgery by Dr. Hibner on July 18,2011
PT for almost 3 years now without any results.
Pudendal Nerve blocks in August,2007 by Dr. Quesda left me with sitting pain.
Unilateral TIR approach with Dr. Bautrant on 18 Febuary,2010 with no major improvements and sitting is much worse.
MRI By Dr. Potter reveals nerve entrapment in the ST,AC and DN.
Dorsal Nerve Decompression surgery on April 8,2011
Redo surgery by Dr. Hibner on July 18,2011
Re: Entrapment at Distal Alcock's
Thanks, Ali,
I hope the dorsal nerve is not my problem. I could not afford either surgeon who decompresses it. Thank you for explaining who can and cannot take care of the problem.
I hope the dorsal nerve is not my problem. I could not afford either surgeon who decompresses it. Thank you for explaining who can and cannot take care of the problem.
Re: Entrapment at Distal Alcock's
Paulette,
when are you seeing dr. conway? I'll be thinking of you....
cari
when are you seeing dr. conway? I'll be thinking of you....
cari
PN after using pickaxe doing yardwork 6/11
Potter MRI: Scar tissue abutting L pudendal.
Hibner consult 10/11 w/ plan: 2 mo. PT
No meds work for me
PRF X 3 times in Denver ( was pain free for 5 months after second)
Potter MRI: Scar tissue abutting L pudendal.
Hibner consult 10/11 w/ plan: 2 mo. PT
No meds work for me
PRF X 3 times in Denver ( was pain free for 5 months after second)
Re: Entrapment at Distal Alcock's
cari,
I am scheduled for surgery Aug. 23. But after reading Dr. Dellon's chapter on pelvic pain, I'm not sure I should. I am convinced that I am entrapped at the FCN. But maybe the pudendal nerve also. Too bad I did not have a MRI with Potter. May have to postpone surgery.
I am scheduled for surgery Aug. 23. But after reading Dr. Dellon's chapter on pelvic pain, I'm not sure I should. I am convinced that I am entrapped at the FCN. But maybe the pudendal nerve also. Too bad I did not have a MRI with Potter. May have to postpone surgery.