Differential for pelvic pain (updated)

Hysterectomy, Ovary Removal, SIJD, Piriformis Syndrome etc
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Violet M
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Re: Differential for pelvic pain (updated)

Post by Violet M »

Gigas wrote:
Being stuck in that loop mean forgetting all those "answers" are outside the mainstream. I'm not going to revive my well-documented rant (much repeated in 2004-2006 when I was in the pain soup) except for this quote from an objective source that should give the PNE faithful pause:
Pudendal nerve neuropathy is likely to be a probable diagnosis if the pain is unilateral, has a burning quality and is exacerbated by unilateral rectal palpation of the ischial spine, with delayed pudendal motor latency on that side only. However, such cases account for only a small proportion of all those presenting with perineal pain. Proof of diagnosis rests on pain relief following decompression of the nerve in Alcock’s canal and is rarely achieved. The value of the clinical neurophysiological investigations is debatable; some centres in Europe claim that the investigations have great sensitivity, while other centres, which also have a specialized interest in pelvic floor neurophysiology, have not identified any cases.
— European Association of Urology, Guidelines on Chronic Pelvic Pain
Translation: PNE does not exist (if it did, surgery for it should work).

The reality is worse: there are no good records to determine whether surgery for PNE works, or not.
The Nantes article on criteria for diagnosing PNE lists similar criteria as what you posted above. I do not see where the EAU says that PNE does not exist. They say it's rare which is what our website says. You have come up with your own translation of what they said and I do not agree with your translation.

Surgery does work for a lot of people -- I'm one of them and I am lucky to be back to work in a job where I often have to sit long hours.
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.
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