Any Dr. Aszmann Success Stories Out There?

[flyer28]

Here are my updates:

1. A week ago (21.2) I was at prof. Urban at his Pelvic pain centre Androgeos in Prague. I had pretty bad pain in January/early February. he palpated all my pelvic floor once again with those results: very painful pelvic muscles, coccyx and even prostate. When he palpated prostate I felt quite bad pain and my pain at the base of penis and along penis was much worse. On the other hand, Alcock canals were not particularly painful. He said that my case is obviously more related to chronic pelvic pain than to any type of entrapment of pudendal nerve. Then he did pre-sacral block - at the inferior hypogastric plexus. He did it without guidance stating that risk is pretty low and the chance to hit n. pudendus is out of question. So I agreed to do that. It came without any complictaion. Next day the pain was worse, but still bearable. From the 3rd day till now the pain is lower. I feel my bulbocavernous and ischiocavernosus to be little bit "worn out", sensitive, but no debilitating pain anymore. Last few days I am functioing 90% normal, like any other people.
So till now I consider that hypogsatric block to be succesful, We will see during the next weeks the long-term outcome. But the fact, that my prostate was painfull and palpation even worsened that perineum/penile pain gives me hint, that maybe the prostate is the culprit and not the pudendus particularly. prof. Urban recommended turf spa, trigger point therapy and some other conservative management.

2. Today I had an appointment with prof. Aszmann in Vienna, I told him about everything above and he agreed that prof. Urban and I might be right in that conclusion. Initially he indicated that there is some "fibrotic thickening" in the right dorsal canal at MRI, but he said that this finding is border-line, so no evident proof. He said that maybe even healthy people might show such indication of certain thickening, without any reason to find it pathological. He suggested that I can contact him after 4-6 weeks, and if I am interested in either Alcock or Distal dorsal nerve block, his radiologist can do that with ultrasound guidance, in order to minimise the risk (prof. Urban makes only finger guided blocks and does not adress dorsal particularly). Aszmann was glad that I am doing quite well right now and does not feel any need of operation for me.

[AliPasha1]

Hi Matt,

All those symptoms that you are describing are indicative of Pudendal nerve Entrapment.Tell Professor Oskar Aszmann to your traditional PNe Surgery along the ligament grip and Alcock's Canal.

Unfortuntely,The Urologists used to tell me the sme thing .

Good lUck
Take care,
Ali

[flyer28]

Hi Ali
I feel definitely better but some portion of pain is still left there, I will wait 4-5 weeks.
I dont think that real entrapment is there. My pain is bilateral and not worsened by sitting.
The intensity of pain is rather low righht now (although still present) and I cannot imagine to risk TG operation, for me it is out of question.
If the pain will persist I might try the evaluation at dr. Beco in Liege or some other options.
We agreed with dr. Aszmann that we will try probably later Alcock canal block under ultrasound guidance, if necessary.
This might help diagnose it more precisely.

dr. Urban said that there are two extreme opinions present in the diagnostic field:
Specialists on PNE do consider every pelvic pain to be PNE, which is obviously not true.
On the other hand, ordinary urologists dismiss every notion of pudendal neuralgy and behave like n.pudendus never exist.
Both standpoints are exaggerated: the true is that in most cases of course the pudendal is irritated, but not really entrapped.
Only small portion of patients is indicative for operation.
In that stage where I am, I would not risk TG operation.
We will see what will come.
Matt

[AliPasha1]

Hi Matt,

TG surgery with Professor Roger Robert is extremely dangerous and still experimental without any proven results in the 20 years of his research.I am not sure about Beco or Bautrant as far as their results are concerned.

I believe Tibet might be a new option in the near future,but also work closely with Oskar Aszmann and plead to him to do the PN surgery at the ligament grip and Alcock's Canal as well as repair the ligament s.He is a very talented surgeon and hopefully he can make a breakthrough .

As you said ,the truth is somewhat in between.

Take care,
Ali

[flyer28]

Hi Ali
I discussed the issue also with dr. Urban in Prague (he is an urologic surgeon).
Basically he said that French TG operations are incredibly invasive and the risk is not worth unless there is clear entrapment/pathology arising from rather invasive nature (injury, complicated birth, other pelvis operations etc.). This approach is a "song from the 90-ties" which is not the mainstream now.
Aszmann s approach is surely more refined, with less risks and shorter recovery periods. that s sure. On the other hand, "still pretty invasive in my eyes".(dr. Urban). He (Urban) sees the future solutions in laparoscopy as well. They are working on this technology (in experimental anatomy on dead bodies) but still not ready to start to perform it. But he thinks that in 5 years this will be the mainstream.
Matt