mri question

[flash gordon]

Could i have my regular urologist prescribe me a proper mri of the pelvic area and then have a pudendal specialist evaluate it? If so what kind of mri should i get? I have penile allydonia.

Fg

[rickim2006]

There is controversy over whether regular MRIs can visualize the pudendal nerves. I think there are better MRIs called a 3TMRI and MRN- magnetic resonance neurography - having said that, I am a physician and I diagnosed myself with PN before having an MRI with Hollis Potter at Hospital for Special Surgery. The reason I say there is controversy over her interpretations is that as a patient on the intake form they ask where is your pain located- my MRI showed some scar tissue on my right side- where my pain is- I would have preferred not to have stated where my pain was and would have had more confidence in the results then.
I have since spoken to many other physicians, and they too question the veracity of these MRI readings.
As a physician and a patient suffering from this life altering condition, I firmly believe a good pelvic floor PT is better than most physicians at not only diagnosing, but treating PN. I have had several rounds of botox with varying degrees of success- however I wouldn't let the physician do anything without my PT telling them exactly where to inject.
I believe the diagnosis of PN should be based on symptoms and a good physical exam. The trouble is finding someone who is well versed in PN/PNE.
Hope this helps.
Ricki

[Richard1969]

Hi Ricki-

I couldn't agree more with you about the working with a good PT. I have confidence in both my Urologist and my pain management Doctor. However, I spend more time with my PT Specialist and she has help discover/uncover more areas. It's simple math, they spend more time with us and know our bodies better than the Dr. Specialists.

My pain has always been on my right side. Glans pain primarily. When she worked on my orbturator external and internus I had a flare afterwards. I had to concentrate not to go into complete spasm. A concentration technique she taught me. I'm scheduled for more injections in three weeks. Im thinking the pisiform is right side, ganglion impar and orbturator internus.

Any suggestions?

-David

[rickim2006]

Hi David-
What type of injections are you planning to receive?
To be honest, when I am in severe pain, there is no med that really touches it- the only thing I do is meditation and breathing. Breath work , sounds simple, and once you get used to it, it is- decreases the pain level enormously.
I also think do home exercises help- my sacroiliac joint falls out of alignment- if i push on the site lateral to the rectum and try to elevate it back into place and then do a piriformis stretch on the opposite side- this too can alleviate some of the pain. I am sure your PT could help with this.
I think it is wonderful when you find healthcare providers who not only know what they are doing, but care about you as well.
I think part of the reason I developed PN is because I was always so worried, and still am about my patients- even though I hardly work anymore.
I remember the patients I couldn't help, not all the ones I did help.
It is nice to be able to talk to someone who understands what you are going through-
Good luck, and let me know how you are doing-
Ricki

[rickim2006]

David,
Just wanted to add that my obturator interns used to be excruciatingly painful. Since we started to focus on the SI joint, I have very little pain when my PT palpates that region- just a thought
RIcki