Resection of perineal branch of PN after injury

[Violet M]

https://www.ncbi.nlm.nih.gov/pubmed/28259114

[Buttercup28]

Hi Violet,

I just noticed that you posted a link to this article about the perineal branch of the PN. Is this the surgery you had?

Thanks,

Buttercup

[Violet M]

No, I had the sacrospinous ligament severed and part of the falciform process of the sacrotuberous ligament shaved off. I think their was some release done in the alcock's canal also. I did not have any nerves cut.

Violet

[stephanies]

Thank you for posting this abstract. I am curious as to how they chose their patients for the procedure and study. If I am correct, it seems at least 10 of the 16 patients had injuries to the PN distal to Alcock's Canal -- the episiotomy patients and the vestibulectomy patients. The other six patients it is unclear where the injury was located. If the athletic injuries were cyclists, that also makes it possible they had injury lower on the nerve where the bike seat exerts pressure. I wonder if the pain-causing area of the nerve being located at the distal portion of the nerve may have been a factor in the improvement from this procedure, as compared to the results that may be obtained from this procedure on persons with pain from a more proximal location on the nerve, such as the at the ligaments. It is interesting to consider the location of the compression or injury with regards to treatments.

[Violet M]

I think that's a good point Stephanie. If the resection was more proximal, especially proximal to other branches of the nerve, it seems like it could make things a lot worse. Also, I'm wonder how it affects sensation and motor function in the areas innervated by that resected nerve.

[jon]

My pain was not from injury. I suspect it was fom using a knee cart for three month, which it used by Dr. Dellon performed this surgery on me. For a ridiculous amount of money. No help. No loss of sensation - anywhere. Not convinced he cut the right nerve. The operative report said he cut the branch going to the penis. I had major penile shrinkage after the surgery, but but could have been the air pressure on the plane flying home the next day. My scrotum and penis filled with fluid and practically doubled in size from fluid. If you have this done DO NOT get on an airplane the next day.

Dellon said he'd never seen that before.

I never saw any articles on it. I was just looking at a picture of the anatomy and asked Dellon if he could the nerve right before it splits in two, and he said he'd do it. He'd alraedy cut the genital branch of the genitofemoral nerve, which did not help.

[Violet M]

Sorry to hear it did not work for you, Jon. Sometimes I wonder about the publications in peer-reviewed literature because often they don't seem to correlate with the stories we read on the forum. Is it that the patients who do well just don't come here......?

Violet