PNE vs. PN diagnosis

PNMLT, EMG, SSEP, and other Nerve function testing.
The different techniques, results and opinions.
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Faith
Posts: 697
Joined: Fri Oct 15, 2010 5:15 pm

PNE vs. PN diagnosis

Post by Faith »

I don't know where to ask this question. So I just decided to post it here. How is a true entrapment diagnosed vs. just neuralgia? I can't seem to figure this out no matter how much I read.
-11/08 vulvodynia began around conception of first & only pregnancy
-3/10 sacral/sitting pain began after SIJD manipulation
-Progressive widespread pain- central sensitization
-PT, meds, injections, botox, ESWT = debilitated.
-5/12 Potter MRI - scarring of left ST, coccygeous & posterior alcock
-12/12 - left FAI/labral hip tear surgery
2014-2019 managed w/ gabapentin, massage, and lifestyle mod
2020 - big flare up
www.thepurposeofpain.blogspot.com
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Violet M
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Location: United States
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Re: PNE vs. PN diagnosis

Post by Violet M »

Faith, this is one of the most frequently asked questions about PN/PNE.

If you want the scientific explanation you can read the Nantes Criteria article for determining if the neuralgia is caused by an entrapment. http://pudendalhope.org/sites/default/f ... iteria.pdf

There isn't a 100% guaranteed way of knowing for sure, especially before surgery. I actually don't agree with everything in this article because I didn't quite match their criteria and it turns out I was entrapped. Dr. Hollis Potter in NYC is doing the 3T MRI now with some special imaging techniques and may be able to locate an entrapment pre-surgery but we don't have confirmation from the surgeons yet that her diagnostic reports are accurate.
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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Celeste
Posts: 574
Joined: Sat Sep 18, 2010 2:24 am
Location: central Ohio

Re: PNE vs. PN diagnosis

Post by Celeste »

To further complicate things, you might have PN pain and be entrapped, and have surgery, but not get relief. This does happen. It's one of the biggest questions we have to answer. I don't know if the answer is that the nerve has permanent damage, or if something else is at play. Some think the nervous system can be permanently changed, others think it can be rebooted. But we do know that many people can get relief from surgery, and it's an option to get relief.
PNE as a result of childbirth, 2002. Treatment by the Houston team, with neurosurgery by Dr. Ansell in 2004. My left side ST and SS ligaments were found to be grown together, encasing the pudendal nerve.

I am cured. I hope you will be, too.

There are no medical answers on the forum. Your only hope is to go to a doctor. I was very happy with the Houston team, which has treated the most PNE patients (well over 400), more than any other US provider.

http://www.tipna.org
AliPasha1
Posts: 739
Joined: Fri Sep 17, 2010 2:35 pm
Location: New Orleans,Louisiana

Re: PNE vs. PN diagnosis

Post by AliPasha1 »

Dear Violet,
We have had two confirmations of where Dr. Hollis Potter exactly pointed out where the Pudendal Nerve was entrapped, when Dr. Hibner operated on Athena's mom as well as RR/RJR.

In addition,Dr. Olga Kalinkin who works with Dr. Hibner cross-checked her images and her MRI report isn't very different from hers.

This is an incredible and promising start as far as PNE imaging is concerned.In my case, she has indicated entrapment of the Pudendal Nerve in the Falciform process of the Sacrotuberous ligament and re-entrapment of the Pudendal Nerve in the Alcock's Canal after surgery as well as dorsal Nerve Entrapment.I am confident that her pre-surgical readings would be mostly correct.However,it needs to be determined whether she is right about Post surgical patients. This would be verified on 25th April,2011 when Dr. Hibner operates on me.

This would also verify whether Dr. Bautrant is able to access the falciform process of the Sacrotuberous ligament by means of TIR approach.

So far my symptoms correlate with her findings.

Regards,
Ali
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
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