Pudendal Nerve Hydrodissection and Vein Stents @ Alocks Cana

[Ray2575]

Hi All,

I joined in Nov 2015 with my first post. I had a Potter MRI and Nerve Conduction Studies at Kessler showing PNE at Alcock's Canal on both sides. When my urologist spoke with Dr. Potter he said she had not observed my condition before of prominent varices in Alcock's canal, markedly compressing both pudendal nerves, with edema in the epineurium of both pudendal nerves in the posterior margin of Alcock's canal.

Vein emobolization was suggested, but others have warned against it due to side effects and edema from the fluid build up that the veins would have normally helped remove. I have done PT, lifestyle changes, medications, etc., but the nerve is trapped and and any sitting at all or torso bending at the hips or long leg stride activities flares situation.

Recently, I was referred to Dr. Shrikhande in NYC and she is recommending 6 rounds of weekly pudendal nerve hydrodissection treatments with PT. It is very expensive and I am waiting on my insurance company for potential coverage. She said another option instead to consider is inserting stents into the veins at Alcock's Canal. She said there are 2 doctors in NYC and 1 in Washington, D.C. doing this procedure. I spoke with my internist and he doesn't understand how a stent, which is normally used to "open up" a vein would be used to reduce a swollen vein. He said all information on both topics he could locate was anecdotal and he couldn't recommend them.

I have read all the posts on hydrodissection and I am not clear it will help as there isn't that much info out there and I don't find anything about vein stents in the forum.

This is almost 4 years of constant searching for a potential solutions and would appreciate any info on Dr. Shrikhande, hydrodissection and vein stents.

Thank you so much if anybody can help me.

[Spinner]

After many years i find myself in a similar position as you. I’ve found that a consultation with an accomplished specialist in vascular surgery to be very helpful in getting answers to the kind of question you’re raising here.

[Violet M]

I am not a doctor and this is just my personal opinion based on what I have read and what I have been told talking to many patients. I can't remember anyone who had success with vein embolization so I agree with you on that. We know that anatomically the blood vessels and nerves run along together. We also know, based on MRN reports, that there are people who have had MRN's that showed a back-up in blood flow in the veins due to the veins being compressed between ligaments. If your swollen veins are due to compression by ligaments with a back-up of blood flow, then I don't know for sure if putting stents in them would prevent the back-up of blood flow because I don't know what the stents are made out of and whether they could withstand compression by ligaments. But even if they did, I can't see how that would help the nerves that are running alongside that are also compressed by the ligaments.

So, I think the question you need to have answered is what is causing the veins to be swollen in the first place. If it is due to ligament compression causing a back flow of blood then that is what needs to be addressed.

The same goes for hydrodissection. I don't think hydrodissection will affect ligaments at all. If you just have fascia and scar tissue build-up that's causing the swollen veins, then maybe hydrodissection could break up some of that, but I doubt it would do anything to release a nerve from ligaments. But, I could be wrong.....
Just trying to think of this from a common-sense standpoint.

Violet