Pulsed RF Ablation Stories? Or PRP Stories?

[jon]

.Has anyone tried pudendal nerv0⁰radiofrequency ablation, aka RF ablation, PRF, and CRF? Or, have you had PRP (platlet-Rich Plasma) treatment?

I've found a doctor in Honolulu that's contracted with Kaiser, who offers it. He also does PRP, which I know is controversial.

I was an Electrical Engineer who spent my career in Silicon Valley developing novel medical devices,including implantable defibrillators and RF generators for performing ablation procedures.

I used to help design RF generators for performing ablation procedures.

I did the math on the effective treatment time in a PubMed study on PRF. First, 19 odds the 20 patients were "very happy" (not a very scientific methodology for reporting study results) with the results.

Out of the entire treatment time of 240 seconds, the nerve was only being hit with RF for a sum total of 1.414 seconds! *

It's no wonder one patient needed 71 treatments in the 6 year study period! In fairness, a couple of patients only needed two, but still...

I was quoted $1200 for ONE procedure by a doctor in Florida.

Any advice regarding these, or any helpful treatments you've tried, would be welcomed!

* Feel free to check my math, below. Gabepentin permanently damaged my brain.

The PubMed paper states that 45 volts of "RF current" was delivered. That's a bit of a misnomer. You don't say, volts of current. Voltage divided by resistance equals current.

The mean resistance spec was 300 ohms, awhich gets measured by the generator after probe insertion into the body, and a return pad stuck on the skin completes the circuit.

45V÷300 ohms = 150mA of current.

2Hz = a 500ms period (1÷2), so each positive portion of each interval is 250ms.

That means the duty cycle (within the positive phase of the treatment frequency) of the 20ms !⁶delivery of RF energy (voltage x current) is calculated by 250/100 = 20/x, which equals a duty cycle of 8%, and 4% of the overall period (1÷frequency) of the total time RF energy is being applied to the pudendal nerve.

But, since the RF waveform has a 50% duty cycle (the percentage of the time the waveform is positive, and for a sine wave you use the root mean square (RMS) value of the voltage for calculation purposes, which is 70.7%, or .707, the effective percentage of time the nerve is being energized is 4%÷2, or 2% x .707 = 1.414%.

That's certainly low enough to prevent the nerve from overheating and potentially damaging the pudendal nerve, which would leave the patient with urinary and/or fecal incontinence.

In my humble opinion, there is absolutely no reason why you need 98.6% of the time to allow for cooling. That's just being too conservative, even considering the severity of the adverse events your trying to avoid.

Of the 240 second treatment time, the effective tome of treatment is only 3.39 seconds.

No wonder it took 71 treatments for one of the patients!

I've read that Continuous RF (CRF) yields better long term results, but I've not yet researched the generator settings or treatment duration. I presume it's longer than 3.39 seconds. It can't be much more, without damaging motor function, depending on the voltage.

Anyway, I said all that to educate myself as much as anything else.

[Violet M]

All of that is way beyond me, Jon.

=I haven't tried those therapies myself but from reading the forum over the years my impression is that they have mixed reviews, and you don't know until you try it if you will be one of the lucky ones -- which makes it really hard to make a decision.

Violet

[bartland]

I had quite a bit of PRP on the past for another injury and honestly, I can't see how it would help with pudendal neuralgia. Its primary function is to make the body build connective tissue, whereas it seems in most cases of PN there are impingements and muscular dysfunction that put pressure on the nerve.

I tried pulsed RF earlier this year. All it did was flare up my pain for a week, with no benefits after that.

.Has anyone tried pudendal nerv0⁰radiofrequency ablation, aka RF ablation, PRF, and CRF? Or, have you had PRP (platlet-Rich Plasma) treatment?

I've found a doctor in Honolulu that's contracted with Kaiser, who offers it. He also does PRP, which I know is controversial.

I was an Electrical Engineer who spent my career in Silicon Valley developing novel medical devices,including implantable defibrillators and RF generators for performing ablation procedures.

I used to help design RF generators for performing ablation procedures.

I did the math on the effective treatment time in a PubMed study on PRF. First, 19 odds the 20 patients were "very happy" (not a very scientific methodology for reporting study results) with the results.

Out of the entire treatment time of 240 seconds, the nerve was only being hit with RF for a sum total of 1.414 seconds! *

It's no wonder one patient needed 71 treatments in the 6 year study period! In fairness, a couple of patients only needed two, but still...

I was quoted $1200 for ONE procedure by a doctor in Florida.

Any advice regarding these, or any helpful treatments you've tried, would be welcomed!

* Feel free to check my math, below. Gabepentin permanently damaged my brain.

The PubMed paper states that 45 volts of "RF current" was delivered. That's a bit of a misnomer. You don't say, volts of current. Voltage divided by resistance equals current.

The mean resistance spec was 300 ohms, awhich gets measured by the generator after probe insertion into the body, and a return pad stuck on the skin completes the circuit.

45V÷300 ohms = 150mA of current.

2Hz = a 500ms period (1÷2), so each positive portion of each interval is 250ms.

That means the duty cycle (within the positive phase of the treatment frequency) of the 20ms !⁶delivery of RF energy (voltage x current) is calculated by 250/100 = 20/x, which equals a duty cycle of 8%, and 4% of the overall period (1÷frequency) of the total time RF energy is being applied to the pudendal nerve.

But, since the RF waveform has a 50% duty cycle (the percentage of the time the waveform is positive, and for a sine wave you use the root mean square (RMS) value of the voltage for calculation purposes, which is 70.7%, or .707, the effective percentage of time the nerve is being energized is 4%÷2, or 2% x .707 = 1.414%.

That's certainly low enough to prevent the nerve from overheating and potentially damaging the pudendal nerve, which would leave the patient with urinary and/or fecal incontinence.

In my humble opinion, there is absolutely no reason why you need 98.6% of the time to allow for cooling. That's just being too conservative, even considering the severity of the adverse events your trying to avoid.

Of the 240 second treatment time, the effective tome of treatment is only 3.39 seconds.

No wonder it took 71 treatments for one of the patients!

I've read that Continuous RF (CRF) yields better long term results, but I've not yet researched the generator settings or treatment duration. I presume it's longer than 3.39 seconds. It can't be much more, without damaging motor function, depending on the voltage.

Anyway, I said all that to educate myself as much as anything else.