what hysterectomies most likely to cause PN?

[nyt]

Celeste, you are right in that hysterectomies may result in PNE even though I do think it is a little recognized complication. However, the dr.'s don't really understand how one can get PNE from a hysterectomy. Most dr.'s think it is the result of an over stretch in other cases if you have very extensive endometriosis then one could theoretically get it from a very invasive surgery by direct damage but all the dr.'s I have asked said the latter would be extremely rare.

[spirit42]

I got my PN(E) from a vaginal hysterectomy. Exactly 3 weeks post-op the vaginal burning and hyperarousal began. I went from one gyne to another, 3 times to the STD clinic, to various emergency rooms, my own gyne refused to see me a couple of months after the surgery, which included a cystocele repair and the saga went on and on. It is very likely that in my case there was some damage done to the branches of the pudendal nerve, such as perineal and clitorial, which must have resolved itself, for this nasty arousal went away even before Dr. Hibner operated on me.

spirit42

[Jane]

I went into hospital for a hysterectomy and at the very last minute the surgeon talked me into having a Sacro-Spinus Fixation. This is where the uterus (in my case prolapsed) is hitched to the Sacro-Spinus ligament with a circular stitch.
As we all now know the Sacro-Spinus ligament is right behind the uterus and therefore in my opinion this kind of surgery should be scrapped because there is a high risk involvement. I knew the minute I came round from the anaesthetic that something was very wrong - it felt as if I had a bonfire in my pelvic area.
Best wishes to you all.

Jane

[Violet M]

Jane, when Dr. Carlstedt did your PNE surgery did he check for a misplaced stitch in the pudendal nerve?

[Amanda]

Jane

You have described just how i felt 8 years ago when i had my hysterectomy as soon as i was awake i was in piercing agony and knew somthing was wrong.
I also had a sacrospinous fixation along with a pelvic floor repair and right oophorectomy
( ovary removal) but of course I was told i was a little hyper....!!!!!!!!
I did a survey a few years ago of PN patients who developed PN after a hysterectomy and the highest incidence strangely enough was abdominal hysterectomies........i strongly believe that a single stitch in the wrong place near or into the PN is the cause of many people developing Pudendal Neuralgia after a hysterectomy.

[calluna]

As to whether sacro-spinous fixation should or should not be used - not using it means that there is a risk of further prolapse.

This is well illustrated by my case - about 15 years ago I had what was intended to be the last of a series of surgeries attempting to repair cystocele, rectocele, and finally uterine prolapse - this was a vaginal hysterectomy, without fixation. It held for about 12 years, I then had a vault prolapse which believe me was not an experience I would like to repeat. It was worse than all the others put together, I would rather be dealing with the pain of PN than be back as I was before the mesh repair.