Health Organization for Pudendal Education

What a brilliant thread! Congratulations to all the posters and especially Hermajesty who came up with the gooods!
I guess we now have a thread that people can be pointed to when they say why cant they have a 3T scan anywhere in the country. I suspect that Filler may be right when he said that 1.5 T is better than 3T - certainly the radiologist at MEDTEL in UK says there is no advantage when nerve scanning to using 3T. and another radiologist in UK has also said that to me. The real value of 3T is that you will see soft tissue better, especially around the very small joints in foot and hand. Plus its quicker and hospitals that are private know there patients want the latest piece of kit. Yes, artifacts can be a problem but I suspect not to someone like Hollis Potter. Its the right initial processing software that matters(this is likely to be commercial ie come withthe machine whether Filler or Hollis Potter) not the hardware. Then the post processing that Filller does and we presume Hollis Potter does is very important. Filler's office ,to be fair, is commenting that a standard 3T MRI is not satisfactory. Presumably they are asked this a lot and part of the reply is a cut and paste job. They are not actually directly comparing a 3TMri thats been post processed with their MRN.
But its a matter of degree perhaps? Is the post processing the really important thing and the tesla of minor importance or is it really critical to have both? That is one question for Hollis Potter isnt it? But if it is important to use 1.5T, I bet thats what she wouold do as she will have 1.5T machines at her disposal. And, of course, we have no way of comparing the Filler/Hollis Potter post processing do we? I c uannot see that we are going to be able to say Filler or Hollis Potter is best at this moment in time unless they were prepared to have a full and frank discussion with each other. And there are difficulties in discussion -not least that Filler is protecting a patent and litigates regularly- I wonder whether Hollis Potters processing may be so near to Fillers that she could be seen as infringing his patent? Each of them are excellent at readng scans but of course Filler is most experienced at these particular scans just becasue he has done so many. So many factors....it may well be that both Hollis Potter and Filler scans are perfectly good for the job - perhaps the diagnostics is already beginning to run ahead of the treatment that can be offered anyway

One thing I do know, I would not, these days, have surgery without going to Hollis Potter or Filler first whoever I was choosing for surgery
Hilary

Hi Hilary,
It seems to me that 1.5 Tesla MRI's can visualize the Pudendal Nerve in the Alcock's Canal and beyond.However,since the 3 Tesla MRI can visualize the soft tissues better because of twice the resonance, Dr. Potter with 3 Tesla is able to visualize the Pudendal Nerve in the claw of the Sacrotuberous ligament and SacroSpinous ligament as well the falciform process of the Sacrotuberous ligament whereas 1.5 Tesla cannot.
However,Dr. Hibner has stated that he isn't comfortable with Dr. Filler's MRN results and wouldn't accept them as a diagnostic tool.

Best Regards,
Ali

AliPasha1 wrote:However,Dr. Hibner has stated that he isn't comfortable with Dr. Filler's MRN results and wouldn't accept them as a diagnostic tool.

Consider that Filler is Hibner's competitor for surgical marketing share. Potter is not a surgeon and is not competition.

You are absolutely correct.That's why he has to do so many redo's of Dr. Filler,Dr. Ansell, Professor Robert and Dr. Conway.The truth will prevail in the end.

Celeste wrote:
Consider that Filler is Hibner's competitor for surgical marketing share. Potter is not a surgeon and is not competition.

Good point

Thanks for this great post. I know there have been questions regarding MRN vs 3T MRI being asked for quite some time. I had considered going to Filler for the MRN and my family dr. had me speak to one of our local radiologist about whether it was worth it or not. Now granted the local radiologist is most likely biased and isn't that familiar with MRN but he felt I would be able to get the answers I needed with the 3T MRI. I had a 3T MRI/MRA when I saw Dr. Hibner 7 weeks ago and all was normal.

As was stated in an early post Dr. Hibner does not have a great opinion of the MRN as I asked him this question. In his opinion he felt with the correct image processing and radiologist he could get the answers he needs without having patients spend more money on something an insurance wouldn't pay for. Dr. Hibner is really trying to look out for the patient and does keep in mind that we don't have unlimited bank accounts. I have not been to Dr. Filler and maybe he is the same so I can only speak regarding my conversations with Dr. Hibner.

I am quite curious how much scar tissue one has to have before it will show up on an MRI or a MRN. Dr. Hibner told me has had patients with normal 3T MRIs but when he goes in there is scar tissue. I know when he did surgery on me I had scar tissue in the left lower abdomen that they removed and took them about 20 mintues that did not show up on the 3T MRI and I had obturator decompression surgery 1.5 years ago that a MRI did not show scar tissue but when Dr. Howard got in there he removed scar tissue around the obturator nerve. Therefore, there is a threshold level of detection of scar tissue and just because it does not show up on the scan doesn't mean you don't have scar tissue. Now I know these where all MRIs but I would anticipate there has to be a threshold of detection for the MRN.

I choice the 3T MRI because my insurance would cover it and would not cover the MRN because it is still considered experimental. I have direct deposits to dr.'s currently and just didn't feel like I could rationale a painful trip to yet another dr. That's just my opinion.

Hi Nyt,
Did you have 3 Tesla MRI with Dr. Potter.

Best Regards,
Ali

Your post was very helpful nyt although not what I wanted to hear...sounds like the bottom line is, these imaging tests are just not going to give you a definitive "no" about scar tissue entrapment...only a "yes" or a "maybe"; so they can't really be used to RULE OUT the need for surgical intervention. Even after all the imaging, one would still need to be opened up to get a definitive answer as to what is there.
I am wondering if that will be true for long...I have heard 3T is not the end of it: That there is experimentation going on up to 10T...Now mind you, I do not know what impact this would have on the ability to view tissues, as I get totally lost when it comes to spinning magnets and am really clueless on the whole topic of how imaging works.

...and also, if infusion through the tissues is so important in determining the preence of scar tissue, how would doing one of these imaging tests with a contrast material infused into the pelvic cavity impact the amount of information available? Does anybody do that?

AliPasha1 wrote:You are absolutely correct.That's why he has to do so many redo's of Dr. Filler,Dr. Ansell, Professor Robert and Dr. Conway.The truth will prevail in the end.

Oh please. Hibner has even done a redo on his OWN work. Nowhere does he say that redo's are the lion's share of his practice, either. You are confusing truth with what you personally choose to believe.