new guy, old problem, just diagnosed

[Karyn]

Hi Carl,
I'm very glad your second surgery with Dr. Conway was more helpful. I sincerely appreciate the information you've shared about your surgeries.

the pudendial EMG showed propogaion delay he was confident there was an entrapment. The surgery was considered a diagnostic procedure.

I'm not quite sure what you mean by this. Could you please explain?

I was treated for illionguinal pain for 2 years as my symptoms just got worse.

Does you ilioinguinal pain still persists or have you had a neurectomy?

The reson for this is that the pudendal nerve is nit visable via the TIA method. The transglutial allows you to see the complete nerve.

I would much rather have a larger incesion and allow the suregon a clear view of the nerve than a minimal view that may not find the problem.

There was a lady who used to post in our community that summed this concept up very well. She basically explained that the words "less invasive" are a mind trap. Less invasive doesn't necessarily mean more effective.

I know that Dr. Conway uses the DaVinci robotic suite for other obgyn procedures. So if there was a way to use a minimally invasive method i would assume he would be working on how to propose/present it (i'm an engineer not a doctor so i'm not clear on how somone would go about creating a new type of procedure).

Yes! I'm aware of Dr. Conways skills using DaVinci Robotics for certain procedures. However, nerve surgeries are very delicate and some of the tools used for "minimally invasive procedures" can cause a great deal of harm to the nerves and surrounding structures.
Some people have improved from the TIR approach. I find it interesting that your PN problem was solved on one side, but you got re-entrapped on the other. It's also interesting to note that some folks who had the TIR surgery and didn't improve and then went on to have the TG approach and were found to be entrapped in the ligaments.
Kind regards,
Karyn

[blightcp]

the pudendial EMG showed propogaion delay he was confident there was an entrapment. The surgery was considered a diagnostic procedure.

I'm not quite sure what you mean by this. Could you please explain?

Dr. Conway is very up front that the PN surgery is a bit of "we will see what we find whne we get there" as everyone had diffrent injuries and isues. A surgery labeld as diagnotic puts it in the same insurance billing as a MRI or cat scan making my most recent $30000 surgery a $250 co-pay. If it ws labeld as a general surgery i would have had to pay $500 plus 10% making the surgery a $3500 bill, maxing my total contribution to $2000. In reality it just changes the price you may have to pay to the insurace.

I was treated for illionguinal pain for 2 years as my symptoms just got worse.

Does you ilioinguinal pain still persists or have you had a neurectomy?

No i never really had illioingunal pain, it was PNE misdiagnosed. I have no long term issues with the illioingunal nerve.

The reson for this is that the pudendal nerve is nit visable via the TIA method. The transglutial allows you to see the complete nerve.

I would much rather have a larger incesion and allow the suregon a clear view of the nerve than a minimal view that may not find the problem.

There was a lady who used to post in our community that summed this concept up very well. She basically explained that the words "less invasive" are a mind trap. Less invasive doesn't necessarily mean more effective.

I would agree that TIA is not as effective as transgluteial. When i had the TIA Dr. Conway was not performing the transgluteial method. He did make me aware that if after 2 years there was still significant a second surgery may be required.

Some people have improved from the TIR approach. I find it interesting that your PN problem was solved on one side, but you got re-entrapped on the other. It's also interesting to note that some folks who had the TIR surgery and didn't improve and then went on to have the TG approach and were found to be entrapped in the ligaments.
Kind regards,
Karyn

On the right side the nerve was being pinched in the "typical" way that the TIA can fix, unfortunaley that is about all the TIA can fix.

The left side had worked it's way into an "extra" fold of the ST liagment. This required the transglutial in order to correct.