Health Organization for Pudendal Education

Can someone please direct me to the stats of success/stories where people benefited from Dellon/Aszmann

As for an orthopedic surgeon...how much knowledge does he have on working with the pudendal nerve?

Stats on Dellon and Aszmann are a bit sketchy at this point. Might be best if you do a search in the upper right on their names. I was just brainstorming on who the surgeons are who still treat males. I guess you could add Filler, Beco, and I've heard of a guy, Deogonkar, in Ohio. The problem is we haven't heard of many successes with them. That's not to say there haven't been successes -- we just haven't heard of them.

Orthopedic surgeons work with nerves all the time. My relative is an ortho surgery resident and just had a microsurgery exam sewing nerves and blood vessels back together. They have to know the pelvis well in order to deal with pelvic fractures. They can learn PNE surgery just as well as Hibner who is an obgyn. It really boils down to whether the surgeon has an interest in learning the procedure.

Violet

From the last time I was in Houston, seemed to me Dr. Ansell was still going to be active with TG surgeries if inquired..

I had TG surgery with Prof. Aszmann in Sept. and I am doing great. I still have some numbness and pain around the gluteal fold and incision site and I know it is going to take a while to get the muscles strong again, but the nerve pain is much better. The flares are way down. I don't think about PN all day. I am enjoying things again.

I went to Austria because I thought I was going to have the anterior approach. It's a long story, but Prof. Aszmann did the modified ligament approach and my understanding is he showed Dr. Hibner how to do this approach. I may be wrong, but that was my understanding. He had just done the TG approach on a male patient from Germany when I was there. I think he does more males than females, but he does both.

However, the last email I got from him, he was very busy and scaling back on his surgeries. The BBC was doing a report on his work and he was very busy with his bionic work with hands, etc.

I am so sorry there are not more doctors to treat men. Prof. Aszmann even talked about the shortage of doctors who knew how to treat people with PN and PNE.

Don't know if this helps, but wanted to give you a heads up on Prof. Aszmann. He is a gifted surgeon and a truly nice man.

Take care.
Barb

Hi Barb,

I did some research on the doctor you had specified but am kind of confused. It says "Dr. Oskar Aszmann has developed surgery to treat pudendal nerve entrapment of the distal pudendal nerve (dorsal nerve of penis or dorsal nerve of clitoris). This is a completely different surgery than the approaches that treat PNE at the ischial spine and alcock's canal." If my PN is entrapped along the SS ligament I am assuming he wouldnt be able to help me? Do you know if this is the case? You had mentioned that this doctor had showed Hibner this approach? So do you know if he does the TG approach and takes a look at the SS ligament as well?

Hi Barb, Do you know where you were entrapped ? I was wondering how some of these doctor's treat surgery, majorly at the ischial spine... It is a hard to decision to make, to have surgery, but with doing injections, and pt, and have not received relief...I looking at other options... If anyone has had surgery, do to entrapment a ischial spine, I would love to hear from you, and your outcome, and which doctor's performed the surgery....Thanks for all your input...

Hi Barb!
That is wonderful that your flares are way down and you are feeling good! I am so happy for you. When did you see a change in the flares decreasing? I am exactly 5 months post op now and my flares are relentless.... Stabbing and burning all in the same old perineal area. I am heading back to Hibner for the perineal block as soon as an OR date becomes available. My doctor here in Canada decided he wasn't comfortable doing the block so close to the operated site.
Are you taking anything for pain or any meds at all still? Are you able to do any exercise or swim? That is so promising and I am very happy for you! Keep us all posted......

Lara

Hi Desperate,

I guess I need to clarify that I went to Prof. Aszmann because Dr. Potter's MRI had seen entrapment of the dorsal nerve to the clitoris and the perineal branch and I went to Austria to have the anterior approach that he is known for. (He also saw my MRI), but once Prof. Aszmann examined me, he found pain at the ischial spine area and not a lot of pain at the dorsal nerve and the perineal branch. The next day, I had a high powered ultrasound that showed my right ligament was very thick, especially compared to the left.

Prof. Aszmann found the nerve entrapped between the sacrotuberous and the sacrospinous ligament. He indicated that it was a high lesion. I am not completely sure what he meant, but he said it was in a very tight spot. He examined the nerve down to the Alcock's canal.

When I said my impression was that he had shown Dr. Hibner this approach. What I meant by that was it was my understanding he had shown Dr. Hibner that you can notch the ligament and not sever it and still be able to see the nerve. I am sure Dr. Hibner already knew how to perform the TG approach.

I am not sure why it is not widely known that Prof. Aszmann also does the TG. The only thing I can think of is because it was Prof. Aszmann and Dr. Dellon who developed the anterior approach and this became what he is known for, but as I said, there was another male patient that had the TG approach and was doing a follow up appt. when I was there.

I know he is extremely busy and was scaling back on some surgeries , but I guess it is worth a shot to check with him and see what his schedule is like now.

I hope this helps. Good luck with your continued search for help. I know how frustrating it can be.

Take care.
Barb

Hi Velmartd,

I hope my answers to Desperate answered your questions. It is a very hard decision to have surgery, but if you have done all conservative treatments and you still have no quality of life, it does become an easier decision. Hope you find some help soon.




Hi Lara,
Yes, my flares are down and seem to be decreasing in severity and frequency. I started seeing a difference about month 5. I still have the pain at my ischial tuberosity, but the stabbing and burning is definitely better. I am doing more walking. I am still taking gabapentin and 1 tramadol a day, but that use to not make a dent in the pain and by the end of the day now, I feel pretty good. I am still taking it easy and not pushing the sitting. It is still going to take awhile, but I am optimistic.

Good luck with the perineal block. I would be interested in knowing if that helps you.

Take care.

Barb

Hi barb
Delighted to learn your flares have calmed do w n, I can't quite imagine the relief it must be wonderful to begin to get your life back!
I a m nearly 4 months post bilateral TG surgery and managing to swim several times a week but flare ups are still intense and life still really limited. I'm hoping to try PT, do you think it's too soon? Desperate to return to work but sadly not well enough and meds wipe me out.
I REALLY HOPE and pray you continue t o improve and thanks for giving us hope.