Surgery with Renaud Bollens

[Barre]

I contacted Renaud Bollens via email and he was very kind to reply and suggested I made an appointment in his private practice , it's only a 90 minutes drive from where I live so I'm seriously considering it.

Even though I only have had symptoms for three months and they seem much milder than most on this forum, mainly pain/discomfort when sitting in my sit bones and defecation issues, they do seem to progress and it's having a huge impact on my quality of life.

My question is this, why would people wait for surgery when the benefits of surgery greatly outweighs the risks in my opinion, especially when done by someone who is an expert.

I think I read that the sooner it is done the greater the chance of a full recovery as the nerve will get progressively more damaged over time, why waste time doing minimally invasive things like PT and medication, that give horrible side effects often with minimal and/or temporary results.

I'm not sure what to do next, doctors so far, although well meaning, don't seem to have a clue and just treat symptoms, not the cause, although I have not had an official diagnosis yet my symptoms certainly seem to be related and it has been suggested by doctors after I told them about my concerns but so far nothing is written in stone yet. But I'm growing tired of being brushed off and want answers and want to start to take a more pro active stand.

Any thoughts on surgery are most welcome.

[snupho]

I don't have experience with Dr. Bollens yet but I'm putting together all my medical procedures so far to send in advance. Hopefully he agrees to see me.

I know there are a couple other doctors that perform laparoscopic surgeries and the other on my list to check in with is Dr. Possover.

I've only been suffering for about 1.5 years but it has been a truly hellish time.

[Barre]

I don't have experience with Dr. Bollens yet but I'm putting together all my medical procedures so far to send in advance. Hopefully he agrees to see me.

I know there are a couple other doctors that perform laparoscopic surgeries and the other on my list to check in with is Dr. Possover.

Are you from Belgium?

I called his private practice today and have a consultation on the 15 the of May, we will see how to proceed from there.

I'm not even sure if it's PN but unfortunately my symptoms and history point in that direction, I hope to get his expert opinion on my symptoms and hopefully get some answers and get the ball moving so to speak.

Dr. Bollens strongly believes that for carefully selected patients surgery should be first or second line treatment as the duration of symptoms is very important for optimal results. Laparoscopic surgery is supposed to be 'minimally' invasive so they can use the we'll try and see approach.

I've only been suffering for about 1.5 years but it has been a truly hellish time.

[April]

Hi Barre,

I think doctors (and other medical professionals) are reluctant to recommend decompression surgery until they are certain that other procedures don't work because the procedure is invasive and doesn't have the same high rates of success that you'd find for other types of surgeries. And, in fact, some patients have gotten worse. I think the lower rate of success has to do with the challenges of determining who is a good candidate for surgery, which involves determining if the nerve entrapped in a ligament. Some people (maybe many people) who have pudendal pain do not have a nerve entrapped in a ligament. And there isn't an easy way to determine if it is entrapped (e.g., most MRIs don't show anything). Usually, doctors make a judgment call based on history (e.g., pain started with a specific event, pain is worse on one side, pain symptoms match nerve pain (burning, stabbing)) and a diagnostic block (numbing agent put on nerve reduces the pain temporarily), so the assessment criteria are less straightforward than just looking at an MRI and seeing a problem. But, I understand your sentiments. I wish I had had my surgery a little sooner (I waited four years), but only because I did have had improvement and I wished I had that sooner. I don't know that waiting four years made my case more difficult to treat with surgery (although it's hard to know since my pain is not entirely gone). In any event, I hope that helps a bit.

April

[Barre]

Thank you April,

I understand the risk and limitations of surgery.

However, after emailing with Dr. Bollens (first doctor I have met who takes his time to answer every email and takes you serious, very refreshing !) I am seriously considering it .

It's quite the dilemma though ,

Sometimes I notice some improvement (waxes and wanes but overall better I think) but I am trying different things at the same time that it's hard to know what is working (limited) , I am taking PEA,palmitoylethanolamide, combined with PT . I have better and worse days.

Dr. Bollens is convinced that many patients start with only minor symptoms but these get worse and new symptoms come when you don't decompress the nerve, he said that if the nerve is just irritated you should see gradual and drastic improvement from postural changes and PT , if not surgery is the best option, he thinks medication should always be a last resort.

He said my referal to the pain clinic can be usefull but they only treat the symptoms and not the cause, it's a bad long term strategy. and there is a risk that the damage might become irreversible over time.

"Good evening
Send me back the questionnaire to know if it’s compatible with a Pudendal nerve probablement ( probably). If the conservative treatment fails ou should have a surgical decompression. The pain clinic will just give you a symptomatic treatment without relief of the pressure on your nerve. It can not be a long term treatment because you have a risk to finish with irreversible damage."

I'm not sure how to proceed from here but I think I will trust the Dr. Bollens judgment, I have read good things about the outcomes, 80 to 85% but in his own words this does not relate to individual patients, it either works or doesnt work, during my consultation I will off course ask more about the risk/benefit.

[April]

It's wonderful that you have a lot of confidence in him. Yes, I would ask a lot of questions. What procedure does he use (e.g.,transgluteal), why does he use that approach and not another, how often does he do this surgery, how he determines that someone is a good candidate for it, and, of course, his stats on success. I guess I wouldn't be rushed because you are worried about irreversible damage. I think you can take more time with the decision if you think you need it.

Keep us posted.

April

[Yonatan]

Hi, I hope this can be useful for you and others.

I had surgery by Dr Bollens in February this year. At 3 months post op I have had considerable improvement in my sitting pain as well as erectile dysfunction. My worst complaint was anal pain. There is still a way to go of course but I am very happy so far and Dr Bollens thinks it is a good prognostic sign that I had improvement already.

I would not hesitate to recommend Dr Bollens if you have had a thorough diagnosis and discussion. For me I had had a CT guided nerve block which helped significantly. Dr Bollens is extremely good at predicting if you have entrapment or not. It is basically a clinical diagnosis. Feel free to contact me with any questions.

[Jack_johnson]

Hi, I hope this can be useful for you and others.

I had surgery by Dr Bollens in February this year. At 3 months post op I have had considerable improvement in my sitting pain as well as erectile dysfunction. My worst complaint was anal pain. There is still a way to go of course but I am very happy so far and Dr Bollens thinks it is a good prognostic sign that I had improvement already.

I would not hesitate to recommend Dr Bollens if you have had a thorough diagnosis and discussion. For me I had had a CT guided nerve block which helped significantly. Dr Bollens is extremely good at predicting if you have entrapment or not. It is basically a clinical diagnosis. Feel free to contact me with any questions.

How bad was your ED? I went to Bollens as well for severe ED. So far the blood flow is better and erections stick around longer but still no sexual sensation and erections are weak.

[Yonatan]

Hi, I hope this can be useful for you and others.

I had surgery by Dr Bollens in February this year. At 3 months post op I have had considerable improvement in my sitting pain as well as erectile dysfunction. My worst complaint was anal pain. There is still a way to go of course but I am very happy so far and Dr Bollens thinks it is a good prognostic sign that I had improvement already.

I would not hesitate to recommend Dr Bollens if you have had a thorough diagnosis and discussion. For me I had had a CT guided nerve block which helped significantly. Dr Bollens is extremely good at predicting if you have entrapment or not. It is basically a clinical diagnosis. Feel free to contact me with any questions.

How bad was your ED? I went to Bollens as well for severe ED. So far the blood flow is better and erections stick around longer but still no sexual sensation and erections are weak.

Hi Jack,

My ED was only mild - some semi erections and a lack of ease in getting an erection compared to before. These symptoms improved really fast for me post operatively. But as i’m sure you know from Dr Bollens, one has to be very patient and see how things go in the months after surgery. All the best

[benraycamp0]

Hi, I hope this can be useful for you and others.

I had surgery by Dr Bollens in February this year. At 3 months post op I have had considerable improvement in my sitting pain as well as erectile dysfunction. My worst complaint was anal pain. There is still a way to go of course but I am very happy so far and Dr Bollens thinks it is a good prognostic sign that I had improvement already.

I would not hesitate to recommend Dr Bollens if you have had a thorough diagnosis and discussion. For me I had had a CT guided nerve block which helped significantly. Dr Bollens is extremely good at predicting if you have entrapment or not. It is basically a clinical diagnosis. Feel free to contact me with any questions.

How bad was your ED? I went to Bollens as well for severe ED. So far the blood flow is better and erections stick around longer but still no sexual sensation and erections are weak.

Hey could you tell us a bit about your history and symptoms before the surgery? I’m considering the surgery with Dr. Bollens so that info could be helpful!,Also when did you get the Bollens surgery?