Surgeons for redo?

[needtoknow]

I have had pudendal nerve entrapment for a few years now, with varying symptoms. I underwent bilateral transgluteal decompression surgery 7 months ago, in France, with a surgeon trained in Nantes. The surgery went well and the post-op as well. I saw nice improvements on both sides, although it definitely takes time. Unfortunately, I strongly believe that my left side got reentraped as all the improvements on that side subsided whereas they are still improving on the right. This might be related to me trying to get back into sports at about 5 months post-op and going climbing.

Given my symptoms and the improvements that the first surgery brought about, I am determined to get things moving again towards finding a solution. In that dynamic, I basically have two main questions on my mind.

• 1. What caused the re-entrapment? I know this is a tricky issue to know, but I want to try my best figuring it out because even if I get a redo, if the underlying problem causing re-entrapment persists, I might end up the same way. I have a small labral tear on the left side, but I don't know to what extent this could be linked. I am very open to suggestions/insights/inputs in that regard.

• 2. With whom to get a redo? I know that not all surgeons are okay with doing re-dos so I'm trying to figure out what my options are. I am therefore very open to comments, suggestions & ideas, knowing that I want the redo surgery to be transgluteal, just like the first.

Many thanks in advance for your help!

[April]

Hi Needtoknow,

I'm so sorry to hear that one side does not seem to be improving after your surgery. But, I think it's probably too early to consider a redo surgery. I know that you feel that the contrast in recovery between the two sides suggests that one side worked and the other didn't or became re-entrapped, but I think it's probably too early to think in those terms unless the surgeon is convinced that is what is going on. I had surgery on only one side, and I became convinced that mine had become re-entrapped because the recovery process wasn't linear. It seemed, many times, like I would improve and then get worse. But I did very gradually improve. I did not fully recover so I still have to manage the pain. But, I did improve. Having said that, I do know that Hibner has done redo surgeries, so you could reach out to him. But, my guess is that he would think it is too soon to consider a redo.

April

[seagreen]

Hi Needtoknow,

Really sorry to hear you think their may have possibly been a re-entrapment on your left side.
I don't have any answers but i did read on the forum that some Drs are able to request MRI that will show the pudendal nerve in detail and sometimes entrapment and some people on the forum say that they have been told there is entrapment from imaging / nerve blocks.
I am also about 7 months out of surgery and also would really like to know what causes re-entrapment as well. I have ongoing pn pain post surgery and i wonder if my pn has been/become entrapped.
I guess the only thing i was told about was scar tissue - i told to do nerve flossing exercises and to mobilize as much as possible to prevent scar tissue from forming.
In terms of Doctors I have read Dr Marc Possover writes about doing revision surgeries on nerves - from my research and other people's reports he is a very brave and skilled surgeon - worth having a look at his website.
Hope you get some relief soon and wishing you healing.

[Violet M]

Hi Needtoknow,

That's some pretty intense exercise you have been doing! There is no way I could have done all of that, 7 months after surgery. Maybe rather than having a redo this early, you could give the nerve some more rest and see if it will calm down and heal. I know it's so tempting to get back into life but it takes time for the healing to take place. But of course, the surgeon might think otherwise so you would want to get their opinion.

There are still some things I am careful not to do 19 years post-op because they cause a flare-up. I am very happy that I am not essentially bedridden like I was before surgery so I am willing to accept the fact that I can't do everything I used to do before I got PN. You can experiment a little and see what you can do that doesn't cause a flare-up and then slowly add things back in as you continue to heal.

Violet

[Tullson48]

Who did your surgery? How much did it cost? Did you have genital numbness/ sensation issues..if so have you regained sensation? thank you