Health Organization for Pudendal Education

I heard an interview on blog talk radio the show is "the pelvic messenger", July 14. The interview was with Dr Hibner and Stephanie Prendergast. The host asked "how do you know the difference between pn & pne?"
Dr. Hibner said it's a matter of common sense. He says that if there is trauma like fall, surgery, childbirth, etc it usually suggests pne. If it comes on slowly it's more likely pn.
Have you found this true or untrue?

Thanks

I suppose the only people who can answer that with any certainty and 'evidence' are those who have had surgery and have been found to be entrapped.
It's an excellent question to ask, going by many post surgery members signatures, it does seem to hold some weight.
It does make sense to me but there will always be exceptions, I think it's hugely important to take the patients history into consideration but a sports person may develop say, muscle damage related PN and continue with activity, not allowing the muscle to heal properly until scar tissue develops, which then properly entraps the nerve. So what may be a slow on set of symptoms may still become PNE. Cyclists often suffer from PN and maybe PNE ? ?
In general though, until proved wrong I would think this reasoning is sound.
I'm fairly positive that I have PNE because of a fall. I haven't had a pain free day since that incident. I have constant base line 'pelvic issues', OK pain, but I try not to categorize it that way which escalate the more I do.
So in answer to your survey, I say TRUE (edited. . . .in that I reckon it's true for me. . . . but would qualify as not proved as I haven't had surgery)

I'm not sure I agree with it. I think there can be a mild enough entrapment that it doesn't cause problems until it does--maybe something subtle that you wouldn't call a trauma sets it off, or some kind of scarring/tethering grows slowly over time until a point of no return is reached.

I sort of agree and sort of disagree. My pain developed slowly which according to Dr. Hibner would mean I had PN, not PNE. But there was the trauma of injury from weightlifting and the positive response to PNE surgery which makes me think it was PNE, not just PN. There, now I'm completely confused!

I think that some people are just phsiologically pre-disposed to get PNE to varying degrees.After all, millions of people lift weights, cycle, have babies, etc. and they never get PN (at least the kind that won't go away). Even most people who fall hard on their butts don't get it. Surgical injuries would be an exception to this category. For myself, I think it just built up over time and like Celeste said, one day it just didn't go away.

Don

With any diagnosis you know there are going to be certain injuries that are highly correlated with certain conditions. For example, a knee injury in a wrestler is more likely to be a lateral collateral ligament (LCL) injury than an anterior collateral ligament (ACL)injury so an ortho dr. will ask a young person what sports they participate in as that helps them narrow down what the likely injury would be. Doesn't mean that the wrestler couldn't have an ACL tear but statistically wrestlers have LCL injuries. All the PN dr.'s know (and us for that matter) if you are a cycler, weightlifter, had a hysterectomy or given birth statistically you know to think PNE if you present with pudendal symptoms not PN. There are always going to be outliers, that is the nature of the beast. It is the outliers who have a harder time getting correct diagnosis and treatment. The outliers are the patients I feel sorry for as many times doctors get stuck in a believe system that won't let them consider other diagnosis and think out of the box.

Interesting. And very hard to generalise, I think.

My PN came from surgery, and it is a very clearcut case - there is evidently something impinging on the nerve but whether there is actually an entrapment remains to be seen. It seems unlikely.

I found this comment interesting as well. I am one that my symptoms sort of came on slowly, but then had a trauma that set them off to a level of disability so I don't know what Dr. Hibner will think in my case. Of course I was postpartum so I did have the truama of the nerve from childbirth too which didn't help, but that was not my direct injury. I will ask him at my appointment next week and report back in the case updates.

Faith,

I read your posts frequently and look forward to hearing how your appt goes this week! Keep us updated!

cari

Faith,
Looking forward as well to hearing about what Dr. Hibner has to say. I think that often many factors can predispose you to PN and then one final insult puts you over the edge. My appt. is Oct. 5. Wishing you all the best.

Don