Health Organization for Pudendal Education

Has anybody had success with this Pulsed Low Frequency Radiofrequency Ablation to the pudendal nerves? I saw a post on here about one person who got a lot better with it. If so, please tell us, as this seems as if it may offer a new alternative to surgery.I just wanted to let everyone know that I do know at least two people who have gotten this new procedure done and it worked well for them. One went from a level 7 to 2 on their pain level. It has to be done with low frequency pulsed to be more safe and effective. There are only one or two I think doctors who do this. It sounds like a possible alternative to surgery, so I would like to hear from more people who have had this done with success. Here is what one person who had success with it done more than one time to them said about where they got it done and more info. about this procedure.

Pulsed radiofrequency nerve ablation has been a way to deal with chronic nerve pain for some time now. It is very new to treat the pudendal nerve this way, however, it can be done and is often successful. There is a difference between PULSED radiofrequency nerve ablation (Pulsed RFNA) and radiofrequency nerve ablation (RFNA). Pulsed RFNA uses a pulse frequency, and regular RFNA does not use pulses, it uses heat. If you have had even a few hours of pain relief with nerve blocks (GUIDED NERVE BLOCKS ARE THE SAFEST AND LIKELY TO BE THE MOST ACCURATE) it is likely you will have a good reaction to Pulsed RFNA.
Pulsed RFNA can give substantial relief lasting between an average of 3-18 months. Any potential side effects will last as long as the pain relief. Incontinence is a potential side effect, however, it is usually not experienced. Like any procedure, it can cause a flare for 3-7 days. However, the recovery is much less than what would be needed for a surgery, which has a low success rate.
Regular RFNA can give similar relief, however, any potential side effects will be permanent. The nerve will likely grow back, and when it does, it can follow an odd path, which can make it more difficult to treat in the future.
I recommend the Pelvic Health & Rehabilitation Center in SF. They also have a program to treat out of town patients, and will try and work with/educate your current PT for when you leave their care. They are fantastic. They also teach classes to PT's and are active in the medical community.

Shawn

Hi Shawn - I know that there are some people on this forum who have had this done, those with good results tend to disappear, though.

I remember that jennyp had had several round of pulsed RF injections, if I recall correctly, she said that they had enabled her to be virtually painfree for up to 8 months. She was seeing Dr Baranowski. (He's based in London.)

johnd.h did talk about planning to have Pulsed RF Lesioning done in February of this year, with Dr Baranowski - I don't know whether he actually had this done, though, as he went on to have surgery in March this year. Last we heard from him was in May this year, he was making a good recovery and was having some days painfree.

Is this something that you are considering?

Hi Calluna,
I wish that people who have success with this, would keep us updated on here to help us all out more. At this point, I am leaving all options on the table including this new procedure. I do not want to rush into surgery without exploring all the options and making sure of my diagnosis. I wish more people who have had success with this would post regarding this treatment, but it may be relatively new for the Pudendal nerve and there does not seem to be a ton of doctors who do it. If you know of anybody else who has success with it let me know and post it here to keep us all updated. Take care. There's Always Hope.

Shawn

I think that what usually happens is that people reappear to tell us that things went well - if you search for pulsed rf, you'll see what I mean. Except that I'm sure you've done that already! There are only a few people with success stories who have hung around to help others.

Thanks for the information, Shawn. I would also like to know who the doctors are who have done this successfully, and if you can have it done if you have already had surgery. There is a doctor in NY who does it, I believe, as well as Stanford, CA and London.

Can anyone tell me which docs in US do pulsed radio frequency?

Dr. Hibner's team in Arizona
Dr. Jason Attaman in Washington
Dr. Ankur Khosla and Dr. William Yancey in Texas

Go here for contact info: http://www.pudendalhope.info/node/58

I am sure there are more in the US but these are the ones I know of.
You can use the search bar in the upper right corner to search for what other patients have said. There may be posts on the forum regarding other doctors who perform this procedure.

Violet

Thanks for info.

Do you know if there are any dangers involved with this procedure? Such as foot drop etc? I don't want to become worse than I am.

Dr. Howard Richard in Maryland does PRF, I believe.

To clarify, this is properly referred to as "Pulsed Radiofrequency Treatment." Some people including physicians erroneously call it "Pulsed Radiofrequency Ablation," which is wrong, as no ablation occurs. The nerve is not ablated (melted/burned). There is no such thing as "Pulsed Low Radiofrequency..." anything.

This procedure is rarely performed so as a profession we have no large data sets to work with. It is my belief there are only a few physicians in the world performing this procedure for the pudendal nerve on a regular basis. It is technically very challenging. It takes 30-45 minutes to perform.

The risks are generally very minimal. There is no published literature to quantify the exact rate of complications. In my experience, including my experience with pulsed RF treatment of other nerves around the body, the risk of a serious complication is less than 0.5%. The risks are the same with all injection procedures which include bleeding, infection, no effect, worsening pain, nerve damage, paralysis, stroke, death. Again, these are a broad range of possible complications.

I believe pulsed radiofrequency treatment of the pudendal nerves to be a good, very minimally invasive option. It generally takes about 2 weeks after treatment to start giving pain relief. It often will give relief for 3-16 months. I generally offer it if standard pudendal nerve blocks have given good short term but poor long term benefit.