Health Organization for Pudendal Education

Dr. Richard Marvel is a Gynecologist specializing in pain management in women and men. He is currently able to provide diagnosis and treatment for pudendal neuralgia. He is able to provide pudendal nerve blocks, warm detection threshold testing (WDT), and pudendal nerve motor latency tests. He performs the transgluteal approach to surgery with conservation of the sacrotuberous ligament. He has performed cases with Dr. Eric Bautrant in France, Dr. Antolak in Minnesota, and Dr. Jim Campbell, neurosurgeon at Johns Hopkins. He is a fellow of the American College of Surgery and is on the faculty of the Johns Hopkins University School of Medicine. He is currently offering Botox injections as well.


6569 North Charles Street
Physicians Pavilion West Suite 705
Towson, MD 21204
Phone: 443-632-0200
132 Holiday Court, Suite 210
Annapolis, MD 21401
Phone: 410-353-7266

If you discover this is outdated information, please post an update for other forum members. Thank you.

The last time I heard he was no longer offering surgery due to the low success rate he had...but this was when I saw him last back in 2/09...things might have changed since then.

Kiki, I think he quit offering the TIR approach because of the bad results but later he learned the TG and last I heard he is now offering the TG approach. Someone please correct me if I'm wrong.

Update as of June 2011
Dr. Marvel moved his Center for Pelvic Pain from Towson to a new Annapolis location

130 Lubrano Drive
Suite 111
Annapolis, Maryland 21401
Phone 410 573-1436
Fax 410 573-1442

He is performing TG surgery.

Thanks for providing contact detail.

You are welcome and we (Jason -seawalker) just found out Dr. Marvel does not accept insurance if you are a male patient.
Janet

Hello,
I had a hemorrhoidectomy on july 2011,and on the 4th week after surgery i started having pain in my rectum,vagina,perinium and coccyx,the colo-rectal specialist
that performed the surgery diagnosed me with levator ani syndrome wich is basically mucle spasm",i cannot sit,sex is painful ,not during but after mainly the day after,
i have burning sensation,no numbness tough,but a lot of pain,to the people that have been diagnosed with prudendal nerve damage is my question.My specialist says that he doubts is a nerve damage because i dont have incontinence,and that i have the opposite he has seen in people with prudendal nerve,wich is a very weak pelvic muscles,i am so confused and every day i struggle to even get up from bed,my life has taken a terrible turn and i feel very isolated .can someone here tell me what his/her symptoms are?
please? i really need help .i live in Maryland i am a 43 yr old woman,two daughters,born by c-section(both),was very athletic before this tragedy,a hard runner a very happy woman.

Can somebody help me?

Lara, the people that I've known with pudendal neuralgia (during the 7 years I've been on the pudendal forums) don't usually have primary complaints of weak pelvic floor muscles and incontinence although occasionally incontinence is one of the symptoms. Usually, their pelvic floor muscles are very tight/tense and often pain is their #1 symptom. It's true that many women who have had vaginal deliveries suffer from incontinence and weak pelvic floor muscles possibly due to damage to the pudendal nerve from childbirth but that is not the same as the pain of pudendal neuralgia.

There are a couple of doctors and physical therapists in Maryland who can help you determine if you have pudendal neuralgia. They are listed on the website at www.pudendalhope.org (see the menu on the left of that page for a list of doctors and PT's). I see you have posted under the topic of Dr. Marvel's contact information. He is one of the physicians in Maryland.

I'm glad you found our site and hope you will find valuable information here.

Violet M

Hi Lara,
Just to reiterate what Violet said. . . .you don't HAVE to have incontinence with PN, as the motor function of the pudendal nerveS can affect the bladder but that would be from the same motor effected problems on both nerves. Most people have one side affected OR both sides but one less so than the other, so that the pudendal motor function is still active to the bladder to some capacity. As Violet said incontinence can be a problem but it doesn't have to be, same with pelvic floor muscles.
I am no doctor but the burning sensation you describe almost certainly IS nerve related. . . I would try the list that Violet has suggested as I wonder how special your secialist is??
Good luck with your search for a diagnosis and treatment.
take care,
Helen

Thank you so much for your replies, i went to a urogynecologist(refered by my colorectal specialist) and ....same diagnosis"Levator ani syndrome" ,muscle spasm,etc.
he prescribed me valium vaginal suppositories of 1 mg twice a day,i cannot deny they are helping a lot,but i also know that they are just helping with the symptoms and not the root of the problem,this friday i have an appointment for an MRI,and next week i will see a dr in a pain management clinic, .
What are/were your symptoms? how did they start?
my primary care dr mentioned something about ,"nerve block" wich really scares me,what nerves do they block? and what is the succes rate in such procedure? it seems you guys a lot more than myself,this is so new for me.Could this be medical malpractice? i ask this because my primary dr mentioned the word"lawyer',however he wants to se my medical records from the hospital where i had the hemorrhoidectomy .
Thank you so much for your help,i am so frustrated right now,not being able to run,sit,have sex ,ughhh this is too much for me ,i am so depressed .


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