Health Organization for Pudendal Education

I have been asking various members of this (and other) forums this question. So far the results seem to be about 50/50. Like many other treatments, it does not appear to be a "quick fix" for PN/pelvic/perineum pain ("p-pain") but rather just another piece of the puzzle.

If you have had surgery to repair a torn labrum, or have been diagnosed with a torn labrum and are considering surgery, please post your experience, or what you've heard from other patients about their experiences, here. In this way we can make better informed decisions about whether or not to pursue orthopaedic surgery in our quest to obtain relief from p-pain.

Please also indicate whether or not you had symptoms of hip pain before your surgery, or whether you pursued surgery for the sole purpose of reducing your p-pain as part of a study by doctors Deborah Coady (gyno) and Stuart Coleman (ortho surgeon) at HSS in NYC. This factor may also assist those who are contemplating future surgeries.

Thank you!

Hi all:

I have corresponded with 5 women who have had FAI/Labrum repair surgery who also had PN symptoms. 3 of the 5 are significantly better and consider themselves cured of PN from the surgery, one of them said the surgery reduced her hip pain -- which helped her pelvic floor relax, and she is significantly better, but with a lot of PT and other lifestyle changes. And one person i corresponded with said her PN and hip pain are worse -- and that she knew others that are worse but i havent spoken to them. So, out of the 5 women, 4 have significantly reduced their PN as a result of the surgery. So far, no one has reported immediate relief -- they said it took up to 12 months after the surgery and that they got gradually better over time. This corresponds to the 70% success rate my surgeon, Struam Coleman reported in the study he did on Torn Labrum surgery and Vulvydynia.

I have had hip pain for the past two years, and lower back/SIJ pain for the past year. The hip pain was only when my hip was in flexion and internal or external rotation. This pain preceeded my PN symptoms but i didnt pay much attention to it until recently and didn't think it was related to the PN symptoms that i had, which are: urinary frequncy/ vulvar burning (right side), clitoral pain/sensitivity, feeling like something was pushing out of me (like giving birth), painful sex, pain when wearing tight clothes of anything rubbing against me. Fun Fun Fun. The PN started after sitting for long periods of time at work.

Physical therapy, Elavil, massage, acupuncture and a stand up desk have brought me to a place where my PN pain is a 1 -- from an 8.

After discovering that i had torn labrums, i had my hip injected with Decadron (a contizone) and lidocaine -- i had some minor relief of the PN symptoms and the hip pain -- they also discovered that i had a torn Psoas and my psoas was in a lot of pain during the arthrogram. When i met with Dr. Coleman he said i was a perfect candidate for the surgery and that it would cure my hip pain and hopefully the PN.

My hip pain is worse and continues to really bother me. So, i am having the surgery on July 17th. I continue to try and find people who have had the surgery and have been cured of PN.

Hi Beverley,
I'm glad that you have your surgery scheduled and that you have been able to talk to several women about the PN/hip issue link. It is really interesting, and I am hoping that once you have surgery you will feel 100% better. I sent you a PM awhile ago, but I am not sure if you received it.

I am just curious, did you have any kind of acute injury to your hip before the pain started? Did the other women you spoke with who had hip tears and PN all have hip pain?

Thanks Jackie

Hi all,

I too have a Labral tear (in my right hip). My surgeon says that I most likey have one on the other side as well but that has yet to be imaged/diagnosed. I see my surgeon in a few days to discuss the results of the MR Arthrogram (with diagnostic anesthetic block) and probable surgery. The injection of contrast for the Arthrogram and the diagnostic anesthetic block made the hip pain MUCH worse, but seemed to eliminate my vulval burning and pain/clitoral sensitivity & pain for about 3 hours. I say that it "seemed" to eliminate those symptoms because I'm not totally sure that the reason I wasn't feeling any pain in that area was because the pain in the hip was SOOOOO severe (9/10) and providing a pretty good distraction.

Assuming the surgeon thinks it's a good idea, I will be moving forward with surgery. So, I'm pretty keen to hear all about other people's experiences with this too!

I have had Vulvodynia/PN symptoms for going on 2 years but hip pain for only around 4 months. The hip has however, clicked and popped for perhaps 6-7 months. I certainly hope that there is a relationship here! In any case, I need to do something about the hip, as it is a source of pretty significant pain all by itself. I'm not sure about my vulval burning and stinging symptoms but I do feel that there is a definite relationship between the hip pain and the clitoral pain and sensitivity. The two seem to go hand in hand.

My surgeon, a veteran of Labral Tear surgeries, was not aware of any relationship to Vulvodynia/PN.

HI All: i am schedule for surgery next tuesday and am getting a little nervous but am looking forward to hopefully ending this once and for all. Jackie -- i sent you a PM back after you PM me - did you get that? I will keep you all posted on the surgery.!!

Thanks for this Beverley, I hope you can be another success story The very best of luck and my good wishes to that end. OH! if it could be THE end of this
Take care,
Helen

Here is a link to an abstract presented by Dr. Deborah Coady at a medical retreat about the relationship b/w labral hip tears and pudendal neuralgia (aka generalized unprovoked vulvodynia) http://tinyurl.com/7yhwbxt it is on page 29 of 32.

And another article featured in the National Vulvodynia Association News explaining how pelvic floor pain can becaused by orthopedic issues http://tinyurl.com/dxp339c. Unfortuantely she doesn't talk about Sacroiliac joint dysfunction (other than injecting into the SI joint -which isn't really a good diagnostic for SIJD), but it was an informative article.

Hi faith,
As you know, I have also wondered if my physiotherapist diagnosed SIJD was a partial cause of my pain. I have decided that the answer is YES!
Although every physio I saw told me my right side SI joint was 'stuck' (the other one 'springs') and my pelvic was up and rotated, after being fixed (no leg length discrepancy) I never felt any better pain wise. Of course I didn't stay fixed as the next physio said exactly the same. Because the fixings were inconclusive I couldn't really correlate SIJD with my pelvic pain.
However, I have always had a 'gravity thing' in that, if I stand or walk I do get extra pain which is relieved by propping myself up, leaning on furniture etc. I am able to bend and have no back ache so I knew this wasn't because of any spinal problems and spinal skeletal support. I also do back exercises precisely because doctors have apportioned blame here, so couldn't say there is any spinal muscle laxity either; yet I find it advantageous to rest my upper body weight as described.(not overweight) I have put this down to a skeletal issue as I couldn't see how muscles would benefit from extra support?? resulting in a direct lessening of some pelvic pain when supported. Because my main pelvic pain is in the SI joint and sacral end of the piriformis muscle it is hard to differentiate where one pain ends and the other begins.
I still wouldn't say that fixing my SI will help overall (could be wrong) but I firmly believe that it's the scar tissue around the nerves in and near my p muscle (from the lump/haematoma I had there after my fall) that is responsible for the nerve pain issues.
Just though I'd share this as I know you have always wondered how much part your SIJD played in your symptoms. Do you (or anyone) have any similar need to 'hang over' or rest on things to relieve what must be a pelvic pressure/gravity. . . . . .therefore skeletal? pain.
Helen

I am one day post op and am feeling good. I was terrified to have surgery but i had a great experience at Hospital for Special Surgery with Dr. Coleman. Dr. Coleman said my hip was a mess -- his words, that my Psoas was very inflamed. I am glad i had the surgery because even if the hip didn't CAUSE the PN it certainly couldn't have been helping it. I will keep everyone posted on how my PN progesses.

Hi,
I'm so glad that you had your surgery and that you are feeling pretty good. I think you're right about the hip/PN pain connection, and hopefully now you can heal and move forward with your journey to pain-free living. I am waiting to hear back from Dr. Kelly at HSS about an appointment, so I'm glad to hear that you had a good experience there.

Hugs, Jackie