Health Organization for Pudendal Education

For Botox Patients:

This Sticky is intended to be used to list those doctors who are performing Botox injections specifically to help people with pelvic floor/PNE-type symptoms. If you have seen such a doctor and have had a positive response to Botox treatments, please post your doctor's information. Please be sure to include an specific information about where the Botox was injected, dosage, your results, special instructions, etc. that might be helpful to others.

Dr. Noor Gajraj

For Texas patients only, Dr. Noor Gajraj performs Botox inhections.
Contact:
Noor Gajraj, M.D. FRCA, DABPM
Anesthesia and Pain Management
4100 West 15th Sreet, Suite 200
Plano, Texas 75093
Phone (972) 612-0162
FAX: (972) 612-0173

However, if you are out-of-state, Dr. Gajraj is not able to see you. But, he is willing to speak with your local doctor who would like to administer the injections for you.
New Process for Dr. Gajraj->He will talk with your Doctor

Dr. Sheldon Jordan is a PNE aware Neurologist who can help people with these types of symptoms. He is listed on the Homepage link for Doctors.

Dr. Sheldon Jordan – Neurologist
2811 Wilshire Blvd. #800
Santa Monica, California 90403, USA
Phone 310 829-5968, ext 244

Dr. Charles Popeney – Neurologist
Fort Bend Neurology
2225 Williams Trace Blvd
Sugar Land, TX 77478-4513
(281) 980-2525


Lawrence Poree'
2000 Van Ness Ave. #402 (same building as P.T. Stephanie Pendrgast)
San Francisco, CA. 94109

415-567-1219

Australian Doctors:
Prof. Thierry Vancaillie. Royal Hospital for Women. Randwick NSW. Australia.

Dr. Abbott, Endo/Gynae Clinic at the Royal Hospital for Women at Randwick.

This is a short list. :/

Anyone have updates to the list? Surely there are more doctors than this that know how to do this procedure.

I live in the Orlando, FL, area. Does anyone know of a doctor in this general area that could do botox to the pelvic floor? My muscles are in spasm and it REALLY sucks.

I have found several docs that say on their websites that they do botox for pain. But the pelvic floor muscles are another issue. It's not like sticking a needle into the gluteus maximus. I'm not even sure how they get to the obterator internus and the levitor ani.

Anyone know? Particularly on a male?

C

Dr. Kristine Whitmore in Philadelphia does Botox internally, under sedation. Her phone no. is: 215-863-8100. She is located at 207 N. Broad St., Philadelphia.

Does anyone know if Dr. Richard Marvel in Baltimore, MD does Botox, or if he refers a patient to John Hopkins Medical center, also in Baltimore?

Bamboo

Dear All,

I perform botox injections for pudendal neuralgia issues and pelvic pain.

One of the most common targets is the obturator internus muscle which is often spastic and this spasm squeezes and irritates the pudendal nerve. This muscle can easily be targeted using image guidance. If image guidance is not used, this muscle is virtually impossible to target effectively.

All such injections are performed with image guidance using ultrasound. This ensures increased safety and efficacy. This also makes the procedure much more comfortable, as for many of the pelvic muscles I can place the needle in your buttock near where your wallet pocket would be, rather than place the needle in your vagina or perineum. I am then able to guide a long needle down to the deep muscles. This is much more comfortable.

Unfortunately, unless you also have urination problems, botox used in this region is NOT covered by most insurances. Therefore there is an out of pocket cost for the botox medication.

Hi Dr. Attaman

This is interesting to me because I was told once years ago my problem was the obterator internus. I just got done doing some exercises for it (feet and buttocks against the wall - turn feet in to each other as far as you can, hold, turn feet out, hold) and I really flared my vaginal pain up. Have people who have gotten botoxed in the obterator internus had relief of vaginal burning. Mine is left-sided (always) And I do have urinary issues. Always have had them. Frequency, urgency, pain (especially in the urethral sphincter)

Thanks
L

Lily, I never tried Botox but using a TENS unit to relax the obturator internus relieved vaginal burning for me. Dr. Gajraj's article suggests trying a short term anesthetic (bupivacaine) as a trial to see if it helps before trying Botox. http://www.pudendalhope.info/sites/defa ... Gajraj.pdf

Violet

Lily721 wrote:Hi Dr. Attaman

This is interesting to me because I was told once years ago my problem was the obterator internus. I just got done doing some exercises for it (feet and buttocks against the wall - turn feet in to each other as far as you can, hold, turn feet out, hold) and I really flared my vaginal pain up. Have people who have gotten botoxed in the obterator internus had relief of vaginal burning. Mine is left-sided (always) And I do have urinary issues. Always have had them. Frequency, urgency, pain (especially in the urethral sphincter)

Thanks
L

Dear Lily721,

That stretching and activation of the obturator triggers your pain is a big clue. Yes, botox of the obturator internus has helped a number of my patients with pudendal neuralgia. Best of Luck, Dr. Attaman

Dr. Attaman,

Just wondering whether these patients who had relief from Botox to the OI muscle had it after pudendal nerve release surgery or before, and whether the Botox provided any type of permanent relief.

Thanks,

Violet