Health Organization for Pudendal Education

Hello All:

Got my MRI report in the mail today from my MRI with Dr Kalinkin. I'm kind of freaking out since I don't understand what it means and I don't have an appt. with Dr Hibner until next week.

Curious if anyone has any thoughts:

"There is preserved fat planes surrounding the pudendal nerve in the inter ligamentous space, in the Alcocks canal bilaterally. There is no perineural scarring or edema. There is slight asymmetry of accompanying pudendal nerve vessels with right pudendal vessels slightly larger than the left pudendal vessels. Pudendal nerve branch to the rectum are symmetrical bilaterally. RIGHT PERINEAL BRANCH VESSEL IS TORTUOUS AND PROMINENT. There is no single intensity assymetry on the diffusion weighted imaging along the course of the pudendal nerve. Sciatic nerve is symmetrical bilaterally. Femoral, obtrutor, superior and inferior gluteal neurovascular bundles bundles are symmetrical bilaterlly....

IMPRESSION:
No MRI significant assymetry of the pudendal neurovascular bundle. RIGHT PERINEAL BRANCH VESSEL IS TORTUOUS AND PROMINENT. Correlate clinically for pudendal neuralgia."

Thanks!
Merrie

And sorry all this is under Elizabeth and not my normal log in which is Merrie. I lost my username and password at one point and had set this up as a separate log in. Apparently my computer here at work remembered that since I usually do not post at work.

Thanks!
Merrie

tortuous means it twists a lot and prominent means obvious/large

if by vessel they mean an artery or a vein, it could mean that your artery or vein there is a varicose vein.
if that branch were next to the nerve, it could be putting pressure on it.

Thanks for your feedback Pianogal. I had a similar thought after thinking about this all day. I have been trying to do some research on the internet and have not come up with anything more on point.

Im frustrated the MRI does not say anything more specific re/ the dorsal nerve. Im going to see if I can call Dr Kalinkin for more info.

Merrie

Hi Merrie,
Who is Dr. Galinkin by the way?Were you referring to Dr. Olga Kalinkin by any chance? By means of Dr. Hollis Potter and Dr. Olga Kalinkin MRI results,it is becoming obvious that in some cases,the Perenial as well as the dorsal branches of the Pudendal nerve are the culprits and not the main trunk itself.
This is indeed very interesting now.Now the big question is that how will Dr. Hibner address the Perenial and dorsal branch entrapments?

Merrie,please make sure that you do discuss these with Dr. Hibner when you meet him.Also ask him to what extent can he he decompress the Perenial branch?Does he decompress it at the Alcock's Canal level or when it branches off the Pudendal/Alcock's Canal.




Warmest Reqards,
Ali

Ali- yes it is dr Olga Kalinkin in phx who did the MRI.

So you think that the perenial blood vessel being tortuous and prominent may mean nerve entrapment in the perineal area? I was afraid of that.

I will absolutely discuss this with dr hibner next week as it's one of the main reasons for my appt. I'm also going to see if there is any chance of me speaking with dr Kalinkin before then.

Thanks!
Merrie

If it is a perineal vessel that is of concern, perhaps ask Dr. Hibner if he can remove it, thus removing pressure on your pudendal nerve or perineal branch. He can remove things using the DaVinci robot. He is very prominent and successful and adept at DaVinci robotic surgery. Perhaps you do not have an entrapment after all. I pray this is the case.

A's Mommy

Hi AM,
Can he do the DaVinci Robotic surgery on men too?
Thanks,
Ali

Thanks A's mommy. I hope you are right and I will absolutely discuss with Dr Hibner. He initially recommended davinci hysterectomy for me given my other pelvic pain conditions (adenomyosis and related issues) so maybe he can kill 2 birds with one stone so to speak! I am fighting the insurance fight right now and am praying to god I can get my surgery approved to be performed by Dr H.

Will keep you all posted! Thanks again for all the feedback and support!

Merrie