Botox to coccyxgeus lavator ani and obturator

Botox options, which Doctors use this form of treatment and techniques offered.
jaxi123
Posts: 505
Joined: Thu Sep 30, 2010 12:35 am

Botox to coccyxgeus lavator ani and obturator

Post by jaxi123 »

Anyone had good results with these muscles being injected with Botox?
shana
Posts: 121
Joined: Sun Mar 03, 2013 6:24 am

Re: Botox to coccyxgeus lavator ani and obturator

Post by shana »

What I didn't realize and I think most people don't realize that Botox is usually administered blindly, meaning the doctor feels for the muscle and injects so it's a hit or miss kind of thing. When I had it done, it was a miss. I'm now scheduled for a CT guided pudendal block to the Alcock's canal and a month later I'm scheduled for another round of Botox. I am praying this will give me relief, even just enough relief to help me sit for more than 5 minutes without being in excruciating pain.
Good Luck
Shana
'08 diagnosed with vulvar vestibulitis
'09 vestibulectomy-Dr. Goldstein-failed
'11 right labral repair and release-Dr. Coleman
2/10-8/12 severe depression, minimal dr appointmen
4 different physical therapists '08-'12 no improvement whatsoever
'13 pudendal nerve blocks-Dr. Chapman
More PT
Dr. Conway officially diagnosed PN/PNE 7/13
9/13 Bilateral hip repair Dr. Coleman
10/13-5/14 Major Depression, no dr appointments
More PT
6/14 Dr. Hibner confirmed diagnosis
Looking for help..hoping for answers
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Violet M
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Joined: Mon Sep 06, 2010 6:04 am
Location: United States
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Re: Botox to coccyxgeus lavator ani and obturator

Post by Violet M »

Shana, Dr. Gajraj uses image guidance to give Botox into the obturator internus muscle. You can find his article if you go to the pudendalhope.org homepage, go to publications, and go to the section on Botox. The article describes how it's done.

Good luck with your nerve blocks.

Violet
PNE since 2002. Started from weightlifting. PNE surgery from Dr. Bautrant, Oct 2004. Pain now is usually a 0 and I can sit for hours on certain chairs. No longer take medication for PNE. Can work full time and do "The Firm" exercise program. 99% cured from PGAD. PNE surgery was right for me but it might not be for you. Do your research.
make-it-stop
Posts: 68
Joined: Tue May 10, 2011 6:53 am
Location: Chicago, IL

Re: Botox to coccyxgeus lavator ani and obturator

Post by make-it-stop »

Violet, do you know if Dr. Hibner uses imaging guidance when giving botox injections? I'm looking for someone to do botox injections in all of my pelvic muscles.
5/11: burning in all areas innervated by PN; self-diagnosed PN
5/11: pelvic floor PT (PT #1) did not help after 2 sessions; she gave up
12/11: Kalinkin MRI doesn't show anything significant
12/11: Consult with Hibner; agreed with PN diagnosis, likely due to tight pelvic muscles
12/11 - 12/13: Tried 4 other pelvic PTs - tbh, they weren't great - no results
1/14 - 11/15: pelvic PT with PT #6 (better results, feel about 30% better after 2.5 years of PT)
Related conditions: MPS, S.I dysfunction
jaxi123
Posts: 505
Joined: Thu Sep 30, 2010 12:35 am

Re: Botox to coccyxgeus lavator ani and obturator

Post by jaxi123 »

Dr hibner does not do guided botox injections. He does them vaginally by feel and touch. Done in the hospital and very expensive.
make-it-stop
Posts: 68
Joined: Tue May 10, 2011 6:53 am
Location: Chicago, IL

Re: Botox to coccyxgeus lavator ani and obturator

Post by make-it-stop »

Thanks jaxi. I wonder how much it really is necessary to use guidance. I wish this decision on whether to get it wasn't so hard!
5/11: burning in all areas innervated by PN; self-diagnosed PN
5/11: pelvic floor PT (PT #1) did not help after 2 sessions; she gave up
12/11: Kalinkin MRI doesn't show anything significant
12/11: Consult with Hibner; agreed with PN diagnosis, likely due to tight pelvic muscles
12/11 - 12/13: Tried 4 other pelvic PTs - tbh, they weren't great - no results
1/14 - 11/15: pelvic PT with PT #6 (better results, feel about 30% better after 2.5 years of PT)
Related conditions: MPS, S.I dysfunction
jaxi123
Posts: 505
Joined: Thu Sep 30, 2010 12:35 am

Re: Botox to coccyxgeus lavator ani and obturator

Post by jaxi123 »

I have only had 1 guided Botox inj and it did nothing.

The rest have been done by feel and touch. Only 1set of injections gave me slight relief for only 2 months.
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ezer
Posts: 689
Joined: Sun Sep 19, 2010 6:53 am

Re: Botox to coccyxgeus lavator ani and obturator

Post by ezer »

I had a very bad reaction to Botox (guided injections). I experienced urinary incontinence and insane pain. The pain was significantly worse than after my PNE surgery. It went away eventually after a couple of months. I would avoid at all cost.
2002 PN pain started following a fall on a wet marble floor
2004 Headache in the pelvis clinic. Diagnosed with PNE by Drs. Jerome Weiss, Stephen Mann, and Rodney Anderson
2004-2007 PT, Botox, diagnosed with PNE by Dr. Sheldon Jordan
2010 MRN and 3T MRI showing PNE. Diagnosed with PNE by Dr. Aaron Filler. 2 failed PNE surgeries.
2011-2012 Horrific PN pain.
2013 Experimented with various Mind-body modalities
3/2014 Significantly better
11/2014 Cured. No pain whatsoever since
nyt
Posts: 1165
Joined: Sun Oct 31, 2010 3:24 am

Re: Botox to coccyxgeus lavator ani and obturator

Post by nyt »

I've had very good results with botox. For me, it has had a cumulative effect, has helped with the constant ache in my butt, the constant vice grip feeling in my pelvic floor and my constipation. I think I've had it done about 10 or 12 times. The plan is to get me on a regular 3 month schedule now that they are doing it in Rochester, NY. Anesthesia gives me ketamine because of my CRPS/RSD to keep that calmed down and we always do it close to when I have a ketamine infusion. Anesthesia has figured out a cocktail of drugs that has really minimized my flare after the botox. I have urinary incontinence since my bladder sling came out and the botox does make my urinary incontinence worse. I wear pads anyway so not a big deal for me considering what I get out of it.

There is no way to know whether you will be one of the individuals who responds positively or one that has a negative reaction.
2/07 LAVH and TOT 7/07 TOT right side removed 9/07 IL, IH and GN neuropathy 11/07 PN - Dr. Howard
6/08 Obturator neuralgia - Dr. Conway 11/08 Disability, piriformis syndrome - Dr. Howard
4/09 Bilateral obturator decompression surgery, BLL RSD - Dr. Howard
9/10 Removed left side TOT, botox, re-evaluate obturator nerve - Dr. Hibner
2/11 LFCN and saphenous neuralgia - Dr. Dellon 2/11 MRI with Dr. Potter - confirmed entrapment
5/11 Right side TG - Dr. Hibner 2012 Left side TG - Dr. Hibner
make-it-stop
Posts: 68
Joined: Tue May 10, 2011 6:53 am
Location: Chicago, IL

Re: Botox to coccyxgeus lavator ani and obturator

Post by make-it-stop »

Thank you both for your experiences. I have visited 3 doctors now who have recommended the botox in the pelvic muscles and all 3 have made it sound like there is no risk of getting worse. But I have now read about so many horrifying experiences on this site (and only 1 good), so that makes me wonder why the doctors keep saying that most people get better and no one gets worse. Do they just look the other way when patients inform them that they have significant problems from the injections? I think if I do choose to get this done, I'll ask If only one muscle can be injected to start.
5/11: burning in all areas innervated by PN; self-diagnosed PN
5/11: pelvic floor PT (PT #1) did not help after 2 sessions; she gave up
12/11: Kalinkin MRI doesn't show anything significant
12/11: Consult with Hibner; agreed with PN diagnosis, likely due to tight pelvic muscles
12/11 - 12/13: Tried 4 other pelvic PTs - tbh, they weren't great - no results
1/14 - 11/15: pelvic PT with PT #6 (better results, feel about 30% better after 2.5 years of PT)
Related conditions: MPS, S.I dysfunction
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