Health Organization for Pudendal Education

Hi all,

I had a pudendal hydrodissection last month. Had total relief after a few days, and then it flared excruciatingly. Took weeks to calm back down to baseline. I then had an ilioinguinal block/hydrodissection. No relief. Next, my doctor suggests a PFCN hydrodissection. I'm naturally nervous about using up my "3 steroid shots." I've been told steroid crystallization around the nerve can cause more pain.

At the same time, I am feeling pretty desperate. I have pain in the middle of my glute, inside my sit bone, the clitoris (the worst!) and intense aching across the mons pubis. Pelvic MRI was "normal" but did show hip impingement and degeneration on both sides. Pain is on left side only.

2013: Burning pain began after oophorectomy. Misdiagnosed with subclinical BV/yeast for years.
2015: Went to pelvic PT for 3 mos, pain completely resolved for a few months. Was told pelvic floor was very tight.
2016: Pain returned. Went back to same PT but it did not help.
2017-18: Tried 4 more PTs, for 8 sessions+ each. One helped me be pain-free for a couple weeks, but the pain returned.

Has anyone been cured by a PFCN hydrodissection? Should I try a chiropractor? Hip surgery? (No one has suggested this to me but I read some posts here saying it can help.) I'm exhausted from this pain and it has dramatically changed my life. Thank you in advance.

I don't remember whether anyone has had success with it but if you do a search in the upper right on the word hydrodissection you will find some posts on the topic. I'm not sure if any of them are specific to PFCN. Sorry it hasn't worked for you so far. Is it 3 steroid injections total that you are allowed or 3 at each different injection site?

You might want to do an advanced search on Lernica's posts on femoral acetabular impingements. I don't know if your hip might be the problem but she had great success with surgery for FAI. I think someone named Jax87 also had success with hip surgery for PN pain.

Violet

Thank you Violet. I've read a lot of the forum and really appreciate what you do.

I'll read up on Lernica's experience.

Maybe I'll try one of those out of town PT programs. I see a lot of PTs offer them. Do you have a sense of which is best?

Sorry, I'm not sure what you mean. Do you mean you want to go see an out-of-town PT or are you referring to something else? I think going to an out-of-town PT would be a real challenge because for PT you have to go on a regular basis.

Violet

Thanks Violet. I just mean that some famous pelvic PTs offer "out of town" programs where they see people 2-3x a week, intensively.

I'm now wondering if it's my piriformis causing all this trouble. I had a massage therapist tell me that the piriformis muscle was immobile on my painful side. Poking at it causes the muscle to scream. I did read online that sometimes the piriformis can impinge the pudendal. I guess I'll try loosening the piriformis through some stretches I found online, like rolling around on a tennis ball, and see if that helps. It would be so great if that were the answer!

In addition to PN, I had priformis spasms that caused buttock pain/numbness including numbness down my leg and in my foot. It's a real challenge getting the knots out of that muscle. I found a TENS unit to be really helpful in calming it down.

Violet

Hi trying2heal:
How are you feeling now? Do you feel you got any lasting relief from the prolotherapy or hydrodissection? Which doctor did you use for that and the hydrodissection? Sounds like it was painful. Hope it is netting you some relief.

I have done out of town travel for PT for a week or so a couple times. Since you got some relief from PT at one point, it might be good to get an evaluation and some treatment from an expert.

Stephanies