Injections for Pudendal nerve entrapment

[Kita]

My daughter was diagnosed with PNE just today by Dr. Antolak in MN. He wants to do a series of 4 injections, steroids and lidocaine(?). Has anyone had this series of shots and if so, did they help. He says he has cured people with these injections. I hope he is right.
Are these injections worth trying? Is there a risk of side effects?
Thank you for any replies.

[Kara29]

I had 8 injections. As with anything invasive there is some risk. Did you ask the Doctor about this? If there area where the injections gets red, irritated, inflamed, and is hot, then it could be infected. Other than that the Doctor would have to tell you what he wants you all to look for. PNE injections can be very helpful for some patients and I feel it's worth it, if there is a chance at reducing her pain and giving her some of her life back. I, unfortunately didn't get long term relief from my injections but my case involves lots of different factors than just PNE. There are web sites and message boards that talk all PN and PNE if you want to go there for more information. http://www.tipna.org/faq/IntroductoryFAQ.htm


Good Luck to you and your daughter. I hope the injections are a success for her and she gets some pain relief in the weeks to come.

Well Wishes,

Kara

I'm going to add some information written by a different doctor. Here it is quoted.

"1. What is a nerve block?

In the context of PNE, a nerve block involves injecting a liquid at a precise location near a nerve. For a small nerve like the pudendal that takes slightly different paths in different people, this requires more than just studying a person's body and deciding where to insert the needle, at what angle, and how deep. It requires imaging of some type, such as Xray (fluoroscope) or CT. Without the accuracy these imaging systems provide, it is difficult or impossible to know if the needle tip is located correctly. If incorrectly located, the nerve can be damaged or the injected liquid will be too far away to have its intended effect. Dr. Bensignor says the needle tip must be within one millimeter of the target.

There are two main types of injected liquids: a local anesthetic and slow-release steroids. The local is a short term diagnostic tool. If the pain goes away and stays gone for the short term, the location was correct and the nerve can be suspected of being a contributor or the sole source of pain. The steroids are a long term therapeutic attempt. In some cases they will cause the nerve, if it is irritated, to get better. This can take days or weeks, and improvement may be temporary or permanent. This delay explains why physicians prefer a delay of several weeks between nerve blocks with steroids. If the nerve is not irritated, the steroids have no effect.

Two main locations are used. The ischial spine block is done by injecting into the sacrospinous ligament. Alcock's canal block is done by injecting into the sacrotuberous ligament. These are not the same as the blocks carried out for childbirth pain. In some cases the blocks may worsen the pain a little but this should last only a few days. My CT guided nerve block on the ischial spines was no more uncomfortable than getting a dental filling. It was really quite a minor procedure.

Dr. Bensignor replied to a question from Dave Arney on June 24, 2002:

Question - "For the people who are cured through shots alone, are they cured immediately or does it come gradually? Are a series of blocks done?"

Answer - "There is generally an immediate but short (a few hours) effect of local anasthetics. In good cases, the relief from steroids takes 2 to 4 weeks, sometimes after a transcient worsening of the pain for a few days. Long term relief usually requires 2 or 3 injections. When a long term (several months) relief is obtained from these injections, a recurrence of the pain may happen but is exceptional (less than 10%)."

[CCB]

Kita,
I'm so sorry to hear your daughter has PNE, so does mine.
Liz has received about 4 nerve blocks and a few stopped the pain for a few weeks.
I want to let you know of another site that discusses pne if you have not seen it yet, pudendal.info
I have found this site very helpful and have seen your daughters doctor's name mentioned as one of the best.
Good luck with your search.
Cici

[Kita]

Thank you for your replies.
CCB, Is your daughter considering the surgery? I see on the web site that you recommended that if the injections help then you definitely have PNE.
My daughter is still contemplating whether to have the injections.
One thing she has done recently is go off birth control pills, along with IC she has VV. And the VV seems to be better since stopping the BCP. She is hoping that perhaps with time and off the pill she may improve. I pray that will happen but I think it would be a miracle.

[Kara29]

My PNE is happening May 6th in New Hampshire. I also can't take any form of birth control and have VV but I had a surgery to take away the Vestibulitis part of it. I have a good team of Doctors and I'm fortunate to have good health insurance. I'm nervous about my surgery in May. I always get nervous before an operation becuase they always find other problems when they go in there..............

Kara