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Diagnosis of nerve injury following pelvic surgery

CMSol profile image
26 Replies

Diagnosis of nerve injury following pelvic surgery

Hi all, I am acting for various unfortunate ladies who have terrible chronic pelvic pain, affecting their groin/ legs etc and mobility after different types of pelvic surgery. In one case this is owing to the positioning of a staple in the pudendal nerve and this became apparent after an MRI. We are not sure how on earth a surgeon managed to leave a staple in the pudendal nerve and this should not happen.

In another case, a lady probably has pudendal neuropathy following a gynaecological procedure and really is in terrible pain with constant mobility issues but has experienced some, but not complete, pain relief from nerve block injections to date.

I wish to know more about MRN scanning and whether anybody has any experience of firm diagnoses being reached in relation to their nerve pain after pelvic surgery and if so by what particular investigation. I'm already an experienced practitioner in the field of medicolegal and gynaecology but am very keen to expand my knowledge base and hearing directly from those who have managed to obtain firm diagnoses would be invaluable.

I'm very sorry for all of those here who have loved ones, or who are suffering directly with these types of awful chronic pain issues.

Many thanks

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CMSol
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26 Replies
Skye22 profile image
Skye22

Can I ask are you representing clients with a legal interest who are unfortunate to have botched surgery or is it on a personal capacity due to ill health?

CMSol profile image
CMSol in reply to Skye22

Hi there I am representing patients and I have various cases investigating at the moment where I feel just so sorry for my clients. I hope I don't cause any offence by dipping my toe into this forum, I have also suggested my clients engage with the forum directly. I'm just wanting to learn about others' experiences, the types of investigations they've had and what investigations have actually led to diagnoses, treatment and better outcomes, so I can better understand and help the ladies I am acting for.

Caroline

Skye22 profile image
Skye22 in reply to CMSol

Hi there no offence taken.

For your clients this is a fantastic forum for health information, sharing experiences and support in living with chronic pelvic pain conditions, also advice on how to have some semblance of a "normal " life.

My story is far to long to explain fully suffice to say I suffer from chronic pelvic pain as a result of 13 surgeries (NHS) first being hysterectomy aged 21! then left with adhesions on pelvis,abdomen, bowel and bladder

Every diagnostic test you could think of diagnosis: dysfunctional bowel and bladder, levator-ani syndrome, painful bladder syndrome, slow transit colon and more that I can't think of at the moment.

I do feel bitter about having so much surgery and being told "this will help with your pain" to now being left in chronic pain with no hope of future surgery due to risk of complications!!

I now have a wonderful team of docs and specialist physio who work with me providing treatments to help me "manage" my conditions. As much as I can I focus on what "I can do" rather than drowning in self pity, and I wish all like minded people the strength to carry on and fight for the right to a health care that we are all entitled to !!!

Stay strong!!!!!!

CMSol profile image
CMSol in reply to Skye22

You are obviously a very brave and stoic person with such a positive attitude. |Iam so sorry you had to have hysterectomy at such a young age and I wish you all the very best

Caroline

Hello! This is a topic I have been searching for as well.

I am 6 months postpartum, with a diagnosed sudden onset of slow transit constipation, a stage 2 rectocele, as well as dsynergistic defeacation immediately following the birth. To reach this diagnosis, I have gone through the MRI defecography, anal monometry, pudental nerve motor latency test, Endo anal ultra sound (ERUS - no levator ani tear), and slow transit marker study.

The birth was also one where the baby’s weight was (1) grossly underestimated, he was predicted 3kg(6.6 pounds) but came out 3.7kg (8.2 pounds, macrosomic by Asian standards, and I am petite); and (2) our request for an elective c section was only communicated too late due to the hospital’s protocols/bureaucracy, and (3) our senior consultant gynae (which we selected as we were paying privately) was no where for the first 1.5 days of the delivery even though he had assured us he will be present. He came too late, at the 40th hour or so when the fetal heartbeat had dropped, and therefore resulted in a forceps delivery and a second degree episiotomy.

Baby was healthy and all, but what followed was a loss in sensation of urine (which I got back in a week) and urge to pass stools (which I have yet to get back, unless assisted with both resolor and dulcolax). I also have a prolapse as a result, and pelvic pain and bloat from the inability to also pass gas that is managed by simethcone.

Before the birth I have never had a single episode of constipation and also do not have a prolapse. I am 31 and very healthy, a healthy BMI of 18. No history of any ailments. I do yoga regularly, jog twice weekly, and have a balanced diet. This is my first child.

I am still in the midst of a full diagnosis on all the pain, but in the meantime have started thinking about how to seek closure for my emotions.. what are the recourses available, and whether the negligence can be proven in the first place.

I have been to 10 specialists: gynaes, urogynaes, colorectal, and about 4 different physiotherapists (pelvic floor, and biofeedback) and though there may be good guesses, I have not gotten a definitive confirmation on the cause for a sudden onset of the slow transit, and whether this is related to any nerve injury that may arise from the 48h long forceps birth of a large baby (macrosomic by Asian standards, 3.7kg > 3.6kg guidelines; esp when I’m petite myself).

I am here to learn from similar experiences and to understand the approach I can take for my recovery of slow transit, and also in the event we decide to seek recourse from the doctor/hospital — are there tests we can take to establish the cause of the sudden onset of slow transit (e.g. which part of the nervous system is affected, or can it be hormonal?). There are scholarly articles that point that it may be related to damage during pelvic surgery and childbirth - how can this be tested, and if indeed proven that it is nerve related, are there positive stories of recovery from such injury?

CMSol profile image
CMSol in reply to

Hi there, the first thing you need to do is go through the formal complaints procedure, so write a letter of complaint about your various issues with how your birth management plan was handled and also the actual labour and delivery.

The formal complaints procedure (don't mention claiming, just complaining) is a fantastic early opportunity to ensure that the healthcare provider has to state in black-and-white their responses to your concerns. That black-and-white correspondence can then be used later on, if you do decide you wish to look at the possibility of a clinical negligence claim.

In clinical negligence claims, you don't have to prove 100% that injury arose because of substandard care. Your medico legal experts only have to say that it is more likely than not that any injuries you have sustained are as a result of substandard care, rather than an unfortunate complication of delivering any child. Therefore, the standard of proof in relation to the cause of your ongoing issues is 51% plus .

I really wasn't on here looking for clients, I can promise you, I have just referred my clients to this forum for support! I was interested in learning more from others experiences about investigative positive results they have had that may have led to improved outcomes for them, so I can better assist my current clients. However, if you do want some assistance, entirely free of charge, with the complaints process, my firm would be very happy to help you with that. However, you can contact any specialist UK clinical negligence solicitor for that . My firm is Medical Solicitors and you can find us on the Internet.

Whoever you decide to approach, please look carefully at their online reviews as what clients say about the service they receive from solicitors is of course very important. The last thing you want, when you feel let down by healthcare professionals, is to receive any less than an excellent service from legal professionals.

In terms of your need to know precisely, on a personal level, that your ongoing issues are because of the failure to appreciate the size of your baby, the consequent prolonged labour and the failure to deal with the request for elective cesarean section, resulting in assisted delivery, I hope you can obtain some resolution via those from whom you're seeking ongoing medical opinions. If not, if you do engage with solicitors, and there is a subsequent full investigation into a clinical negligence claim, then those solicitors would instruct the most experienced medical experts in fields such as colorectal surgery and other to look in more detail at these issues.

All the best

Caroline

jude5 profile image
jude5

This forum should not be used for legal firms to advertise their business. Using covert terminology is a pretence that is subversive and frankly immoral.

CMSol profile image
CMSol in reply to jude5

Dear Jude

My firm doesn't have any need to go chasing for work on forums. My interest is genuinely in expanding my knowledge to help my current clients. If you look at our firm's reviews you will see what our clients say about us which speaks for itself. I am sorry you are offendd.

C

Chica1943 profile image
Chica1943

My MRI/MRN done at UTSW in Dallas did show the problem with my pudental nerve

CMSol profile image
CMSol in reply to Chica1943

Thank you! I will let one of my ladies know as she has been looking at a place in London for MRN.

alansommer profile image
alansommer

Can you treat my sister? She is desperate. Something very similar happened to her...

CMSol profile image
CMSol in reply to alansommer

Hi there I am not a doctor so cannot provide treatment. Dr McNeil is one of (if not the) best out there, so I have been told!

uclh.nhs.uk/OurServices/Con...

alansommer profile image
alansommer in reply to alansommer

Thank you! Would you have his contact? The link you provided leads to another physician, I believe...

alansommer profile image
alansommer in reply to alansommer

Also, I found so many Drs McNeil... dont know the right one...

CMSol profile image
CMSol in reply to alansommer

I am sorry. It is Miss Sohier Elneil, Consultant in Urogynaecology & Uro-neurology, at University College London ( Euston Road Urogynae Unit)

alansommer profile image
alansommer in reply to CMSol

Thank you! Ill look her up!

alansommer profile image
alansommer in reply to alansommer

Do you take customers in Israel as well? Sorry to ask.

CMSol profile image
CMSol in reply to alansommer

Hello again, we can only act for clients who are complaining of poor medical treatment that has actually been provided in the UK. This can include clients abroad but they would have had to come to the UK for the treatment about which they are complaining.

C

alansommer profile image
alansommer in reply to CMSol

ok. My sister was the victim of a major medical error during a laparoscopy and now she is on a bed with pain for more than 2 years. It is a very sad story. Those physicians should not be able to practise anymore. They are a danger to patients. Can you recomend a good attorney in Israel? Thank you

CMSol profile image
CMSol in reply to alansommer

I'm so sorry, I do not know of any firm in particular. What you should do is to see if the Israel Law Society (there is usually some kind of Law Society in every country) can recommend specialists in medical malpractice geographically convenient for your sister. Other than that, it's doing Internet searches to find specialists. She should not end up with a general personal injury practitioner. She should make sure that she is with a firm that has a department dedicated to medical negligence.

I hope that helps!

alansommer profile image
alansommer in reply to CMSol

Thank you!

Pelvic18 profile image
Pelvic18

Im that person 5 surgeries 1 year still in pain

Krisclowers profile image
Krisclowers

I had a MRN at Emory in Atlanta. They diagnosed damage to my pudendal nerve as well as damage to the nerves leading off the pudendal nerve. I. Had 2 cryoablations. One helped and one didn't.

CMSol profile image
CMSol in reply to Krisclowers

Thank you

Pudendal72 profile image
Pudendal72

Don't forget the men. My husband has Pudendal nerve damage following the insertion of an ATOM sling. It's been a little over 2 years and he still suffers, even though the sling has been removed. He claims he knew something was wrong on the operating table when he felt as though the doctor was slamming him against the table.

CMSol profile image
CMSol in reply to Pudendal72

Goodness, I am so sorry and than you for drawing this to my attention. I hope he is getting all the help he needs including access to nerve block injections. C

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