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Anyone had a MRN? Prolotherapy? Interstim or neuromodulator for pudental nerve issues?

Blima45 profile image
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Hi. Has anyone had a MRN- which is a MRI Neuro graphy to diagnose issue with pudental nerve? I know a diagnostic pudental nerve block can be done but am wondering if there is an actual test that someone had that can find “where” the pudental nerve is being compressed or entrapped ?

Also- anyone have success with prolotherapy for pudental nerve issues?

Anyone have success with the placement of Interstim or other type of neuromodulator?

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Blima45 profile image
Blima45
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12 Replies

I have had 2 interstims, put directly to my pudendal nerve. They have helped me with urination and defecation. But, I want to say I have had much better results with radiofrequency ablation of my pudendal nerve. I have been in extreme pain for 11 years after I was severely injured by transvaginal mesh. Both PN nerves were damaged. About 2 months ago I got a nerve block that helped a lot. So I went forward 6 weeks ago with the radiofrequency ablation, I have been pain free since! I am now able to do things that I have been unable to do for 11 years. I have been climbing ladders painting my daughters new home. Before I had intractable pain. I was told by 3 highly specialized PT specialists that I had muscle atrophy that would not come back. My muscles are working. I am giving God the credit. But He did direct me to the radiofrequency ablation. Yesterday, I planted several plants in the flower beds in front of my home. Pain free! It isn't perfect. My bladder still does not "squeeze", and my bowels are still very slow. Also, sexual function is gone. The pudendal nerve controls all 3 areas. I recently learned that both PN nerves have to be damaged to lose urination, defecation ability. Last time I tried sex with my husband, after the block, the pain came back in full. Did not go away until the nerve ablation. I am hesitant to go there again. I also get botox shots into the pelvic floor, they help a lot. I believe both the ablation and botox are working together and keeping me pain free. I am ecstatic!!

anna1234567 profile image
anna1234567

Prolotherapy made it worse for me.

Blima45 profile image
Blima45 in reply toanna1234567

Hi. Could you tell me what your symptoms were and how many prolotherapy injections did you go through… did anything seem to make it better?Beatrice

Chica1943 profile image
Chica1943

I had an MRN that showed that there was an area of PN that was causing problems

Blima45 profile image
Blima45 in reply toChica1943

Hi. Could you tell me which type of doctor referred you for an MRN?Also, what did they do once they found damage to the nerve? Did it help?

All my symptoms are bowel and bladder related- increased pressure all the time.

Last week I had a hysterectomy hoping some of pressure would be lessesned but so far I seem to have irritated my nose and bladder even more.. I’m in Brooklyn NY and have been to so many many types of specialists… I know from online about MRN… but I have yet to have dr prescribe one for me. I have had MRI pelvis with and without contrast and report did not mention anything with my pudental nerve or any other nerve…

Chica1943 profile image
Chica1943 in reply toBlima45

I think it was a dr in the UTSW healthcare system. She was head of the pelvic health dept Nothing was done at thst time as I was hesitant to have procedures that were not showing definitive successful results. Now I’m considering having the Botox shots.

Pattimoe profile image
Pattimoe

yes I had an MR in 10 years ago with no definitive results. They were looking for piriformus syndrome at the time. I believe I had it done in Cincinnati OH. Was very disappointing because it showed no abnormalities and I was in such pain at the time. I believe I paid $4000 for nothing! PN was not even mentioned.

I have had PN for 6 years after a bad fall from a ladder onto my behind. I had a regular pelvic MRI with and without contrast that showed no pudenal nerve abnormality. I have since been managing my PN with medication and PT and lifestyle changes, primarily. Recently spasms increased and my pain level. I was just referred to a pain management Dr that knows a lot about pelvic pain. He ordered a MRN immediately saying a regular pelvic MRI won't show the nerve properly. He suspects nerve compression. Depending on what the MRN shows, I will have a pudenal block and then a piriformis block. If neither confirm diagnosis, then he will do a L1 or L2 block. I had a pudenal block about 5 years ago but it was done vaginally and according to my new pain management dr, it wasn't done properly has it was distal to the start of the pudenal nerve. He is trying to determine the root cause of my issues rather than just treat with meds, PT etc. I'm cautiously optimistic. I want my life back.

Marjun profile image
Marjun in reply to

Hi krucksman,

I was wondering if your MRN showed anything. Also, I was curious if either of the nerve blocks helped , the pudendal or the piriformis?

I have PN symptoms, and my pain management dr ordered a mrn. It did not show obvious nerve compression however it showed T2 hyper intensity distal to the sciatic notch and it showed slight edema in the quadratus femoris. They have not ordered the pudendal or the piriformis injections yet, but they’ve tried everything else under the sun….at least this is how I feel. I have had facet joint injections at L2-L4, ganglion nerve impar block, SI joint injections, and the most recent, caudal injection. I have done tons of PT, had 6 visits with a chiropractor. None of this has helped. My condition has been ongoing for over 1 1/2 years. I’ve been managing with a nerve pain killer, gabapentin and anti depressant, remeron.

Oh. And I just started going to an osteopath for OMT. The first time was very relaxing but after 2 days, pain returned. She mentioned trying prolotherapy. I'm investigating. I won't do unless my new pain dr. recommends. I am also meditating 2x per day, per the osteopath. Once, the root cause of my issue is known, my pain dr. will recommend a treatment plan. I remain optimistic.

Rxmom profile image
Rxmom

Hi - good news !!! I’ve had PN 9 yrs, seen 8 or 9 docs, tried 2 ganglion impars, scans, tests, blocks of all kinds, 2 rounds of Botox, 2 rounds w proclaim scs stim, Lis surg, and surgeries to fix predictable fissures… opioid, tca’s, neuroleptic,..nothing helps (except certain MJ strains)

BUT in august I started zanaflex 2.5mg three times a day along with 500mg magnesium glycinate with significant lessening of the pelvic floor spasms. I took flexeril & skelaxin in past with no relief.

Zanaflex is more specific for smooth muscle like pelvic floor (as opposed to striated muscles like back, leg, arm..).

Good luck everyone … this is a hell of an frustrating affliction. I am interested in knowing if the ablation caused functional issues.

Thx

Pattimoe profile image
Pattimoe in reply toRxmom

Wow! Your list is a lot like mine! I am now 90% pain free and the only difference is that I’m taking Amitriptaline and CBD, AND have done mind/body work (a lot!)

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