Advice Please

[CecilyParsley]

Hi everyone. I have had 16 gynaecological operations starting at aged 13 and ending 23 years ago a day before my 40th birthday when I had an emergency hysterectomy where for some reason they left my cervix.

Following my op they tried HRT but my BP shot up so I was taken off it. Urinary incontinence has got worse as the years have gone by and six years ago I began to experience severe burning pain up inside like a red hot poker. The pain is bad enough but the added issues make it intolerable. My heart rate increases and I literally drip with sweat, my BP increases and I feel restless and agitated, unable to sleep for as long as it lasts. Generally it continues 2-4 days. I end up sleep deprived and miserable.

I also experience hardening of the clitoris when this happens which is uncomfortable.

I saw a private Gynaecologist last year who said there is no need to examine you you have Pudendal Neuralgia and it is incurable. She referred me to a private anaesthetist specialising in pain management. Initially I thought this was a good thing but after four appointments, suffering Seratonin Syndrome as a consequence of her choice of pain relief, I am unsure. Each time she says I am in too much pain due to other conditions ( Bechets, Raynauds, Osteoarthritis) to do the nerve blockers and I have a limited income. She diagnosed compression of the genitofemeral nerve and said the agitation, sweating etc were my autonomic system. She warned that if I had a general anaesthetic for a planned knee replacement I would “die on the table”.

Finally my appointment for the NHS Gynaecologist came through and I saw a Registrar two days ago. She examined me and said she could see nothing wrong so was discharging me. She said I should go back to the private Anaesthetist and get pain blockers. I was quite horrified by this as I have worked hard all my life until my illness and cannot afford to pay out continuously. She eventually agreed to send me to a pain specialist but said I would have to wait up to a year.She refuted any connection of my pelvic issues or my Bechets to my urinary incontinence.

Has anyone please got any advice to give me? I would be very grateful. I am unsure whether to ask for a referral to Neurology or try and find the money for the private Anaesthetist.

[CatsandCars]

I'm so sorry that you are going through all of this. I haven't had any experience with the condition you mentioned, but since you don't have any replies yet, I read your post. What a dilemma. A year to see a pain specialist? I'm no expert, but I'm not sure a neurologist would be able to help you since they mostly treat problems with the brain and central nervous system. Could you call one of their offices and ask if they treat PN? I'm in the US, so I'm not familiar with how your health care system works.

Serotonin syndrome can happen with medication for nerve pain, unfortunately. But the anesthetist didn't seem very helpful. It might be good to see a different one to get a second opinion and see if they will do nerve blocks. Is there any kind of pudendal neuralgia website that can recommend doctors? Perhaps there are charitable organizations that could help you with the cost? It would definitely be worth looking into. I really hope you're able to get some relief!

[CecilyParsley in reply to CatsandCars]

Thank you so much for responding. It is a dilemma. The anaesthetist I saw is the best private pain specialist in my area but she told me I woukd die on the table if I get my knee replacements. It frightened me to death to be honest. I will wait until I get the letter advising if my referral and then it should indicate the wait period. I will have to make a decision then.

[bantam12]

Red hot poker pain and urinary issues, has no Dr considered vaginal atrophy ? this can cause all the symptoms you have and more. There are so many different treatments so might be something to think about.

[CecilyParsley]

I have vaginal atrophy but the gynaecologist told me the severity of it which causes my heart rate to 86 during rest and the profuse sweating and agitation does not fit with that diagnosis. I use Vagifem for the atrophy and moisturiser which has seen my UTI`s go from monthly to approximately three per year.

The fact that this red hot poker pain is sporadic also confirms it us not the atrophy causing it. Thank you for replying though. I suffered for years with burning, irritation and UTI`s before the Urology Nurse diagnosed it.