CandaceCrank606
De BISAWiki
What could possibly be worse than experiencing an unpleasant condition and feeling embarrassed to discuss the issue because of its intimate nature? Such is the situation for a lot of struggling with pudendal neuralgia, a little known ailment that affects probably the most sensitive parts of the body. This area is innervated by the pudendal nerve, named after the Latin word for shame. Due to the location of the discomfort combined with inadequate knowledge, some physicians reference the pain as psychological. But nothing might be more wrong. Unfortunately, discussing the problem with gynecologists, urologists and neurologists often proves fruitless because most have no knowledge concerning the condition and therefore cannot diagnose it.
Pudendal neuralgia is a chronic or painful condition that occurs in both women and men, although studies reveal that about two-thirds of these with the disease are women. The primary symptom is pain within the genitals or the anal-rectal area and also the immense discomfort is usually worse when sitting. The pain tends to move around within the pelvic area and may occur on a single or both sides of the body. Sufferers describe the pain sensation as burning, knife-like or aching, stabbing, pinching, twisting as well as numbness. These symptoms are usually accompanied by urinary problems, bowel irregularity and sexual dysfunction. Because the pudendal nerve is responsible for sexual pleasure and is one of the greatest nerves related to orgasm, intercourse is extremely painful, if not impossible for many pudendalites. If this nerve becomes damaged, irritated, or entrapped, and pudendal neuralgia takes hold, life loses the majority of its pleasure.
So, where exactly is the pudendal nerve? It lies deep in the pelvis and follows a path which comes in the sacral area and then separates into three branches, one going to the anal-rectal area, someone to the perineum, and one towards the penis or clitoris. Since there are slight anatomic variations with each person, a patient�s symptoms depends on which from the branches may take a hit, although often the 3 branches are participating. The fact that the pudendal nerve carries sensory, motor, and autonomic signals increases the number of symptoms that can be exhibited.
Because pudendal neuralgia is unusual and could be similar to other diseases, it is usually misdiagnosed, leading some to possess inappropriate and unnecessary surgery. At the start of the diagnosis process, it's crucially vital that you undergo an MRI of the lumbar-sacral and pelvic regions to find out that no tumors or cysts are pressing on the nerve. In addition, the patient should be screened for possible infections or immune diseases, as well as having an assessment by a pelvic floor physical therapist to determine the health from the pelvic floor muscles and also to uncover whether skeletal alignment abnormalities exist. A precise patient history is needed to assess whether there has been a trauma or an problems for the nerve from surgery, childbirth, or exercise. Tests that provide additional diagnostic clues include sensory testing, the pudendal nerve motor latency test, and electromyography. A nerve block that gives several hours of relief is another tool that helps to find out if the pudendal nerve is the source of pain.
Probably the most common symptoms that accompanies pudendal neuralgia is severe depression. Many people using the disease have committed suicide because of the intractable pain. For that reason, you should consider antidepressants, as they possibly can help lessen the hypersensitivity of the sex organs in addition to relieving bladder problems. Certain anti-seizure drugs reportedly help to alleviate neuropathic pain while anti-anxiety drugs provide substantial relief of fits and assist with sleeping. Uninformed physicians are reluctant to prescribe opiates to have an illness that shows no visible abnormality, the desperate nature of genital nerve pain mandates that opiates be advised for these patients. While medications are not always satisfactory, they do help take the edge from the pain for many people. Until the correct treatment is determined, it's imperative that patients with pudendal neuralgia receive adequate pain management because the pain related to this illness could be intense.
Treatment depends upon the cause of distress towards the nerve. Once the cause isn't obvious patients are advised to try minimal invasive and least risky therapies initially.
Physical therapy that includes myofascial release and trigger point therapy internally with the vagina or rectum assists with relaxing from the pelvic floor, particularly if pelvic floor dysfunction may be the cause of nerve irritation. If no improvement is found after six to twelve sessions, nerve damage or nerve entrapment might be considered.
Botox is now used in medical settings to unwind muscles and shows promise when injected into pelvic floor muscles; though getting a physician skilled at this treatment is difficult.
Pudendal nerve blocks utilizing a long-acting analgesic and a steroid can help to eliminate the nerve inflammation and therefore are usually given in a number of three injections four to six weeks apart.
If physical rehabilitation, Botox, and nerve injections fail to provide adequate relief, some patients opt for pudendal nerve decompression surgery.
There are three published methods to pudendal nerve decompression surgery but there's debate among members of the pudendal nerve entrapment community regarding which approach is the best. Since there are advantages and disadvantages to each approach, patients face considerable confusion when deciding which type of surgery to choose. Since there are only a number of surgeons in the world who perform these surgeries, most sufferers have to travel long distances for help. Moreover, the recovery period is usually painful and takes anywhere from 6 months to many years since nerves heal very slowly. Unfortunately, early statistics indicate that just 60 to 80 percent of surgeries are successful in offering at least a 50 percent improvement. Patients whose surgeries aren't successful or who don't desire to pursue surgery have the choice of attempting an intrathecal pain pump which delivers pain medication locally and helps to prevent a few of the negative effects of oral medications. Others pursue the option of a neurostimulator either to the sacral area or directly to the pudendal nerves. They are relatively new therapies for pudendal neuralgia so it's difficult to predict success rates. Some pudendalites have devised ingenious contraptions for pain relief ranging from u-shaped cushions cut from garden pads up to balloons filled with water, frozen, and inserted in to the vagina. They have a favorite cushion for sitting and lots of have special computer set-ups for home and office use in to avoid sitting. Generally speaking, jeans really are a no-no, so patients revise their wardrobes to incorporate baggy pants and baggy underwear - if they're in a position to tolerate wearing underwear.
Clearly more research is required to find effective techniques to better manage the pain sensation and debilitation of pudendal neuralgia. On the other hand, friends and family close to anyone who has this devastating illness play a huge role in assisting patients cope, thereby maintaining the best quality of life possible. Support, love and understanding are of primary importance for those suffering with this affliction.
