O'keefeDarwin56
De BISAWiki
What may be worse than struggling with an unpleasant condition and feeling ashamed to discuss the problem because of its intimate nature? Such is the situation for a lot of struggling with pudendal neuralgia, just a little known ailment that affects one of the most sensitive parts of the body. El born area is innervated by the pudendal nerve, named after the Latin word for shame. Due to the location from the discomfort combined with inadequate knowledge, some physicians make reference to the pain sensation as psychological. But nothing might be more wrong. Unfortunately, discussing the problem with gynecologists, urologists and neurologists often proves fruitless because most know nothing concerning the condition and for that reason cannot diagnose it.
Pudendal neuralgia is really 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 main symptom is pain in the genitals or the anal-rectal area and the immense discomfort is generally worse when sitting. The pain tends to move around in the pelvic area and may occur on a single or both sides from 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 primary nerves associated with orgasm, sexual activity is extremely painful, if not impossible for a lot of pudendalites. When 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 within the pelvis and follows a path that comes from the sacral area and then separates into three branches, one visiting the anal-rectal area, one to the perineum, and one to the penis or clitoris. Since there are slight anatomic variations with every person, a patient�s symptoms depends which of the branches may take a hit, although often the 3 branches are involved. The truth that the pudendal nerve carries sensory, motor, and autonomic signals adds to the variety of symptoms that may be exhibited.
Because pudendal neuralgia is unusual and could be much like other diseases, it is usually misdiagnosed, leading some to possess inappropriate and unnecessary surgery. Early in the diagnosis process, it is crucially important to undergo an MRI of the lumbar-sacral and pelvic regions to find out that no tumors or cysts are pressing on the nerve. Additionally, the individual ought to be screened for possible infections or immune diseases, as well as an evaluation with a pelvic floor physiotherapist to determine the health of the pelvic floor muscles and also to uncover whether skeletal alignment abnormalities exist. An accurate patient history is needed to assess whether there's been a trauma or perhaps an injury to the nerve from surgery, childbirth, or exercise. Tests that offer additional diagnostic clues include sensory testing, the pudendal nerve motor latency test, and electromyography. A nerve block that provides several hours of relief is yet another tool that can help to determine when the pudendal nerve may be the source of pain.
Probably the most common symptoms that accompanies pudendal neuralgia is severe depression. Some people using the disease have committed suicide due to the intractable pain. Because of this, it is important to consider antidepressants, as they can help decrease the hypersensitivity from the genital area along with relieving bladder problems. Certain anti-seizure drugs reportedly assistance to alleviate neuropathic pain while anti-anxiety drugs provide substantial relief of muscle spasms and assist with sleeping. Uninformed physicians are unwilling to prescribe opiates for an illness that shows no visible abnormality, the desperate nature of genital nerve pain mandates that opiates be advised of these patients. While medications are not always satisfactory, they are doing help go ahead and take edge from the pain for many people. Until the correct treatment methods are 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 is not obvious people are advised to try minimal invasive and least risky therapies initially.
Physical therapy which includes myofascial release and trigger point therapy internally with the vagina or rectum assists with relaxing from the pelvic floor, especially if pelvic floor dysfunction may be the reason for nerve irritation. If no improvement is located after six to twelve sessions, nerve damage or nerve entrapment might be considered.
Botox has become used in medical settings to unwind muscles and shows promise when injected into pelvic floor muscles; though finding a physician adept at laser hair removal is difficult.
Pudendal nerve blocks using a long-acting analgesic along with a steroid can reduce the nerve inflammation and therefore are usually given in a number of three injections 4 to 6 weeks apart.
If physical rehabilitation, Botox, and nerve injections fail to provide adequate relief, some patients go for pudendal nerve decompression surgery.
There are three published approaches to pudendal nerve decompression surgery but there is debate among people in the pudendal nerve entrapment community as to 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. Because there are only a handful of surgeons in the world who perform these surgeries, most sufferers have to travel long distances for help. Moreover, the recovery period is often painful and takes between six months to many years since nerves heal very slowly. Unfortunately, early statistics indicate that just Sixty to eighty percent of surgeries are successful in offering a minimum of a 50 % improvement. Patients whose surgeries aren't successful or who do not wish to pursue surgery have the option of attempting an intrathecal pain pump which delivers pain medication locally helping to avoid some of the side effects of oral medications. Others pursue a choice of a neurostimulator with the idea to the sacral area or straight to the pudendal nerves. These are relatively new therapies for pudendal neuralgia so it's difficult to predict success rates. Some pudendalites have devised ingenious contraptions to decrease your pain which range from u-shaped cushions cut from garden pads all the way to balloons full of water, frozen, and inserted in to the vagina. They have a popular cushion for sitting and many have particular computer set-ups for home and office use within order to avoid sitting. Generally speaking, jeans really are a no-no, so patients revise their wardrobes to include baggy pants and baggy underwear - if they are in a position to tolerate wearing underwear.
Clearly more scientific studies are necessary to find effective techniques to better manage the pain and debilitation of pudendal neuralgia. But in the meantime, family and friends close to anyone who has this devastating illness play a crucial role in helping patients cope, thereby maintaining the highest quality of life possible. Support, love and understanding have primary importance for those suffering with this affliction.
