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Gynecology

Chronic Pelvic Pain (and PNE)

04/28/2005

Question:

I have been suffering from chronic pelvic pain for almost three years with no solution from any gynecologist, pain specialist, physical therapist, etc. I have had treatments such as epidurals, acupuncture (administered by a Doctor) various kinds of physical therapy, therapeutic massage including pelvic floor treatments, countless pain medications. My GP and Pain Specialist have advised me to accept my situation as chronic pain, with no clear solution or diagnosis. I have looked into the possibility of PNE (Pudendal Nerve Entrapment) treatment (injections and surgery) available through Doctors Renney (Houston) and Antolack (MN), but I don`t see any data to convince me that their treatments are necessarily the answer to my problems. I have just finished reading several articles about PNE in the February issue of the Urology Times. A gynecologist(also a surgeon) in LA has suggested that my symptons sound like PNE. I have not been examined by a neurologist or a uro-gynecologist re pelvic pain, though my gynecologist says I don`t have a gynecological problem (have had biopsies, MRIs,a bone scan, a cat scan etc). Can you or anyone advise me in this area? I cannot travel any great distance because of the pain of sitting, so I cannot go to LA for testing. Can anyone in your group make any suggestions that would be of help or send me in some promising direction? I have done quite a bit of research in the area of chronic pelvic pain, as you might guess. Thank you for listening.

Answer:

You need further investigation to determine whether or not you have PNE. I would think that a neurologist, physiatrist or urogynecologist would be the best places to start. You may consider a second opinion from a gynecologist.

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Response by:

University of Cincinnati Thomas A deHoop, MD
Associate Professor of Clinical Obstetrics and Gynecology
Director, Medical Student Education
Department of Obstetrics & Gynecology
College of Medicine
University of Cincinnati
Thomas  A deHoop, MD