webslave wrote:Surgery is supposed to give quick, dramatic relief to people who really do have entrapped nerves, if you read the literature. You are supposed to feel most of the improvements within a month after surgery.
Yet if you go to the forums where all these supposed "entrapment" cases obsess about the topic, you find that almost all of them are patiently waiting for some improvement months and even years after surgery! The existence of the PN forums and the encouragement of this surgery is one of the crazier aspects of the pelvic pain scene.
Webslave is being rather kind in "the literature" term. There is very little published on the concept of PN or entrapment. It is very experimental, with most of the 600 or so procedures done in the world each year by about 8 drs. There were 500,000 heart bypasses done in 2007 in the U.S. alone.
Reading the little available there seems to be no consensus on the diagnostic procedure. Some consider different EMG tests, others don't . Pain only on sitting is considered an issue by some, not others.Etc. Some Dr's have changed their criteria over time, some are operated on despite not meeting all of a Dr's criteria. Some of the dr's charge big $$$ for this. If you talked to 200 well qualified neurosurgeons or urologists in the world selected at random, perhaps a small % have even heard of it.
You're kind of in covered wagon headed west 1850's style on this one. kinda a pioneer, with injuns arrows and all. I heard Dr. Shoskes mentions PN in his book. I don't know about entrapment or in what context he views it if so.
The few sites actively advocating PN and entrapment as a cause of pelvic pain do have reports of people (and a few insurers) spending $15,000-$60000 or so and their results. From what I read women about 2:1 vs men, most with hysterectomy histories (but still with lotsa bicycling, weights, swimming etc and sitting). As before pretty mixed results. That said, with about (7000?) or so of these procedures done in the last 20 years, about 80-100 or so are fully or partially recounted in patient stories on the internet. In English at least.
It is amazing how froggy some of these folks are. Several have had 3 or more operations, and some have travelled through Europe and the US having several, spending upwards of $100,000. Unfortunately, some starting with relatively mild symptoms seem to be getting additional surgeries to correct problems from previous procedures. The frequent culprit being of all things, the lidocane "diagnostic" nerve blocks used by some MD's, which leave some in much increased pain for quite a time.
For the most part, if the reports keep it real, I think they are valuable as the people share their results months after surgery, as a contribution to science. If you read, you can get a sense of which of the 8 drs are trying to be useful, and which are profiting selling rifles and whisky to the injuns.
Unfortunately the 70-90+% much improved/cured rate claimed in the little literature available seems to be no where near what is actually realized. Other than before-after reports of surgical results most information (mostly opinions) on the sites is of much less use. There just isn't much published available. A lot of it is psychological support after being told they are nuts by 10 MD's. Many have been there. The guy claiming 90% in my opinion is selling heap big medicine to the natives, and plans on buying an island and retiring.
Most would be far better off starting off here and leaving the invasive stuff as a last resort. (hi pain levels, ceasing exercise for several years).
I think it was discussed before that many of the participants in Dr. Wise's published study of 100 or so patients had a previously invasive procedure done before the clinic. Don't know how this affects things in the study, but is illustrative.
--jjf
