Nantes Teams Study on Nerve Blocks

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Nantes Teams Study on Nerve Blocks

Postby Violet M » Sat Aug 20, 2016 10:05 pm

The Nantes team is recommending steroids no longer be used in pudendal nerve blocks.

http://www.ncbi.nlm.nih.gov/pubmed/27465823

If you are thinking of having a pudendal nerve block, you might want to show this to your doctor.

Violet
PNE since 2002. Started from weightlifting. PNE surgery from Dr. Bautrant, Oct 2004. Pain now is usually a 0 and I can sit for hours on certain chairs. No longer take medication for PNE. Can work full time and do "The Firm" exercise program. 99% cured from PGAD. PNE surgery was right for me but it might not be for you. Do your research.
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Re: Nantes Teams Study on Nerve Blocks

Postby Gabriel81 » Fri Feb 17, 2017 7:37 pm

De Bisschop used Corticosteroids only (!) because it help to restore the cell wall impermeability compromised in inflamed nerve cells anso also told me that lidocayne is neuro-toxic (!)
2004 Urethral burnings, chronic prostatitis diagnosis, unuseful drugs. Lately added chronic pelvic contracture.
2011 Pudendal Neuralgia diagnosis, nerve blocks and oral drugs.
2013 Two neuromodulation surgeries.
2016 Possover negate Pudendal Neuralgia (no pain elicited on rectal exploration), says problem is more central but MRI- neurography show nothing.
2017 De Bisshop found Oedema/hyperpressure and neurological abnormal response on intrapiriform area, most on sx.
Failed injection blocks.
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Re: Nantes Teams Study on Nerve Blocks

Postby Violet M » Sun Feb 19, 2017 5:13 am

Bupivacaine (marcaine) would be a little better than lidocaine. https://www.ncbi.nlm.nih.gov/pubmed/16135351
PNE since 2002. Started from weightlifting. PNE surgery from Dr. Bautrant, Oct 2004. Pain now is usually a 0 and I can sit for hours on certain chairs. No longer take medication for PNE. Can work full time and do "The Firm" exercise program. 99% cured from PGAD. PNE surgery was right for me but it might not be for you. Do your research.
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Re: Nantes Teams Study on Nerve Blocks

Postby Violet M » Thu Jul 06, 2017 1:12 am

There has been some discussion between Dr. Antolak and Prof. Robert's team about the steroids in nerve blocks but I don't have access to reading these. If anyone has access to these journals I would be interested to hear a summary of the conversation if it's worthwhile.

https://www.ncbi.nlm.nih.gov/pubmed/28544719
https://www.ncbi.nlm.nih.gov/pubmed/28544720

Violet
PNE since 2002. Started from weightlifting. PNE surgery from Dr. Bautrant, Oct 2004. Pain now is usually a 0 and I can sit for hours on certain chairs. No longer take medication for PNE. Can work full time and do "The Firm" exercise program. 99% cured from PGAD. PNE surgery was right for me but it might not be for you. Do your research.
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Re: Nantes Teams Study on Nerve Blocks

Postby Violet M » Sun Oct 15, 2017 11:03 pm

We have been saying for years on this forum that there aren't many patients who post here who have long-term relief from steroid nerve blocks and that there is a risk from getting worse from them. I think there might be some diagnostic value in nerve blocks containing marcaine, although even that is "iffy" because the block doesn't always hit the target, or it may infiltrate other areas of the pelvis. So, I will continue to repeat that I am not a big fan of nerve blocks. In Prof. Robert's article over 10 years ago he said don't get more than 3 steroid nerve blocks due to possible nerve damage. So we have been warned, and now his colleagues are saying no steroids at all.

Violet
PNE since 2002. Started from weightlifting. PNE surgery from Dr. Bautrant, Oct 2004. Pain now is usually a 0 and I can sit for hours on certain chairs. No longer take medication for PNE. Can work full time and do "The Firm" exercise program. 99% cured from PGAD. PNE surgery was right for me but it might not be for you. Do your research.
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Re: Nantes Teams Study on Nerve Blocks

Postby April » Mon Oct 16, 2017 1:35 am

Hi Violet and Others,

Your post reminded me that I downloaded that exchange back in July and have been meaning to post it (I have access to a medical library). I attached it now. In a nutshell, Antolak and Chung list reasons why Labat and his colleagues may not have gotten an effect (e.g., injection was not in the best place, limitations in the way they measured the outcome), and Labat and his colleagues note that their results are based on a true experimental design (random assignment to conditions) that was double-blinded (i.e., the best way scientifically to assess the effect of a treatment) and that if Antolak and Chung want to draw conclusions about the effectiveness of their injection technique, they need to do such a test. I buy Labat and his colleagues' argument.

April

I just realized that the exchange I uploaded (from BJOG) is probably copyrighted, so I cannot post it, so I just removed it. If one of the moderators determines that posting is okay, let me know and I'll re-post.

April
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Re: Nantes Teams Study on Nerve Blocks

Postby Violet M » Mon Oct 16, 2017 2:32 am

Thanks, April. Your summary is perfect.

Violet
PNE since 2002. Started from weightlifting. PNE surgery from Dr. Bautrant, Oct 2004. Pain now is usually a 0 and I can sit for hours on certain chairs. No longer take medication for PNE. Can work full time and do "The Firm" exercise program. 99% cured from PGAD. PNE surgery was right for me but it might not be for you. Do your research.
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