New male member, 14 years of rectal pain/tightness...

[HerMajesty]

Hello and welcome!
There has been more positive things posted abouut Dr. Potter than Dr. Filler, but yes some people have had good experiences with Dr. Filler too. To be honest I think they are in the minority. I had a reasonably good experience with Dr. Filler, but from what I have heard of Dr. Potter's MRI's, I think they show more.
One thing I have definitely noted about Dr. Filler is that he is fixated on the idea of pudendal entrapment in the piriformis muscle as a kind of a "fall back position". He seems to implicate it as the culprit an awful lot. I kind of get the impression it is a pet theory of his. So if you were to go to him, and he were to reccomend piriformis related treatment, you would have to ask yourself if the evidence is there or if it just means he did not find anything, but is telling you what he tells everyone. Anyway, he does not take any insurance in-network, and charges above usual and customary. I thought the MRN was helpful but when he recommended piriformis injections to me, I went and got them from a local anesthesiologist with 100% insurance coverage. To get the same thing from Dr. Filler would have been like financing a car. So the key with him is to shop around a bit.
My underlying problem was joint dysfunction, which will not generally show up on ANY imaging study. When I got that corrected I went from disabled to 75% better - just still chasing the last 25%. diagnosis of pelvic joint dysfunction requires hands on assessment by a PT with manual therapy training. So keep that in mind if your scans are negative, or if you have a known problem with misalignment and /or a history of significant physical trauma.

[Violet M]

Hi Ace,

Am I correct in assuming that you did not even have a few hours relief from the nerve blocks and that you had a normal PNMLT and that's why Dr. Renney didn't think you had PNE??? I am not a huge believer in either one of these diagnostic criteria because based on these two criteria alone -- PNMLT and nerve block results -- I probably would have been told I did not have PNE. I think they can provide valuable information but do not provide a 100% accurate diagnosis.

What about when you have a rectal exam and the examiner presses along the course of the pudendal nerve. Does that cause a problem for you?

I think it is too soon to know how accurate Dr. Potter is at making a diagnosis for PNE -- we haven't heard much feedback regarding the accuracy of her readings as borne out in surgical findings. The general consensus among forum posters seems to be that the MRN sometimes gives valuable information but doesn't catch every case of PNE. I haven't heard of difficulties getting appts. with either Dr. Filler or Dr. Potter. You might want to do a a forum word search on both of these docs so you can see what people are saying about them. There is already a fair amount of information on this forum about them.

[Charlie]

Hello and welcome!
There has been more positive things posted abouut Dr. Potter than Dr. Filler.

The problem with Potter is that she cannot operate on you. She can only suggest a treatment.

[Selbourne]

My underlying problem was joint dysfunction, which will not generally show up on ANY imaging study. When I got that corrected I went from disabled to 75% better - just still chasing the last 25%.

That's interesting ... how was it diagnosed,, and how fixed? thanks.

[HerMajesty]

Charlie, true although from what I have observed, the surgeons are taking her data seriously and operating on the basis of it.

Selbourne, It was diagnosed by my pelvic floor PT. Some kinds of joint dysfunction can be very hard to discern, but mine came with extreme assymetry including a 11/2 inch difference in leg length I had failed to notice on my own. I uncosciously compensated by standing with one hip way out, which I did not know and which others I later found out interpreted as "attitude" or "sexiness", LOL.
Most pelvic floor PT's can discern the kind of joint dysfunction that results in asymmetry of bony pelvic landmarks, notable on palpation. There is such a thing as symmetrical pelvic dysfunction (such as sacrum in posterior glide, which is when the sacrum is jammed backwards against both ilia: locks up all motion withing the pelvis, without any asymmetry at all). The only way I know of to diagnose symmetrical motion dysfunction is through PT Manual Therapy spring testing.
I was too complicated for my PT to correct, so she sent me to Jerry Hesch, MHS, PT, who developed the Hesch Method of Manual Therapy. He corrected the pattern of dysfunction in 2 visits. My disclaimer here is that after Mr. Hesch fixed me I went to work with him, and I have to balance my desire not to be commercial on this board, with the fact that I am in fact personally involved in sometrhing unique that can help some people with pelvic pain issues. so anyway I will give you a link, let you know that Jerry Hesch has many assessment videos on youtube showing his own refinement of spring testing (Hesch Springing With Awareness), and not go on and on about it. www.heschmanualtherapy.com
BTW, the reason joint dysfunction does not show on imaging, is because imaging is a still piucture and joint dysfunction is an abnormality of motion.

[Selbourne]

That's really stunning, Majesty. I know it must be possibe ... I once used to put my wallet in my back pocket and sat on it like that,, this disturbed my spine alignment,, and suffered awful spinal pain until my spine doc toled me not to ... pain went away !!