Can Alcock's Canal be properly decompressed laparoscopically?

[Violet M]

In the past he has done phone consultations. Someone about a year ago told me they had a phone consultation with him that cost 300 euros. I don't think he does face to face online telemed consultations though -- just phone conversations. Before I flew to France I had a phone conversation with him but that was over 20 years ago.

Violet

[Balenul]

In the past he has done phone consultations. Someone about a year ago told me they had a phone consultation with him that cost $300 euros. I don't think he does face to face online telemed consultations though -- just phone conversations. Before I flew to France I had a phone conversation with him but that was over 20 years ago.

Violet

phone is 2025 seems very old approach imo especially for that insane price

[Balenul]

Dr. Bollens laparoscopic approach allows access to the pudendal nerve from the ischial spine into Alcock’s canal, and has several advantages.
It’s minimally invasive, avoids cutting through muscle, allows for bilateral decompression in one session, and offers a quicker recovery compared to open surgery. While some surgeons use open microsurgical techniques for very distal cases, studies and surgical experience show that the laparoscopic method provides excellent visibility and effective decompression for most entrapments in the ischial spine/Alcock’s canal region. For many, it’s a highly effective and less traumatic option.

/Mathew

imo bollens is not a correct person.he deleted many questions i put you youtube he disliked.He rush surgeries instantly etc.I would avoid him.He cured some but damaged others also.....I talk with him on video call and he told me to do a surgery very fast even if all my symptoms are in urethra ....and no problems sitting etc.Alcock canal can be decompressed by laparoscopic surgeries but not so good as other approaches.Also in some case perineal branch could be a problem ( maybe my case since i only have urethral pain ) and Bollens can t reach but he wanted to do a surgery on me...

[tompster]

Yes, of course! I had laproscopic surgery with Dr Bautrant and his surgical report indicated Alcocks canal was fully dialated and decompressed during surgery. I cannot recall his name, but the second was the surgeon in Portland Oregon that works at the Pearl Womens Clinic, it could be Dr Fogellson and also a Dr Grubbells who all do laproscopic. I went with Dr Bautrant because he has done more than a thousand of these surgeries. I hope they can be of help to you.

Oh thanks for the reply! I am just dubious because at the Alcock's Canal level it's my understanding that the pudendal nerve becomes almost microscopic, and enmeshed into Alcocks Canal, which requires microscopy to decompress. I have not seen any laprascopic videos in which the pudendal nerve is visible within the Alcocks Canal, and even if it was, I don't know how they could go about decompressing it without causing injury in such an incredibly delicate intertwined area.
Did Dr. Bautrant give you any further info on his technique of 'decomrpessing Alcock's canal'? I know that some surgeons who do open surgery do a "french bread" approach where they make small interconnecting incisions to expand it, but I was not aware that it could be fully dilated, especially via laprascopy.

[eraser]

Hi tompster,

Violet posted an article which discusses the success rates of the different approaches, if I recall correctly (I read it ages ago now) - so I'd suggest having a read of that. I have recently had surgery by Dr Bollens and I had the laparoscopic approach and fibrotic tissue was found in Alcock's canal.

He can do either approach and when he has a consultation with you, he tries to pick the most suitable approach. Ultimately, until you have the procedure irrespective of the approach they have to see what they find.

I wouldn't get too concerned with what is the best or worst approach as this is quite subjective and it is difficult enough to even get the initial diagnosis, without taking on this burden. There are fewer and fewer surgeons globally performing the surgery it appears for context. The other thing to remember is that the site of compression can be distal to where the pain is experienced, so you’re looking for pain within the distribution of the nerve overall as it doesn’t always relate to specific branches despite what it feels like.

With Dr Bollens, he's a nice guy and knows what he is doing. The surgery is much cheaper in Europe if you are self-paying. Does this help?
Obviously surgery must only be your own decision but if I know now what I did, over 19 months ago, I would have had surgery as soon as possible.

Good luck!

I am looking to possibly have my pudendal nerve decompressed by Dr. Bollens, as it seems that I may have compression in the ischial spine/Alcock's Canal region.

He performs surgery laparoscopically.

However I am not convinced that is the best approach for Alcock's Canal. I know other surgeons do an "open surgery" and decompress the Alcocks Canal region under a microscope, as I believe the nerve isn't visible to the naked eye at this level.

Does anyone have any info on one method being better than the other for this area?

Thank you so much.

[Violet M]

There are pros and cons to each approach. With the TG approach the ligaments are cut and some people have reported pelvic instability afterward. While there is better visualization of the nerve during surgery, there may also be a risk for more formation of scar tissue, especially if you tend to form scar tissue as some people do. With the laparoscopic approach there is a much smaller incision which could mean a faster healing of the surgical site. Of course, the ultimate goal is complete decompression of the nerve so a good question for the surgeon is whether the TG approach is more likely to accomplish that goal or whether they feel that they can achieve a complete decompression in all areas with the laparoscopic approach.

Violet