PNSBDS Protocol for Pelvic Pain Syndromes

[drkirkandrew]

This is the general outline of the PNSBDS Protocol for Pelvic Pain. This treatment has demonstrated success for treating Pudendal Neuralgia/Entrapment and Chronic Prostatitis (NIH IIIB).

https://docs.google.com/file/d/0B3QjR4b ... daMkk/edit

General information, as featured on the 'Pelvic Messenger':

http://www.blogtalkradio.com/pelvicmess ... elvic-pain

[nyt]

Thank you for posting this informative article.

[deBBieW]

Hello Dr. Andrew,
Yes, thank you so much, I have read most of this article and plan to listen to the Pelvic Messenger radio message this weekend.

I'll probably be in touch,
Debbie

[eraser]

This is the general outline of the PNSBDS Protocol for Pelvic Pain. This treatment has demonstrated success for treating Pudendal Neuralgia/Entrapment and Chronic Prostatitis (NIH IIIB).

https://docs.google.com/file/d/0B3QjR4b ... daMkk/edit

General information, as featured on the 'Pelvic Messenger':

http://www.blogtalkradio.com/pelvicmess ... elvic-pain

I think the article means well but it is poor quality and verging on inaccurate in many places.
Prostatitis is not the same as pudendal neuralgia/pudendal neuralgia. There are a lot of problems with the diagnosis of prostatitis and it is over diagnosed in practice.

[Violet M]

I can't tell for sure if he is equating chronic prostatis with pudendal neuralgia or just including both of them as separate diagnoses in the list of problems that their protocol addresses.
The article is from a few years back so it would be interesting to hear where their research has led.

[eraser]

I think they are grouping them together for discussion purposes but the diagnosis and treatment is very dissimilar. I think it also implied PN was a musculoskeletal disorder, which was a new one on me.

I can't tell for sure if he is equating chronic prostatis with pudendal neuralgia or just including both of them as separate diagnoses in the list of problems that their protocol addresses.
The article is from a few years back so it would be interesting to hear where their research has led.

[Violet M]

I think they are grouping them together for discussion purposes but the diagnosis and treatment is very dissimilar. I think it also implied PN was a musculoskeletal disorder, which was a new one on me.

Right, I don't even know how chronic prostatitis is diagnosed and treated.

As far as PN, there are a number of different causes so I don't think you can automatically conclude it's musculoskeletal.

[eraser]

Yep, that was my take on it.

Well apart from bacterial prostatitis, it should be a diagnosis of exclusion but unfortunately there isn’t a test so most urologists guess and fob people off until it self-resolves or symptoms lessen with an alpha blocker. When it doesn’t resolve, they call it chronic pelvic pain syndrome and fob people off with exercises. For men this often leads to PN not being diagnosed.

I think they are grouping them together for discussion purposes but the diagnosis and treatment is very dissimilar. I think it also implied PN was a musculoskeletal disorder, which was a new one on me.

Right, I don't even know how chronic prostatitis is diagnosed and treated.

As far as PN, there are a number of different causes so I don't think you can automatically conclude it's musculoskeletal.

[Violet M]

For men this often leads to PN not being diagnosed.

That's sad.

And for women they are often diagnosed with vulvodynia which literally means pain in the vulva -- like they didn't already know they had pain there? It tells you nothing about the actual cause. I suppose the same could be said about pudendal neuralgia if you really stop and think about it. It doesn't really give you a clue as to what is causing the neuralgia. So it's sometimes left up to the patient to figure out what the cause is which is why this type of forum is so important. Sometimes you get clues from other people as to what might be going on in your own case.

[eraser]

Based on my experience, I am sadly not surprised that women suffer similar misdiagnoses.

I actually think pudendal neuralgia needs to be reclassified as a syndrome and that part of the workup must involve finding the actual cause. Sadly pain physicians just don't bother in general, lazy medicine due to incompetence.

And for women they are often diagnosed with vulvodynia which literally means pain in the vulva -- like they didn't already know they had pain there? It tells you nothing about the actual cause. I suppose the same could be said about pudendal neuralgia if you really stop and think about it. It doesn't really give you a clue as to what is causing the neuralgia. So it's sometimes left up to the patient to figure out what the cause is which is why this type of forum is so important. Sometimes you get clues from other people as to what might be going on in your own case.