Pelvic Floor Dysfunction

Fissure like pains...anyone?

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Re: Pelvic Floor Dysfunction

Postby pafen » 23 Aug 2014, 20:23

Hi,

Has anybody had an MRN that identifies nerve damage/entrapment for the pelvis?

There is a place in Brisbane QLD here that does it. However they have never had a case where they were able to prove entrapment. It's a fairly new procedure here and costs $500 for the scan at QLD radiology in Coorparoo qld.
Hemroidectomy, anal abscess, fissure, LIS
Pelvic floor Dysfunction since late 2012
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Re: Pelvic Floor Dysfunction

Postby Alyssa » 23 Aug 2014, 20:50

There's a few people here that have healed from lis surgery but still have chronic rectal pain... Could it be that the lis surgery only deals with the sphincter and not the muscles surrounding it?
2/14 Fissure developed
3/14 Diagnosed w/ fissure given Nifedipine
4/14 Referred to Pelvic Floor Physical Therapy=Pelvic Floor Dysfunction
5/14 Fissure declared "healed"/chronic anal pain persists
9/5/14 Botox to pelvic floor
9/22 biofeedback
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Re: Pelvic Floor Dysfunction

Postby msimon » 23 Aug 2014, 22:33

That sounds very plausible to me Alyssa. I just got a bit of botox into my internal sphincter (only 10 units) but it was enough to flare my pelvic floor up even more now. It's more mysterious to me how anyone avoids chronic rectal pain after ongoing pain down there and then surgery yet too!
Dec '13 Fissure from anoscope
3 X internal sphincter botox
'08-'15 Botox for pelvic floor dysfunction
Nov '14 LIS/sentinel tag removal
Feb '15 Deroofing of recurrent infection from LIS
summer '15-healed but still ongoing muscle dysfunction/pain
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Re: Pelvic Floor Dysfunction

Postby Alyssa » 23 Aug 2014, 22:48

But that is the issue... Which one do we try first? The fissure or the muscles?
2/14 Fissure developed
3/14 Diagnosed w/ fissure given Nifedipine
4/14 Referred to Pelvic Floor Physical Therapy=Pelvic Floor Dysfunction
5/14 Fissure declared "healed"/chronic anal pain persists
9/5/14 Botox to pelvic floor
9/22 biofeedback
Alyssa
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Re: Pelvic Floor Dysfunction

Postby msimon » 24 Aug 2014, 00:39

Well, in theory I suppose you would go after the muscles first, assuming they are the cause...it's trial and error unfortunately. Unfortunately, I seem to keep making errors in judgement. I get the sense you are afraid but I always like to comfort myself in that it is always temporary. I have had a lot of botox for a long time and have been having bad effects from it in the last year or two (some muscle imbalances have occurred where I am really weak in some areas and tight in others) but in the beginning it made such a huge difference to me. I think the reasons I have been a difficult case is that I have bad health anxiety (mostly centering around butt pain and fear of surgery/hemmorhoids) and irritable bowel syndrome. Is the Doctor doing the injections very experienced in treating this with botox?
Dec '13 Fissure from anoscope
3 X internal sphincter botox
'08-'15 Botox for pelvic floor dysfunction
Nov '14 LIS/sentinel tag removal
Feb '15 Deroofing of recurrent infection from LIS
summer '15-healed but still ongoing muscle dysfunction/pain
msimon
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Re: Pelvic Floor Dysfunction

Postby pafen » 24 Aug 2014, 00:44

Hi,

I think Botox will at least allow you to break the cycle of the constant spasm.

As a last resort I have found valium very effective for the pain but have only taken it on and off.
Hemroidectomy, anal abscess, fissure, LIS
Pelvic floor Dysfunction since late 2012
pafen
Proctosphincteranalogist
 
Posts: 130
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Re: Pelvic Floor Dysfunction

Postby Alyssa » 24 Aug 2014, 01:20

Dr. Gunter works with women suffering from chronic pelvic pain; she's been practicing for 18 years. It took me 6 months in order to get referred to her... She also treats my friend who suffers from PN (she gets nerve blocks) and she comes highly recommended from her.
Last edited by Alyssa on 24 Aug 2014, 01:24, edited 1 time in total.
2/14 Fissure developed
3/14 Diagnosed w/ fissure given Nifedipine
4/14 Referred to Pelvic Floor Physical Therapy=Pelvic Floor Dysfunction
5/14 Fissure declared "healed"/chronic anal pain persists
9/5/14 Botox to pelvic floor
9/22 biofeedback
Alyssa
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Posts: 735
Topics: 26
Joined: 29 Apr 2014, 11:24
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Re: Pelvic Floor Dysfunction

Postby Alyssa » 24 Aug 2014, 01:23

Msimon,

I read in your forum that you got botched Botox this last time (new doctor right) how could a doctor not know where the Botox should be injected at?
2/14 Fissure developed
3/14 Diagnosed w/ fissure given Nifedipine
4/14 Referred to Pelvic Floor Physical Therapy=Pelvic Floor Dysfunction
5/14 Fissure declared "healed"/chronic anal pain persists
9/5/14 Botox to pelvic floor
9/22 biofeedback
Alyssa
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Posts: 735
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Joined: 29 Apr 2014, 11:24
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Re: Pelvic Floor Dysfunction

Postby msimon » 24 Aug 2014, 03:32

Yeah, I don't know that botched was the correct term. I went to her complaining of having trouble having BMs (and mentioned the puborectalis muscle) and she injected where she felt tight bands of muscle (which was not into this one-she was far too high up) which lay higher up in the pelvic floor. The result was a constant urge to have a BM but with an inability to relax the muscles at the bottom end (the puborectalis and external anal sphincter). Now I have 2 fissures instead of one and still cannot relax the muscles. I went to my CRS and he put a little into my internal sphincter. I actually begged him to put it into the puborectalis as I had him insert his finger to check and he confirmed by plucking what felt like a guitar string. He didn't feel comfortable injecting there. I feel so defeated :groan: It's so hard to find the help you need sometimes. It's really good that you seem to be lined up for some decent care.
Dec '13 Fissure from anoscope
3 X internal sphincter botox
'08-'15 Botox for pelvic floor dysfunction
Nov '14 LIS/sentinel tag removal
Feb '15 Deroofing of recurrent infection from LIS
summer '15-healed but still ongoing muscle dysfunction/pain
msimon
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Posts: 1343
Topics: 64
Joined: 08 Aug 2014, 19:38
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Re: Pelvic Floor Dysfunction

Postby pafen » 24 Aug 2014, 16:45

Hi,

Another thought if the fissure was deeper inside such as the rectum, the LIS wouldn't be able to fix this as it only targets the sphincter muscle spasm??

So if the fissure is deeper inside and the muscles surrounding the rectum are in spasm as a result of the pain, wouldn't the only options be Botox or high fibre diet with softeners?

I have had about 3 days in a row now, soft bowel movements, absolutely no straining and can already notice a difference with my pain levels.

Having said that all it takes is one bad bowel movement to back to be square one.
Hemroidectomy, anal abscess, fissure, LIS
Pelvic floor Dysfunction since late 2012
pafen
Proctosphincteranalogist
 
Posts: 130
Topics: 8
Joined: 18 Aug 2014, 04:30
Location: Queensland Australia
Has thanked: 6 times
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Gender: Male


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