Botox and Physical Therapy while under anesthesia

I saw a Urogyn today andhe told me something about my pelvic muscles are too tesnse and thats whats causing me the pain and difficulty to urinate or have a bm. He wants to do botox and physical therapy and a cytoscope under anesthesia. Possibly more pending the results of the MRI I hace in 2 weeks. Has anyone used this type of treatment and did i thelp??

Tater218 -

I did have pelvic floor physical therapy and it did help with my pelvic pain.

I also had a cystoscopy years ago when my Drs kept finding micro amounts of blood in my urine they wanted to make sure that the bladder was okay. The cystoscopy was under a local anethesia just in that area so they could insert the cytoscope.

Here are a couple links to initial studies on Botox and pelvic pain -

http://findarticles.com/p/articles/m.../ai_113754611/

http://tvnz.co.nz/view/page/411749/856019

Although this link says prostatitis in it, it is a good description of chronic pelvic pain and once you get past the first couple of paragraphs it applies to both males and females. Even the diagram they use is female but they state it applies to both sexes.

http://www.chronicprostatitis.com/myoneuropathy.html

I hope this gives you some information that you didn't have before and that it helps.



G.

Thank you for the links. I was having a time finding anything googling it myself yesterday. I noticed my 1000 typos lol, I posted that from my phone and I guess I didn't notice them on there last night.

So with the pelvic PT is it electric type stuff or manual? I know there are exercises and stuff, I was too far prolapsed before my first surgery to even be able to do kegels. And now my pelvic muscles are kinda chronically kinked. He is doing 8 weeks (2x a week) worth of PT in one shot and the botox, and whatever else. He says I'll feel like crap for about 2 weeks then I'll be better. (as long as nothing serious shows on the MRI) I think my big fear is what if the botox makes me lose function of muscles I need and I'm trying to figure out what kind of PT he could do in that situation. After the pelvic repairs that were supposed to "fix" me during my hyster, that obviously didn't make me worry more. But its a totally new dr, hospital etc. This dr is supposed to be one of the best in the country. Gosh I hope so! I need to get better

Yeah, don't know about the botox and what would happen if it were overdone so I would say talk to the Dr.

I had monitor pads attached to my perineum so the could measure the electrical levels of the muscles to see how tensed they were. They were attached to a biofeedback machine so I would try to learn how to relax the muscles. Tense and release on command from the machine and watch the drop in the line and try to fully relax the muscles. No additional electrical stimulation was introduced in my procedures but some do have that, I think maybe more if they don't have enough stimulation vs. too much like you and I .

I also had manual massage both external (along my stomach where I had trigger points) and internal (for the vaginal trigger points). They also gave me exercises to do to help release the muscles. Most of these were pretty standard PT types of exercises. The only one that was related directly to the pelvic floor release was the one using the dilator. My massage therapists were female.

I hope this helps.

G.

I saw a urogyno a few days ago and he said I had levator spasm condition which is what you have- inability to release and relax pelvic floor muscles. He prescribed a cream that has Valium in it so i can insert it vaginally and it will relax those muscles and also pelvic floor pt. I'm interested to see how this pt will go...I hadn't heard of the pt under anesthesia before. if you hear of any pt tips let me know please

bhamilton320, how is the cream working for you? I had the botox in the right and left levator ani muscles as well as throughout the other pelvic muscles and PT (I'm still not sure how they did that part, my OR report-which I think is just the residents rough draft that the NP gave me at my 2wk post op didn't say) As far as pain goes, I'm still in alot of it. But I think that pain is from another source. Possibly the sling, but I can't really prove it so idk. I haven't tried sex yet so I can't say if that part is better or not, peeing is not any easier and now I have sharp painful knife-like spasms in my urethra that I didn't have before. I don't find it completely impossible to have a bm now, but there is still a problem. Now it seems when I feel like i need to go I better go or else. I think if I were to have any looser stools I would have leakage.
As far as my MRI results pre-op to see what was going on and what that was he felt when he did my rectal exam (he said it felt like mesh but wasn't totally sure) I never got to talk to him about that. The day of my appt he was running very far behind and after waiting about 3-4 hours the NP came in to see me because she didn't want me to wait any longer. She said she needed to give me my BRCA results anyway so she wanted to talk to me. She and I watched the video of my MRI, but she couldn't tell me anything about it. I think I knew as much about what it said as her She told me she would get with him before my actual pre-op appt which was 12/2 to see if he was changing his gameplan any. She told me he said no change to what he had planned, but I still really don't know what it said. When I went to my post-op check on 12/20 with the NP (whom I love, she is so sweet and very honest) I told her that my right pelvic pain (which she is labeling groin pain) is much worse now and I am just beyond miserable. Its like you could cut my pelvic region in half from mid thigh to mid abdomen and the entire right side is effected, the closer to the vagina the worse the pain and it wraps from front to back. you can see visual swelling of the right side of my pubic area as well as the right side of my vagina (I guess its the labia area on the outside, I can't see the inside lol) She looked really discouraged and basically said that maybe the dr wasn't understanding me properly when I told him back in Oct where all my pain was and because I was so tender internally he just took it as all being related to the muscles. I have survived using ice packs and those Thermacare Menstural heat pads you put in your undies and icy hot. It takes take the pain away but it distracts me from it some. The dilaudud they gave me after the surgery didnt really help the pain much. The NP gave me Baclofen and Ultram to try. It was the best she could prescribe without the dr doing it and he was in the OR that day so I would have had to wait for her to get an ok from him. Baclofen helps some, I forgot to take it one night and really noticed the pain was much much worse. But it doesn't really resolve it enough to say I'm comfortable. She said I MUST see the dr at my 6wk post op (which is Jan 20) They made me his 1st appt of the day so he can't be too far backed up to see me.

I have this deep gut feeling I'm not going to get better anytime soon I told the NP I'd rather they numb my whole pelvis and never even be able to feel sex or anything again than to live with this pain. Asking a dr to give you pain medication is like asking them to write you an rx for cocaine! And I don't even want the stuff like dilaudid, percocet etc. I just want pain relief that I can be semi-functional with and be able to drive to the grocery store and get the groceries and drive home without my whole leg swelling and such. I needed the hysterectomy, it wasn't optional, at the time of consult with my original gyn, becuase he thought it was all just pre-cancerous I could have opted to keep my cervix and ovaries, but my cervix caused alot of pain and my ovaries were not functioning properly as well as covered in cysts. Later pathology showed that I had several complex cysts on my ovaries that could have turned malignant and that there was a tumor on the endocervix and the cervix had multiple lesions on it which all tells me I think I made a good choice saying to take them. My bladder sling, was medically needed but still optional according to my dr (and my original OR report and notes which I have read over and over trying to decipher what went wrong) I couldn't cough without leaking everywhere and I had a stage 4 cystocele as well as a stage 3 rectocele. Had I not trusted that it was the best option to go ahead and agree to those repairs, my dr told me he would not have been able to put me back together without doing something to hold me up. I only wish I had asked exactly what they were using in me before surgery and researched it beforehand so I could have had a say in it. I would have asked for a fascia sling, but then again that might not even be the cause, but I can't figure out what else it could be.

This post ended up being WAY longer than I expected it to be, oopsy lol. Hopefully someone out there will be looking for someone with a similar story and find it. -I had an Obtryx sling by Boston Scientific just FYI, I'm having a hard time finding data on that particular one so if anyone else has it and has problems please share with me. Either on here or via PM.