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Pudendal (or Paracervical) Nerve Block: Confusing Result, please help! Pudendal (or Paracervical) Nerve Block: Confusing Result, please help!

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Unread 08-12-2005, 01:17 PM
Pudendal (or Paracervical) Nerve Block: Confusing Result, please help!

Hello everyone: After many months of wasting time with a local doctor I didn't care for very much, I returned to the only one I've trusted - an hour's flight away in upstate NY. I felt lucky that he took me back as a patient after referring me to the first similar specialist in my area. If you know anything about my story...this is the physician who performed my only briefly-successful presacral neurectomy two years ago.

He performed a paracervical block. The kit he was using said "Pudendal" on it, so i'm not sure if there's a difference between the two types. In any case, it wasn't so bad. Since my pain became 24-7 nearly five years ago, the worst part of any gyn exam for me has been the insertion of the speculum. Even though my vagina hasn't been part of the pain situation - I've "just" had continuous cramps - the speculum pinches so badly I want to scream. I don't know if it's an aftereffect of having suppressed my period with various progestins, and/or taking painkillers over the long term, but that part is just horrid - if anyone can relate, please tell me....

Anyway, when the doctor injected the anesthetic, my pain level was at about an 8 out of 10 - really bad. I skipped a dose of medication, but since my pain has been so severe lately, I was doubled over long before that.

With the injections, the pain disappeared. Just like that. Instantly. But the relief didn't last as long as the doctor said it would - or could: 60-90 minutes. By the time 40-45 minutes had passed, I was doubled over again. The doctor had said that a sudden return of the pain wouldn't be a good sign. It wasn't sudden, though: the return started as an external stiffness across my stomach muscles - like the way you might feel after holding in your belly for too long before letting it out. Then the pain returned in earnest. I didn't feel better again until DH and I reached the local hotel we'd discovered on our trips to this city and had lunch, so I could take my medication with something on my stomach.

In the first 20 minutes of excitement about the relief, I was so happy. I even booked the surgical date. Now I wonder-did I goof? I didn't stay out in the waiting room for as long as the doctor said to. I got cocky. I lifted a heavy bag. Could not resting/lifting have contributed to the anesthetic not lasting as long as he said it might?

The doctor said that, if we wanted to be super-cautious, we could repeat the block before proceeding to a hysterectomy. The day trip is difficult, but not impossible, for us. To be honest, though, I am just wondering whether to "go for the crown" regardless; my mother died of cervical cancer, and most women in my maternal line have died of one gyn cancer or another. It would be nice to have that off my mind.

In doing a search here on the word "pudendal," though, I came across some info I'd been completely unaware of before; the fact that anticardiolipin syndrome is a contraindication to hysterectomy. I've been to a rheumatologist for other reasons and, in the battery of tests that includes this one, have shown up as "borderline" or "equivocal" for the syndrome. One more fly in the ointment - but as always, I am glad for the information. Better to know, so I can ask.....

But back to my actual question: Has anyone's doctor used a paracervical/pudendal block as a test to see whether a hysterectomy would stop her pain? If so, how did it work for you? Any experiences/thoughts are, as always, very welcome and appreciated.

Thanks to everyone for reading...have a restful, painfree weekend!

Love,

Hannah
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