To those of you with the incredible research skills: Need to compare 2 procedures

Hi everyone: I hope you are having pain-free or at lease less-painful days, and that you were at least able to enjoy the holidays.

Since my visiit to the endo specialist in upstate NY, in which I was told that I am not a good hyst candidate (because my disease is minimal; the pain itself has become the problem) I've been seeking info on nerve-ablating procedures, which he said are my best hope. My two options are a surgical one - a prescaral neurectomy done via a laparoscopy or a laparotomy - or a "permanent" superior hypogastric plexus block - a newer procedure that is performed much less invasively, via injection under light anesthesia. I'm undecided because the surgery seems more precise; s/he visualizes the nerve itself. However, the block is performed under xray, CT scan, or fluoroscopic guidance, which as a much faster recovery, but the surgeon is taking his or her best guess with it.

I've read that both carry the risk of permanently impaired bowel and bladder function, as well as sexual side effects. What I want to know is, which is LESS risky? The first one has been done for years, while the injections have not. The hypogastiric block does not carry the risk of general anesthesia, though, which is a positive.

I have found very little information directly comparing the two approaches. If anyone is aware of an unbiased article about this topic, plese let me know. Thank you!

Painfree wishes, hugs, and best wishes for a pleasant weekend,

Hannah

Hi Hannah,

I did a couple of searches using Google (best search engine around). I got lots of references ... here are a few (did not have time to read through these, but the sources look reputable).

http://www.themenopausecenter.com/presneur.html

http://www.obgyn.net/english/pubs/fe..._carter_p6.htm

http://www.metropolitanpain.com/supe..._injection.htm

http://www.upstate.edu/anesthesia/uh...ogastric.shtml

http://paincenter.stanford.edu/hypog...exus_block.htm

http://www.hmcnet.harvard.edu/brigha.../superior.html


To find more references, use Google.com and search on these keywords:

presacral neurectomy

Hypogastric plexus block


Hope this helps!

Beth

Thank you so much....I will read these all weekend.

Meanwhile I'm getting back into bed, where I'm increasingly spending most of my days...I really must decide soon. In a way, this couldn't have happened to a worse person (shouldn't have to any of us of course), as I'm not a risk-taker at all; e.g., I got my license at 17 like everyone else, but was too timid to drive daily until I was 32!

Thanks again and have a nice, painfree weekend!

((HUGS))

Hannah

Dear Hannah:

My favorite search engine is www.dogpile.com

It will fetch info from dozens of other search engines.

Good luck on your research; I hope you find some answers soon.

Sending huge cyberhugs

Thank you; this has found some very obscure sites and articles; I have already learned from a Canadian site that the injection's results may be only temporary! My pain dr. has claimed that the relief would be permanent; I cannot see myself going under even mild anesthesia every few months and worrying that the anesthesiologist will "hit" the right spot each time. I'd almost rather have the nerve servered once, as with a presacral, and be done with it!

Of course I'll check with my drs and do more research, but this goes to show you how one single article can open your eyes to more possibilities than they may have mentioned - so you know which questions to ask before consenting to anything so serious.

Thank you SO much; painfree wishes and ((HUGS)) from a very grateful,

Hannah

Superior Hypogastric Plexus Block:

http://www.pain-manage.org.tw/ray/ray12.htm
http://www.medscape.com/viewarticle/408975_4
http://www.fibromyalgia.com/papers_superior.htm
http://www.medscape.com/content/2000...08975_ref.html
http://www.metropolitanpain.com/supe..._injection.htm
http://www.e-streams.com/es0308/es0308_918.htm
http://www.threemc.co.kr/AY/aneth_pre.htm
http://www.doctorsforpain.com/patient/nerveblocks.html

Uterosacral nerve ablation:
http://womenshealth.about.com/gi/dyn...d/lunatext.htm

Parasacral Nerve Block:

	Quote:
anesthetic . Additionally, the superior and inferior ... of the pelvic splachnic nerves (inferior hypogastric plexus). ... according to whether this block is used ... http://www.nysora.com/guests/gaertner/gaertner.html

Neurectomy for nerve entrapment:
http://www.adhesions.org/forums/ADHE...0008/date.html

Good Luck ((Hannah)) Hope this was of some help...((hugs))