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Vaginal cuff nerve pain? Vaginal cuff nerve pain?

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  #1  
Unread 04-24-2003, 03:04 PM
Vaginal cuff nerve pain?

Hi,
I haven't posted or visited in a long time. I had my hyst on 8/5. THings were OK for a few months but then I started getting pain again and developed multiple stubborn trigger points in my abdominal wall.... trigger point therapy and massage therapy have not helped... I continue to trend towards more pain.

ANyway, I traveled out of state to see Dr. Slocumb at the University of Colorado medical center in Denver. He runs a pelvic pain clinic up there. Part of his exam revealed that the scar in the vaginal cuff was extremely painful... he just pressed on it with a q-tip and I thought I was going to hit the ceiling... He commented that it was possibly nerve entrapment or neuromas (?). My local doctor has never heard of this happening...

ANyway, Dr. S did trigger point injections in the abdominal wall trigger points and I am in more pain than I was previously (maybe from the exam?). Hopefully everything will calm down soon. He also prescribed Desipramine (anti-depressant) to take at bedtime to help with sleep and pain... I am having a hard time with the side affects.

He may do injections into the painful scar in the vaginal cuff next time.

Just wondering if anyone else has experienced this.

Sblumen
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  #2  
Unread 04-24-2003, 09:13 PM
Vaginal cuff nerve pain?

((((Sweetie))))) I'm so sorry you've been having so much pain since your hyst

I do not have experience with this nerve entrapment or with trigger point injections, however I'm sure someone will come along soon with some insight.

I just wanted to send some s your way and to let you know that you're not along.

  #3  
Unread 04-25-2003, 06:08 PM
Vaginal cuff nerve pain?

((Sblumen)),
My Intestines are adherred to my cuff by Adhesions, along with some Nerve damage...talk about painful There are a few other ((Sisters)) here with Vaginal cuff nerve damage as well...
Here is some info I have on this that might be of some help to you & your *Doctor*

http://www.medhelp.org/forums/neuro/archive/16463.html
http://www.medhelp.org/HealthTopics/Scar.html
http://forums.obgyn.net/forums/wome....0006/1993.html
http://neuro-www.mgh.harvard.edu/fo...ervedamage.html
http://www.gwpharm.com/news_pres_13_jun_02_int.html
http://www.newshe.com/factsheets/Pe...or_Trauma.shtml
http://www.perspectivesinnursing.org/v1n2/Smith.html
http://www.medhelp.org/forums/neuro/archive/12786.html

Nerve damage after surgery:
http://neuro-www.mgh.harvard.edu/fo...ervedamage.html

Nerve Pain Expert Q&A:
http://health.discovery.com/centers...erve/nerve.html

http://health.discovery.com/converg...ry/surgery.html
http://painlinks.org/rsd_tmj1.html#RSDS

adhesions on cuff:
http://www.angelfire.com/mt/nashrose/opobgyn.html

Incapacitating pelvic pain:
http://members.aol.com/EndoRama/hysterectomy.html

http://www.dukeuroandgyncare.com/questionare.pdf

rebounding pain:
http://www.cgmh.com.tw/heal/journal/gr0206.htm

Pelvic Pain Assessment Form:
http://www.pelvicpain.org/pdf/FRM_Pa...stionnaire.pdf

Adhesions-type of scar tissue that results in the sticking together of some ..
http://www.utc.edu/~utcnurse/projects/SC/cpp21.htm

dx~ nerve damage or entrapment?
http://neuro-www.mgh.harvard.edu/neu...ervedamageoren

Adhesions tug on the nerve during simple movements, causing pain...
http://www.tcwellness.com/issues/2000/03/4.html

Severe Neuropathy - Genitofemerol & Ilioinguial nerve entrapment: http://www.medhelp.org/forums/neuro/archive/9977.html

Abdominal Cutaneous Nerve Entrapment Syndrome (ACNES):
http://www.kaiserpermanente.org/medi...m02/acnes.html

http://www.neuropathy.org/

Acoustic neuroma
http://www.nlm.nih.gov/medlineplus/e...cle/000778.htm

I hope this is of some help Pls keep us posted...(((hugs)))
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  #4  
Unread 04-26-2003, 09:54 AM
vaginal cuff pain

I wished I would have found this site way before I had my hysterectomy! I had a hysterectomy 6 years ago because of ovarian cysts that turned out to be normal and gone at surgery but because I was 44 at the time the doctor chose to take my organs go figure! Anyway 3 weeks into recovery I developed a horrible pain in what felt like the bladder and right behind the incision. 4 months I went to a surgeon who told me to go home and put it behind me, 6 months I had a second surgery which removed adhesions from the bowel and bladder but the pain never left. I have had every test there is, including 3 cystoscopies. I have always felt a burn in the bladder but along with it a pulling pain when I would bear down to urinate . Sometimes it is worse than others and then I can even have days where I think oh thank you it is finally going to just go away but it always returns I usually have 3 to 4 days maybe pain free then the rest is in misery. I always wondered if it could be a nerve involvement on the vaginal cuff as it sometimes feels like the cuff is attached to something This 6 years have been like living in jail and I gave up on continually going to different doctors for one the expense, the last I looked it was 50,000 dollars my insurance has paid let alone what we have paid out. I haven't been able to have sex at all because of pain severe days afterwards. I am wondering since this post if anyone has had vaginal cuff injections and if they have worked or not. i think it is so awful women have to go through this but it is a good thing there is sites like this one where other women know what you are going through as I have found the women around me don't like to talk about this at all. thanks for any imput.
  #5  
Unread 04-26-2003, 02:51 PM
Vaginal cuff nerve pain?

((patchouli)),
I've been offered the cuff injections but b/c of the pain I experience (even to the touch) I'm not sure I could go thru w/ it. I'm sorry you have been suffering for so very long I'm soo glad you found us tho! Here you will find several of us going thru a variety of pain & complications many months & years Post Hyst...it is wonderful having others who truley understand our pain We usually dont have answers but what we do have is tons of love, support, compassion along w/ some knowledge we have picked up in our own personal quest for answers & relief. The most important thing I have learned from when my journey of pain & complications started in Jan 2000 is that we are our own best Advoate when it comes to our health. No one knows our bodies better than we do..we KNOW when something is wrong, despite what some Drs & tests might say, WE have to live w/ whatever the outcome of any surgery, procedure, therapy, medicine regime that is suggested in hopes to help relieve pain/symptoms...
Knowledge is POWER Educating & researching our symptoms/DX will empower us to better advocate. There are always options..which are sometimes offered, sometimes not.. To make a decision on which treatment to use research allow's us to better understand what it will entail & most importantly, IMO, the possible risks...by weighing the Pro's & Con's of all viable options..a well-educated decision can be made..one that we know all sides of!

Unfortunately, I have my own horror story, just as many of us do..I'll spare you the details..lol..what I will share is some info that might be of some help to you in finding some answers to your pain & problems. Have you ever heard of IC? It is a Chronic, painful condition of the bladder..many here have been dx'd w/ this post op. I will list some links on that as well as some others w/ info on various pain syndromes, bladder conditions ect...

  Quote:
Interstitial Cystitis(IC):

Interstitial cystitis (IC), one of the chronic pelvic pain disorders, is a
condition resulting in recurring discomfort or pain in the bladder and the
surrounding pelvic region. The symptoms of IC vary from case to case and even in
the same individual. People may experience mild discomfort, pressure,
tenderness, or intense pain in the bladder and surrounding pelvic area. Symptoms
may include an urgent need to urinate (urgency), frequent need to urinate
(frequency), or a combination of these symptoms. Pain may change in intensity as
the bladder fills with urine or as it empties. Women's symptoms often get worse
during menstruation.
In IC, the bladder wall may be irritated and become scarred or stiff.
Glomerulations (pinpoint bleeding caused by recurrent irritation) may appear on
the bladder wall. Some people with IC find that their bladders cannot hold much
urine, which increases the frequency of urination. Frequency, however, is not
always specifically related to bladder size; many people with severe frequency
have normal bladder capacity. People with severe cases of IC may urinate as many
as 60 times a day.
Also, people with IC often experience pain during sexual intercourse. IC is far
more common in women than in men. Of the more than 700,000 Americans estimated
to have IC, 90 percent are women.

What Causes IC?
Some of the symptoms of IC resemble those of bacterial infection, but medical
tests reveal no organisms in the urine of patients with IC. Furthermore,
patients with IC do not respond to antibiotic therapy. Researchers are working
to understand the causes of IC and to find effective treatments.
One theory being studied is that IC is an autoimmune response following a
bladder infection. Another theory is that a bacterium may be present in bladder
cells but not detectable through routine urine tests. Some scientists have
suggested that certain substances in urine may be irritating to people with IC,
but no substance unique to people with IC has as yet been isolated. Researchers
are beginning to explore the possibility that heredity may play a part in some
forms of IC. In a few cases, IC has affected a mother and a daughter or two
sisters, but it does not commonly run in families. No gene has yet been
implicated as a cause.

Are There Different Types of IC?

Because IC varies so much in symptoms and severity, most researchers believe
that it is not one, but several, diseases. In the past, cases were mainly
categorized as ulcerative IC or nonulcerative IC, based on whether ulcers had
formed on the bladder wall. But many researchers and clinicians have questioned
the usefulness of this classification, since the vast majority of cases do not
involve ulcers, and their presence or absence does not influence treatment
options as much as other factors do.
Factors that influence treatment options include whether bladder capacity under
anesthesia is great or small, and whether mast cells are present in the tissue
of the bladder wall, which may be a sign of an allergic or autoimmune reaction.
In some cases, the success or failure of a treatment helps characterize the type
of IC. For example, some cases respond to changes in diet while others do not.

How Is IC Diagnosed?
Because symptoms are similar to those of other disorders of the urinary system
and because there is no definitive test to identify IC, doctors must rule out
other conditions before considering a diagnosis of IC. Among these disorders are
urinary tract or vaginal infections, bladder cancer, bladder inflammation or
infection caused by radiation to the pelvic area, eosinophilic and tuberculous
cystitis, kidney stones, endometriosis, neurological disorders, sexually
transmitted diseases, low-count bacteria in the urine and, in men, chronic
bacterial and nonbacterial prostatitis.
Diagnostic tests that help identify other conditions include urinalysis, urine
culture, cystoscopy, biopsy of the bladder wall & urine cytology.

The most important test to
confirm IC is a cystoscopy under anesthesia.

Urinalysis and Urine Culture
These tests can detect and identify the most common organisms that infect the
urine and that may cause symptoms similar to IC. There are, however, organisms
such as Chlamydiathat cannot be detected with these tests, so a negative culture
does not rule out all types of infection. A urine sample is obtained either by
catheterization or by the "clean catch" method. For a clean catch, the patient
washes the genital area before collecting urine "midstream" in a sterile
container. White and red blood cells and bacteria in the urine may indicate an
infection of the urinary tract, which can be treated with an antibiotic. If
urine is sterile for weeks or months while symptoms persist, the doctor may
consider a diagnosis of IC.

Treatment:

Bladder Training:

People who have found adequate relief from pain may be able to reduce frequency
by using bladder training techniques. Methods vary, but basically patients
decide to void (that is, empty their bladder) at designated times and use
relaxation techniques and distractions to keep to the schedule. Gradually,
patients try to lengthen the time between scheduled voids. A diary that records
voiding times is usually helpful in keeping track of progress.
Surgery
Many approaches and techniques are used, each of which has its own advantages
and complications that should be discussed with a surgeon. Surgery should be
considered only if all available treatments have failed and the pain is
disabling. Most doctors are reluctant to operate because the outcome is
unpredictable--some people still have symptoms after surgery.
Those considering surgery should discuss the potential risks and benefits, side
effects, and long- and short-term complications with a surgeon and with their
family, as well as with people who have already had the procedure. Surgery
requires anesthesia, hospitalization, and weeks or months of recovery, and as
the complexity of the procedure increases, so do the chances for complications
and failure.

Studies have found that patients who learn
about the disorder and become involved in their own care do better than patients who do not.
Interstitial Cystitis:
http://www.pelvicpain.org/resources/IPPS2002%20CLPM.ppt
http://www.niddk.nih.gov/health/urol...s/cystitis.htm
http://www.healthorchid.com/content/...cystitis_w.asp
http://www.interstitialcystitis.co.uk/
http://www.wdxcyber.com/what.htm#urinemn
http://www.duj.com/cystitis.html
http://www.healthcentral.com/peds/top/000477.cfm
http://www.womenshealthmatters.ca/ce...ain/index.html
http://www.avera.org/adam/ency/article/000477.htm
http://www.wdxcyber.com/nurine03.htm
http://womenshealth.about.com/librar...y/aa012199.htm
http://www.urologychannel.com/inters...is/index.shtml
http://www.nlm.nih.gov/medlineplus/i...lcystitis.html

bladder diary:
http://www.dukeuroandgyncare.com/diar.html

Interstitial Cystitis - Pelvic Pain from the Bladder:
http://www.wdxcyber.com/nurine04.htm

http://health.discovery.com/centers/...pain/pain.html

http://www.pelvicpain.org/communication.ppt

http://www.pelvicpain.org/pdf/diagnosis_management.pdf

http://www.familydoctor.org/handouts/284.html

http://www.gynsecondopinion.com/pelvic-pain.htm

Interstitial Cystitis: Progress Against Disabling Bladder Condition:

Women and Pain:
http://health.discovery.com/centers.../pain/pain.html

Disorders More Common in Women:
http://www.painfoundation.org/page....age_links.htm#9

Pain Management and Information Organizations:
http://www.painfoundation.org/page....ge_links.htm#26

Chronic Pain In America: Roadblocks To Relief:
http://www.ampainsoc.org/whatsnew/toc_road.htm

You Have Chronic Pain: Now What?
http://www.nlm.nih.gov/cgi/medlinep...%3Fid%3DPN00048
http://www.familydoctor.org/handouts/033.html

Outcomes Similar After Total, Partial Hysterectomy, complications and effects this surgery can have:
http://www.nlm.nih.gov/medlineplus/...tory_10040.html
http://homepage.psy.utexas.edu/home...sterectomy.html
http://www.newshe.com/articles/hysterectomy_3.shtml
http://www.drdeljuncojr.com/hystere...plications.html

http://health.discovery.com/converg...ry/surgery.html
http://painlinks.org/rsd_tmj1.html#RSDS

Urethral Syndrome:
http://www.duj.com/cystitis.html
http://www.medhelp.org/perl6/urology/archive/203.html

Vaginal Problems:
http://www.wdxcyber.com/mvagina.htm

  Quote:
Pain with sexual relations is uncommon but when it occurs, it may significantly disrupt interpersonal relationships. This category refers to pain that occurs only with deep penetration of the vagina and should be differentiated from pain that occurs at the opening of the vagina more superficially.
Deep pelvic pain is much worse when a woman is having intercourse and is on the "top" position. This results in the deepest penile penetration and often moves the pelvic organs. Pain with deep penetration during sexual relations often indicates that anatomical pathology is causing pain.
http://www.wdxcyber.com/ppain.htm#ppaincpp
http://health.yahoo.com/health/encyc...002342/tn.html

http://www.obgyn.net/image_library/hysterectomy.htm

Immediate solutions to your painful intercourse experiences: http://www.dyspareunia.org/html/sex_hurts.htm

Gynecologic Causes of Pain - External: In Vulva or Vagina:

Paravaginal Repair:
http://www.obgyn.net/displayarticle....ures#lap_proc2

vaginal cuff:
http://www.dukeuroandgyncare.com/questionare.pdf
http://www.icsoffice.org/publication...0FLOOR/142.htm

Good Luck..I hope you will continue to visit & share..pls keep us posted on how your doing...(((((((((hugs))))))))))
  #6  
Unread 04-26-2003, 03:31 PM
Vaginal cuff nerve pain?

Sheri,
Great information. Thank you. The doctor in Denver also indicated he thought I had IC but I am still unsure of this. If I have it I only have a mild case unless of course it is causing all this pain - but without much outward urinary trouble except every once and a while... we shall see on that one I guess. In other words, I am in constant pain but I only have trouble with my bladder every once and a while or if I make the mistake of letting it get to full. The later was thought to be due to adhesions because my bladder was stuck to my uterus when they went in to do the hyst.

I did want to mention that Dr. Slocumb was going to do the vaginal cuff injections while I was under general anesthesia in the OR. He said it would be too painful for me otherwise - I would agree with that.

SBlumen
  #7  
Unread 04-26-2003, 05:16 PM
Vaginal cuff nerve pain?

  Quote:
going to do the vaginal cuff injections while I was under general anesthesia in the OR. He said it would be too painful for me otherwise - I would agree with that.
Good..let him know you need extra so it will last for awhile I hope it helps..pls keep us posted...
  #8  
Unread 05-01-2003, 01:01 PM
vaginal cuff pain

THANK YOU SHERI, for all the informational web sites. It is so nice to know this world isn't so scary after all with people who truly care. Thank you and bless your heart.
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