Dr. Renney - You need to seek out a doctor who is open to suggestions that you have PNE. It could be internist orthopedist, urologist or gynecologist. In my case, it was a radiologist who made my diagnosis.

Dr. Renney - Three years ago, the only surgeon with experience in PNE was in France, so I went to him. After I improved, I took an interested team of physicians to France to learn from the experts (Prof. Robert and his associates) and so that care would be available in the US. Our group follows their protocols. Hopefully we can publish data together in the future for the US medical community.

Dr. Renney - PNE is entrapment of the nerve either at the Ischial Spine, between the two ligaments or in Alcocks canal where it is covered by fascia. (Female Nerve Diagram & Male Nerve Diagram) A majority of the cases are at the spine. The nerve resembles the violin strings. It is stretched and does not lie flat. When you sit, tension is placed on the nerve and you have pain. This can also happen during a bowel movement. Some people have it with sexual relations. Dr.

Dr. Renney - The diagnosis is based on the history, the results of the injections and the Pudendal Nerve Motor Latency Test (PNMLT). You need at least two of these for us to feel comfortable with the diagnosis of PNE.

Dr. Renney - 2/3 of PNE cases are men. We have not found any real difference in symptoms between men and women. Dr. Renney - The original studies were done in cyclists. The other causes are similar to those you mentioned. You can add chronic constipation to that list.

Dr. Renney - If the rectal sphincter is injured during childbirth, you probably had a difficult delivery so the pudendal nerve could be stretched or injured. It is not a result of a rectal muscle tear with an episiotomy. Jill O. - Thank you Dr. Renney for appearing tonight.

No. Over 20 years of research has shown no statistical validation for the need to test both eyes. What you measure in one eye is nearly what you have in the other. No. The MacuScope measures the MPPD of the macula and places patients into a high or low risk category for developing AMD. Low MPPD can precede the onset of AMD by decades! No. The MacuScope has detected low MPPD in much younger people.

The patient needs to fast 4 hours prior to the procedure. If the patient’s heart rate is greater than 65 BPM then medication may be administered prior to the exam to slow the heart rate.

Dr. Renney - The main symptom is pain with sitting. You feel great in the AM until you sit for coffee, or drive to work. You get better with lying down. The pain is in the distribution of the pudendal nerve....genitalia, perineal or rectal. It can be any combination of these areas depending on the part of the nerve entrapped.

Dr. Renney - The pain is burning, tingling, sharp, knife like. Sometimes they may have a sensation of a foreign object in the rectum. The pain is hard for people to describe due to the problem being neuropathic. Neuropathic pain is not the same as trauma pain or surgery pain.

Dr. Renney - The treatment is: (1) 3 guided nerve blocks with corticosteroids, (2) use of medications such as neurotin, elavil etc., (3) protection from sitting (4) or the offending factor that causes pain. This can be something as simple as avoiding lifting of bags of groceries or a bike if that causes pain

Dr. Renney - This is my opinion as a patient only. If you still have pain after the injections and the medications don't get you to a zero on the VAS (Visual Analog Scale for pain intensity) and you worry about the pain daily, I say have surgery and hope you get improvement because nothing else has helped. Jill O. - One reason why we invited you to speak is because of a patient named Michael who had been diagnosed with IC. For three years, he tried every IC therapy to no avail.

Dr. Renney - The pain with standing usually deceases somewhat but may not completely resolve if the intensity level is significant.

Dr. Renney - The main point is the history. You need to ask specific questions and you can discover the difference. We see many patients with this diagnosis that actually had PNE.

Dr. Renney - A good example, a patient goes to Mayo clinic for a week, lays around in a hotel, has tests done, and feels great. The reason, he didn't sit, commute or work. So, yes, it depends on level of activity

Dr. Schiller is an eye plastic surgeon, specializing in cosmetic and reconstructive surgery of the eyelids, tear ducts, and orbit. Doctors in this specialty are uniquely qualified to perform delicate and precise surgery of the eyelids.

Dr. Renney - In France, they say they are able to help 68% of their patients with a nerve block (i.e. the pain decreases 80% on the VAS). So, you have to focus on improvement not cure! We have one patient with complete recovery from injections alone (0 on VAS).

Dr. Renney - Yes, don't do anything if it hurts! The only way to diagnose the difference is at surgery. Dr. Renney - If you have pelvic spasms, whether its from IC or PNE, you need to have this evaluated by a person who knows how to deal with pelvic muscles. Remember, sometimes with PT you get worse before you get better due to the chronic spasms.

Our physicians on-staff handle this procedure. You simply place your order where you are referred to the same labs that physicians and hospitals use, which are certified and regulated by governmental agencies.