A Conversation on Pudendal Neuralgia With Dr. Mark Conway, Gynecologist

Pelvic Pain and Pudendal Neuralgia expert Elizabeth Akincilar has a sit-down conversation with renowned gynecologist and pelvic pain expert - Dr. Mark Conway. They discuss Dr. Conway's path to his field, current treatments for PN, and what people need to know to recover from this issue.
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PHRC is the leading physical therapy center for patients experiencing pelvic pain. At PHRC our advanced pelvic floor training allows us to integrate pelvic floor and pelvic girdle physiology to help the person function better as a whole. The benefit of our focus is that it has allowed us to establish a deep well of experience that we are able to draw from when treating this complex part of the body.

[@frankfitzmaurice2759]

This was excellent! We have seen Dr. Conway and were impressed. Don’t forget to stop by the Brewery!

[@PelvicHealth]

We are glad to hear you had a positive experience!

[@stevef7814]

Alcohol is horrible for PN

[@Coolguy-ki4ue]

He sounds like a great doctor.

[@PelvicHealth]

He certainly is!

[@krassis6]

Excellent questions! I am a pelvic health physical therapist and found this interview very informative. Thank you.

[@PelvicHealth]

You are welcome! We are so glad you enjoyed this!

[@b.c.3889]

Great information. I'm In Texas.

[@PelvicHealth]

Let us know if you need any more information or links a directory to locate pelvic pain specialists!

[@wigglywrigglydoo]

Thank you for your great videos. But I just wanted to point out the volume differences between your videos. I had to turn the volume up just to hear this conversation, then when your next video autoplay, it boomed really loudly, I guess now all my neighbors know that I have penile pain, thanks!

[@PelvicHealth]

So sorry to hear this! KZbin can sometimes adjust our levels depending on which microphones we use

[@johns1577]

I've waited since 2008 to try decompression. Meet all Nantes criteria. Successful pudendal nerve block. Pain worsening due to ongoing new stressors. Interested in a consultation.

[@PelvicHealth]

Please feel free to consult with us virtually. You can request an appointment here if you have more questions: pelvicpainrehab.com/telehealth/

[@elliefrangoulis2228]

It’s still not clear if PN can be reversed and sexual function and symptoms can be completely healed? I don’t get why that wouldn’t be? Why is it a life sentence? If a nerve was injured why doesn’t it just heal and return to its original state. I do not understand why no one is addressing this. We don’t want to just manage this. We want to heal it and return to what our lives were before. 💔💔💔

[@PelvicHealth]

I'd like to separate "healing" and "returning to its original state". Even a healed body is not the same body it was prior to injury. It has lived through the trauma and the recovery, learned compensatory strategies, etc. Another way to look at healing is that I'm not comparing my current state to where I was before injury, but instead to where I will be in the future. I can return to the activities I enjoy, and I may have to make modifications because my new body has different needs than my old body. I love this topic, and you should continue the conversation with a PT trained in pelvic pain and also a pain psychologist.

[@elliefrangoulis2228]

@@PelvicHealththat’s a very sad reality I guess whoever says they have healed are then using this language in an effort to make themselves look at the positive side and not because their life has in fact returned to what it was. Perhaps it’s more realistic to say you haven’t healed if you’re not able to have a sex life anymore. Maybe the majority of people with the condition being in their 50s don’t care as much about this aspect but for me being 27 this does sound really really bad as a prognosis and do not want to bypass the reality of what has happened.

[@garyjohnson5869]

Hi. So thanks for the info So I had Surgery on my right side in rear buttocks for Pudenaul nerve. By plastic surgern May 2020 didn’t work then he said let do the other side. I said. No Before doing he told me he’s got this Guarantee me Well know. Dr. Felt bad he said that. But. And. Nice Dr. North Jersey. Dr. Like him. A lot Am from down here 20 mins from the. Phila international airport Should of consulted you Am trying that new Solf wave treatment One time at night it felt different Have not got that feeling of good again so going to stop this Go back to Pelvic floor PT person again

[@PelvicHealth]

We are always here if you decide to consult us virtually!

[@Caldreascent]

Could you tell me where Dr: Conway practices and how I could get in touch with him?

[@PelvicHealth]

Hello! Dr. Conway currently practices in New Hampshire, you can find more info about him via this website, stjosephhospital.com/provider/mark-conway-md/?GMBSocialClimb&MarkConway%2CMD

[@advocate4PNpatients]

Do you happen to know if there is an email for his office?

[@rethaboyd3749]

Phone number please?

[@GCS3T]

What do you do for patients who may have compression of the dorsal branch of the pudendal nerve to the penis or clitoris anteriorly, beyond the reach of your posterior approach? What if there has been damage to those nerves or the perineal branches of the pudendal nerve? What is your solution for those patients?

[@PelvicHealth]

This should be directed towards the surgeons that perform pudendal nerve decompression surgeries. You can likely schedule a telehealth consultation with Mark Conway, MD to discuss this directly with him!

[@marlonyoung6960]

Hi, I have pudendal nerve decompression surgery in February through a clinic in New Jersey. I believe it’s going to be laparoscopic. But I didn’t realize there are al many different types of entrapments. Does this mean the laparoscopic surgery won’t take my pain away ?

[@PelvicHealth]

Yes, there are several surgical techniques to decompress the pudendal nerve. Unfortunately there is not enough research available to say with confidence which surgical technique yields superior results. Therefore, it is impossible for me to hypothesize whether or not you will get pain relief from the laparoscopic approach. I think more importantly, one must consider patient selection, surgical skill and experience with the procedure, and availability of follow up care to ensure the best outcomes.

[@alshimaaeleffish3205]

Hi Marlon did you have your surgery By laparoscopic.how you feel now

[@rahumada7]

Marlon, who is the Dr in New Jersey what is the is name of the office .

[@hickorysocks2628]

How’d it go?

[@Jismag1]

Hi ,I am 70 years old woman and I am suffering with PF for two and a half year now. I had nerve block and see a physiotherapist for more than one year. My pain improve at 60% but I cannot sit on my tailbone and my trigger point which is in my left butt for mor than 15 min. I wonder if a surgery can improve my pain at 90%. I know with age we heel lot more slowly.

[@PelvicHealth]

Unfortunately it is nearly impossible for me to tell if surgery is a viable treatment option for you let alone whether it would improve your pain. I would recommend setting up a telehealth appointment with Mark Conway, MD to further discuss your options. He is in Nashua, New Hampshire, at St. Joseph's Hospital.

[@nawluck]

Can someone's sit bone area be affected by the pudendal nerve? 4 years of chronic pudendaI pain and now the sit bone area is burning.

[@PelvicHealth]

The pudendal nerve innervates the area between the sit bones. Depending on where your pain is, it could be caused by related soft tissue issues, too. Talk to your pelvic PT about the exact location and quality of your pain.

[@fdimichele]

branch of posterior femoral cutaneous nerve

[@dwrav3397]

What you said describes my pain right now..I'm desperate and I don't know what else to do..The pain is indescribable and I can't explain it anymore..I have so much pain in my coccyx, like something is constantly burning me.. I am currently in treatment to see if it gets better..it is awful

[@PelvicHealth]

@@dwrav3397 If you aren't seeing a pudendal neuralgia specialist or a pelvic floor PT, we recommend that as your next line in treatment ❤️

[@paulbarbara2603]

Thanks for presentation.i would like to make you a question please.when I was squaring some throw an object about 70 kg and I accidently prove to hold it and weight it.at that moment my hands splashed down and my pelvic floor seems that are going out of my body.this accident was about 3 years ago.i have been to several professors and had MRI of the pelvis.l,me in pain and have also 3 pudendal blocks and buttox but it seems nothing is working.please help me what should I do. T.k.s.

[@PelvicHealth]

If possible, I would recommend consulting with a pelvic floor physical therapist. A MRI would not identify a muscular issue, but an evaluation with a pelvic floor physical therapist would be able to identify if there is a muscular cause to your symptoms.

[@Caldreascent]

How can I contact Dr. Conway? I live in MA and have been dealing/suffering with this for over 8 months. Did I hear right that he is in NH?

[@PelvicHealth]

Yes you did hear right! You can request an appointment via this website stjosephhospital.com/provider/mark-conway-md/?GMBSocialClimb&MarkConway%2CMD

[@Caldreascent]

Thank you

[@PelvicHealth]

@@Caldreascent You're welcome!

[@lukemarshall118]

I am going on a year with this and I’m wanting to give up so bad

[@PelvicHealth]

Living with Pudendal Neuralgia can be difficult. We recommend seeing a pelvic floor PT to help with your symptoms.

[@Madison.P1234]

Hello, thanks for this informative conversation. Besides the symptoms that you have explained, Could PN cause sacrum and coccyx pain ?

[@PelvicHealth]

Pudendal neuralgia does not cause sacrum or coccyx pain but there are many people who have PN who also have back pain, sacral or tailbone bone. They can be co-occuring.

[@b.c.3889]

I had serious coccyx pain and a caudal injection, not sure if it helped. I had lowest ablations on my SI joints. I think that helped the coccyx pain. That was the second SI nerve ablation in a year.

[@cameroncansler752]

What about no pain but functional issues that the pudendal nerve provides functionality for ?. Can PN compression cause just functional issues , And only pain sometimes ? I had decompression surgery for functional issues . The only pain I ever had for about a month was burning pain after bowel movements. It’s been a year since decompression and im losing all hope .

[@PelvicHealth]

In addition to supplying sensation to the genitals and anus, the PN also controls the skeletal muscles that help you pee, poop and have sex. Recovery after decompression can certainly take a long time, sorry to hear of your frustrations. We suggest working with a pelvic floor physical therapist to support your recovery and help improve your muscle function.

[@alshimaaeleffish3205]

Can I know the doctor name and address iam from Egypt. Is there an doctor do decomposition budendel nerve surgery in Egypt????I can travel to USA 🇺🇸 i only need the address

[@PelvicHealth]

Hello, the doctor in this view is Dr. Mark Conway. You can get more information about him via his website. We do not have a specific doctor referral for Egypt but we can place a few directories below for you to try to find one in your area. pelvicpain.org/IPPS/Patients/Find_A_Provider/IPPS/Content/Professional/Find_A_Provider.aspx?hkey=ac3c51ec-0939-499f-a6a0-c72d0aa2f427 pelvicguru.com/directory/

[@melileka6717]

What is the dose of gabapentin for pn?

[@PelvicHealth]

Hello, the dosage is prescribed by your doctor. We do not have a specific dose for this.

[@stephanieprendergast2643]

Studies suggest the therapeutic dose for gabapentin is 1600mg, but as we state below, a doctor should manage the medications and effective doses vary from person to person.

[@Tbell19898bel]

Hi there. I have a question.. I have a shooting nerve pain inside my vaginal opening and its causing burning and soreness. It started after intercourse and then i got a UTI. I am currently pregnant so im concerned about my delivery coming up in 4 months! Iv been in pain since December please advise 🙏

[@PelvicHealth]

We are sorry to hear that you are having pain. It is challenging to give specific advice via this platform without knowing what is going on in you specific case. You likely would benefit from an evaluation from a skilled Pelvic Floor physical therapist as there are a number of things that could be causing your pain. You are also welcome to book an online consultation with us via this link: pelvicpainrehab.com/telehealth/

[@advocate4PNpatients]

Is there an email contact for Dr Conway’s office?

[@PelvicHealth]

Hello! We do not have his email, but would advise looking him up and contacting his office directly via phone.

[@laurafrick2893]

Avoid surgeries. Optimize your hormone levels, find a neuro muscular massage therapist or pelvic floor therapist. Check for scar tissue and hypertonic pelvic floor muscles at the sit bone, obturator internus muscle, thighs and hips and have therapists work on all of that. May take years. I had surgery with this doctor.

[@PelvicHealth]

Talking with a pelvic floor PT is a great recommendation! Thank you for sharing what you focused on.

[@elliefrangoulis2228]

If you had surgery why are you saying others shouldn’t? He is saying if there are signs of neuropathy you should consider it because damage may be irreversible.

[@ic718708]

Bilateral pudendal cryoablation ruined my life.

[@frstevenjones6493]

I am so sorry. What happened?

[@PelvicHealth]

We are so sorry to hear that. Are you seeking follow up treatment since having that procedure done?

[@robertpagen2770]

What is that ?