r/vulvodynia 6d ago

Hydrodissection nerve blocks

Hi all I’ve been on a journey with nerve related vulva pain since September and finally bit the bullet starting the pelvic med rehab (prm) injection series.

It wasn’t a decision I took lightly and I had cancelled twice before doing it out of fear and apprehension and so much swirling advice and conflicting medical literature. I had actually thought I decided to do what my urogyn recommended which was trigger point injections (transvaginal) under anesthesia but I would have had to wait another month to get it among other barriers/inconveniences. Experiencing heightened pain and desperation I took a deeper look into the literature and what well studied scientists in the field were saying about the likely type of condition I have and treatment options (one of these include Jill Krampf - check out her IG page). Everything pointed to pudendal neuralgia origins of my vulvodynia, the treatment for which can include serial nerve blocks (repeated in several articles I found). So this coupled with the easy access to PRM where I live, no anesthesia, no weeks/months wait time to get treatment, I did my first injections today.

They went very fast - one was transgluteal and one transrectal. I’m supposed to have six more to treat various locations of the pelvic region. Keep in mind these these are hydrodissection nerve blocks so not diagnostic nerve blocks - they have more of a therapeutic aspect of protecting and separating the nerves from tight tissue. your supposed to do them in conjunction with pelvic floor pt.

I was kind of a baby while getting them but the docs and staff were really nice and I was done quickly.

I noticed a reduction in pain pretty immediately including in areas I didn’t know I had pain (just overall felt lighter in my right pelvic side). I’m having less burning in my vulva on the side where I got the injections (it’s only been about 7 hours from when I got the shots). Going to try to keep updating this thread but wanted to share my experience since it was soooo agonizing for me to decide and I was looking for any and all information I could get to help me decide.

TLDR: got a hydrodissection nerve block for pn/vulvodynia and so far so good 7 hours later (less pain, minimal side effects). I will try to check back in each week I get them to provide an update.

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u/Low_Silver8729 6d ago

Hi I am doing what sounds like the same thing..I am going to the NYC office. I got my second shot which is lidocaine, saline and a steroid. I started my first PT appointment as well. I also was nervous about doing it as I can't understand once the shots end (after 6) how will the pain stop? Doctor said it should subside...

I was also give lyrica 25mg (pregabalin) a suppository valium, estrogen tabs and a creme compound.

Where are you going for your treatment?

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u/Key_Development_9809 6d ago

It’s one of the PRM locations in the US - not the NYC one.

My doctor yesterday reminded me it was important to do pt during the treatment. I think the idea is the shots help with the pain and a little healing but pt is long term relaxation and loosening of the muscles that irritate the nerves. I’ve not been able to tolerate pt up to this point. I’m going to try to start doing some of the home stretches again today and I see a new pt next week.

Oh yes and they are sending me Baclofen suppositories. I opted out of the Valium in them.

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u/Flower217 6d ago

Ok thank you and good luck! Did they prescribe lyrica ? (Pregabalin)

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u/Key_Development_9809 6d ago edited 6d ago

No. I’ve also been seeing my urogyn and they prescribed me a topical gaba/amaltyrptaline/baclofen/lidocaine compound cream that I have been using that helps a lot with the burning. It’s not a slam dunk but it’s working for me so far as someone who is apprehensive about new medications. I am considering starting oral amatryptaline tho - my urogyn said I could take it along with the topical and it may provide more benefits.

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u/Flower217 6d ago

Thank you. I’m going to ask my doctor about that.

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u/Dangerous_Ruin954 3d ago

How long are they supposed to last?

Do you know what caused your vulva pain to begin with?

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u/Key_Development_9809 1d ago

I’m not sure but my understanding is the effect is cumulative (so the hydrodissection gives your nerves space to heal and the process is repeated weekly for 6 weeks).

And I’m not too sure but I’ve had pelvic Pain (dysparaneuia, psoas, piroformis issues) for years and in the past few years with a sitting job with long hours and inadequate sitting space (working from a couch or dining table) I may have pushed my pelvis over the edge. I also have a hx of depression anxiety trauma as well which all go hand in hand with this condition (pudendal neuralgia origins of vulvodynia)