Category Archives: Obturator Nerve

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Find Your Nerve Injury

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If you are having trouble figuring out which nerve is causing the sensations you are feeling, see if you can find it here and click on it. Please let us know if this helps.           ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ … Continue reading

Pudendal Nerve Injury Caused by Improper Insertion of TOT Obturator Tape – Pelvic Pain

The two main nerve complications TOT-injured women report in support groups are 1) pudendal and 2) obturator in that order. Because most studies do not evaluate for nerve injuries past 3-12 months, there is no scientific estimate of how common the injury is. Our experience is that it is extremely common. Pudendal injury causes persistent pain localized around the urethra and around the clitoris, irradiating to the one labia majora (maximum at the lower edge of symphysis) or both.

Polypropylene creates cripples when placed inside the pelvis.

The pudendal nerve is nowhere near the pathway of an obturator tape so how did the women get injured? The mystery may have been solved by three Czech investigators.

In 2011, Jaromir Masata & Petr Hubka & Alois Martan decided to look into why their patient, a 48 years old female obtained a pudendal nerve injury. After receiving a TVT-O, the woman experienced what the authors saw as an “atypical” postoperative pain that continued without relief for three years. While the authors treated her with injections and replaced her sling with yet another dubious tape, the work they did to track down the cause of her injury is valuable.

Authors circled scar and placed a “+” pointing to correct placement location.

The woman’s insertion scar (see Figure 1) was in the wrong place. By using a cadaver to trace the aberrant passage of her sling, the researchers found it intersected with the pudendal nerve. How many others were injured this way? Are you one of them? Was your transobturator tape placed incorrectly? If the manufacturer provided short videos and an instruction sheet, was that adequate training for your surgeon?

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Peggy Day is working on a book to combine all these stories. This is an excerpt from Pelvis in Flames: Your Pelvic Mesh Owner’s Guide. Your input is welcome to help make Pelvis in Flames the book you need to read.

If you’d like to join an online support group and learn about erosion, partial removals, surgeons, or just find out that you are not alone, join my group, Surgical Mesh or check the list of support groups here.

Subscribe to PelvicMeshOwnersGuide.com to learn more about pelvic mesh. I’d like to hear from you if you are helped by what you read here or if you need to know more about any particular topic. Comment below or email me privately at [email protected]..

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Obturator Nerve Injury: Obturator? Get Me The Surgeon General!

When talking to women who are suffering the consequences after pelvic mesh implant surgery, the obturator nerve is one of the most common injuries they describe because transobturator tapes (slings) cause mesh trouble. Your obturator nerve begins at your psoas major muscle, travels through your obturator foramen (an opening in the pelvic bone) and then enters your thigh, where it divides into two branches, anterior and posterior.

1 OBturator nerve
Signs & Symptoms
•    Pain localized to medial thigh radiating to groin or knee
•    Pain exacerbated with activity
•    Adductor weakness
•    Paresthesia over medial aspect of distal thigh
•    Loss of adductor tendon reflex with preservation of other lower extremity reflexes
•    Positive EMG (electromyogram)  and nerve conduction tests.

Damage to this nerve can be felt as pain, numbness your skin on the inside of your thighs and weakness of your thighs. This injury can affect the workings of you hip and knee joints and your abductor muscles and gracilis muscle which move the thighs when they close.

Your obturator nerve can be damaged through injury to your nerve itself, but also when the surrounding tissue is injured, causing swelling and inflammation which constricts blood flow inside the nerve itself.

Treatment: Mild damage to your obturator nerve can be treMESH IS FOR STRAWBERRIESated with physical therapy, including stretching, deep tissue massage, and ultrasound. Medication for pain and anti-inflammatory drugs may help. More severe cases may require surgery to release the anterior division through the obturator canal.

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Peggy Day is working on a book to combine all these stories. This is an excerpt from Pelvis in Flames: Your Pelvic Mesh Owner’s Guide. Your input is welcome to help make Pelvis in Flames the book you need to read.

If you’d like to join an online support group and learn about erosion, partial removals, surgeons, or just find out that you are not alone, join my group, Surgical Mesh or check the list of support groups here.

Subscribe to PelvicMeshOwnersGuide.com to learn more about pelvic mesh. I’d like to hear from you if you are helped by what you read here or if you need to know more about any particular topic. Comment below or email me privately at [email protected]..

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