(filmed at the Endometriosis Summit 2024) Dr. Ally explains how the PRM Protocol™️ is a unique, in-office procedure and a safer and more effective approach than the traditional pudendal nerve block. Our protocol is directly treating the inflamed nerves and spastic muscles of the pelvic floor.
Dr. Allyson Shrikhande is a board certified Physical Medicine and Rehabilitation specialist, Chief Medical Officer of Pelvic Rehabilitation Medicine, and an expert in women’s and men’s health and sexual health. A leading expert on pelvic health and a respected researcher, author and lecturer, Dr. Shrikhande is a recognized authority on female and male pelvic pain diagnosis and treatment.
At Pelvic Rehabilitation Medicine™, we believe that the millions of women and men who suffer from pelvic pain should have access to care that provides relief. We don’t believe “a glass of wine will fix it” or that “it’s all in your head”. We will never abandon you - and from leadership to the front office to every pelvic pain specialist you meet, so much of our team has been in your shoes and believes the pelvic pain patient deserves better. This belief is what unifies us all at PRM.
Since 2017, PRM has provided an innovative solution to a health crisis that affects 15% of women and 10% of men. Persistent pelvic pain is often overlooked, untreated, and misguided. At PRM, our mission is to decrease the time patients are suffering from pelvic pain symptoms.
We offer a proprietary, simple, office-based procedure to treat the symptoms of chronic pelvic pain. The PRM Protocol™ consists of a series of pelvic nerve and muscle treatments to directly target inflammation in the pelvis and nerve pain. Depending on the condition causing your pelvic pain, other modalities may be needed in addition to our treatment.
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PRM's procedural approach is unique compared to other pudendal nerve blocks for multiple reasons. So comparing the placement of where we're treating the pudendal nerve, the classic for if you're going to a interventional pain doctor under fluoroscopy or guidance, x ray guidance, they would be putting it between what we call the sacrospinous and sacrotuberous ligaments.
There are these big thick ligaments in the posterior aspect of your sacrum, so they have to pop through these thick ligaments and place it in between. We do not do that. The other option that's commonly offered out there is transvaginal, through the vagina, by a gynecologist, and blind. Blind meaning no guidance at all, and transvaginal blind. So we're not doing that either. And those are the two most common. What we are doing is something, we're using an ultrasound for guidance, which is better because there's no radiation with ultrasound compared to the fluoroscopy and our patients are young and we want to preserve their ovaries.
So we don't want radiation. So that is why we use ultrasound guidance. And also it allows us to do it in an office without anesthesia. And our approach is we're placing it in a place called Alcox canal and the place that allows us to do a high volume technique and dissect out the fascia and create space.
So as well as allows us to access it with the very small diameter needles, a thin needle. So it's very safe and comfortable because if you have to pop through a ligament as the other approach. And, and interventional pain would offer, you need a thicker needle to do that. You don't need that. So we were able to use a very tiny, flexible needle and tunnel it to where we want it to go.
Safer, more comfortable, more accessible, and in addition allows us to do a high volume treatment, more effective technique. That would be the main difference in our approach. The other difference between the PRM Protocol and what else is offered out there is we are addressing something called the cross sensitization that occurs in the pelvis.
So it's a fancy terminology where all the different nerves in the pelvis talk to one another and they're best friends. And so they upregulate one another. So you need to address multiple nerves at once, the ones that have cross innervation, in order to downregulate the pelvis. If you do not do that, they will continuously, even if you treat one, the other one will upregulate and cause pain.
15 сен 2024
