bladder sling surgery and scar tissue

[Chica1943]

I had bladder sling surgery in 2004. Worked for the prolapse and incontinence. I now have pudendal neuropathy.....extremely painful. Can there be a correlation between the two? Is there a test that will show scar tissue within the body? Are you familiar with MR neurography and could you recommend it as a way to pinpoint where the pudendal nerve is being pinched/compressed?
Thank you

[J. Kyle Mathews, MD, DVM]

Sorry to read of your problem.  Pudendal nerve neuropathy has been reported with vaginal vault suspensions most commonly when a sacrospinous ligament fixation is done.  Often permanent suture is used and in some cases these sutures need to be removed.  Pudendal nerve neuropathy has not been reported TO MY KNOWLEDGE with mid urethral slings.  I would think your operative report would be more helpful in determining if the sacrospinous ligaments were used as fixation points and might be the source of your pain.   If this is not the case then locating the area is going to be more difficult and is often determined by examination looking for trigger points.  Good luck.

[Chica1943]

Thank you. I shall review the report from my surgery to see if a  sacrospinous ligament fixation was done.
And what about the MR neurography scan? Do you have knowledge of anyone having it performed and if yes, were the results postitive in terms of finding a point of compression