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Re: vulvar steroid injectionsFrom: dahmd@gate.netWed Apr 3 09:36:02 1996
>>I have treated 2 patients recently who had persistent pain after episiotomy >>repairs due to scar tissue at the perineum, and used a combination of >>depo-medrol and marcaine injected into the tender area, similar to therapy >>used for "trigger points." Both patients wanted to hold off on surgery as >>long as possible, and the injections (1 for each patient) have thus far worked >>great (no more dypareunia). It was ridiculously simple. >>Ashley Hill >>D. Ashley Hill, M.D. >>dahmd@gate.net
>Ashley, could you elaborate a little more on this technique- dosages,etc? Robert: I got the "formula" from an anesthesiologist who is a trigger point expert, at our nearby chronic pain clinic. You take 1cc of 40mg Depo-Medrol (it comes in a vial) and mix it with 9cc of 0.5% Marcaine, shake it up to mix it, and inject however much it takes to form a bleb throughout the affected area. In my "vast experience" of 2 patients, it took 4-5cc of this mixture for each patient. I then check with a needle tip to ensure no sensation around the previously tender area, and bring them back in a few weeks to check out the results. The pain expert told me it sometimes takes 2 or 3 treatments to get a cure, but he has not had to do more than 3. I can't imagine any complications except the tiny chance of infection or hitting a vessel. If anyone on the list has additional advice, I would love to hear it. Thanks, Ashley D. Ashley Hill,M.D. dahmd@gate.net
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