Question: Dec'19- Terrible UTI, treated with Monocef 1g, >20 doses. Two more UTI, treated with oral antibiotic within March'20.
April '20 - 1. Uncomfortable feeling in vagina - UTI tested negative.
2. Uncomfortable pain(stuffiness) started in groin that I have to squish my vagina with palms & sit silently. Also, lower back pain, radiating in legs and whole body discomfort.
3. Increased passing of stool 7-8 times and then 12-13 times over time, extremely nauseous. Vomiting or passing stool after eating slightest of food. Appetite loss too, and afraid to have food.
4. Bowel texture changing very often, from diarrhoea to constipation with no apparent relation to food along with fresh blood or kind of dysentery type Sticky old blood that was not solved with dysentery meds.
5. Since May, passing stool whenever pain increases. - Huge Pelvic pain & (groin pain) started reducing over time.
6. Stinging pelvic pain everytime I get up from chair or toilet.
7. Sudden Food intolerances And stomach gets washed like Bowel prep with huge huge abdominal pain. Never found what those intolerances were for.
8. All of the pain above like pelvic pain, back pain, groin stuffiness were 24 hours thing.
8. Period came late by 20 days on April with hugely reduced bleeding, almost like spotting followed by Low BP, Vomiting, Huge pelvic pain, back pain. Also, I face leg pain from knee to ankle since menarche.
9. Visited numerous Gynaecologist, most called me Psychosomatic and some put me in OCP-was in OCP for 1.5 months, which relieved the symptoms a bit though still bothering enough. Upon being referred to a GI, Colospa-X was suggested which helped a little with frequency of bowel & blood. Also, nothing was found in endoscopy & colonoscopy.
10. Over time, Tremendous Rectal pain as if someone is twisting inside while bowel movement.
11. Once or twice felt pain in urination which solved with drinking of water.
12. Huge bloating but no endo belly.
13. Since November '20 - Having a uncomfortable pain that I can't describe started happening in hips, that makes sitting harder after 40-50 mins XXXXXXX stretching and lying down would help. But the pain was on and off, not exactly of everyday.
14. At times, rare though, urge to have sex as if it will release the uncomfortable pain in vagina.
15. Unable to sneeze or cough or laugh in pelvic pain.
16. Buttock pain increases when bowel doesn't pass. Also I started feeling like, that stool is sitting in the lower part of Rectum but I am unable to pass. I have history of manual evacuation since many years (5-6), also I have chronic constipation.
17. A point that I missed, upon moving around the houses even a little, I would get huge back pain that radiates down to right / left or both but mostly right leg. (laterally, sometimes back, sometimes front) that almost makes me disabled.
From December '20 - All the pain became intolerable especially pelvic pain. I tried to find my ways to a diagnosis.
Jan'21- A gynaecologist clinically diagnosed me with Endometriosis and put me on Lupron 3.75 mg, however I wasn't happy with such option of chemical menopause. Digged further. Found an endometriosis excision specialist.

18. From December / XXXXXXX - I had been having stinging vaginal pain (can't point out place) & rare anal pain which didn't bother me much. It was for 2-3 seconds, like once in a week /10 days mostly at bed time.

On Feb'20 - I underwent excision surgery - Found cystic and scarring endometriosis on posterior leaves of broad ligament, Varicose veins in broad ligaments & coagulated pelvic veins, severely retroverted uterus for which plication of round ligaments were done. Also, a diagnostic cystoscopy with no IC found
Here comes the post-Op symptoms - -

1. Right after waking up from anaesthesia, started feeling huge bladder & UT pain and was unable to pass urine all at a time. The house doctor asked to drink more water which didn't solve the pain.
2. Beside this, started having crazy electric shock / pin pricking / sharp twisting in my vagina - Clitoris, Labia Minora, Urethra, vaginal orifice & mons pubis and rarely in anus almost in any posture at any time. It's like, for few second every 10 minutes i will get a flare up of electric shock that will make me almost collapse. Pain - 10/10. Still relevant
3. I observed urinary frequency and urgency in short of, when little amount of urine starts filling in bladder, I feel huge pain in clitoris since the time of waking up. It's still relevant after 2.5 months post op.
4. At some point, started having pain before, during and after urine passing.
5. Huge pelvic pain, more than pre op (two sides and mid) sometimes electric shock that opioids can't control.
5. Increased food intolerances after surgery to almost everything.
6. Low back pain, buttock pain that radiates towards legs (mostly right), laterally, front and back of thigh and makes me almost disabled.
7. False sense of urination and even sometimes wish to urinate more after passing urine, though nothing comes out. Still relevant
8. Clitoral stimulation often hurts, there's no post orgasmic pain. But getting orgasm has been difficult, not sure if because of stress. Relevant still.

9. Unable to sneeze or cough in pelvic and vaginal pain.

10. Can't strain, not even a bit, sometimes, during bowel pass. Hence, manual evacuation again.
11. The electric shock type pain reduced overtime on its own but sometime in the day flares extreme. It's not continuous, happens few minutes - (2-3) hour in a day. Happens two sides but not at the same time. One side at a time and having same intensity of each other.

12. Can't fart in vaginal pain. A deep twisting pain sitting inside the vagina.
13. Been to MR-NEUROGRAPHY, one radiologist couldn't find anything. And other one has said, "It is Possible / Probably pudental nerve compression due to vascular congestion l".

14. Been to urologist who couldn't find any apparent reason to my urinary issues. Uro dynamic study showed normal.
15. Have been to pain specialist who has given sack of pain medications but I doubt if they're really working.
16. Have been to GI who has given diagnosis of IBS-M and Pelvic floor dyssynergia.
17. I have been told to do Pudental nerve block.

Have you had received my previous reply?
Also, I have few questions like is Pelvic floor muscle spasm same pelvic floor dysfunction? Because today my actual surgeon sent me a text of me having not much dysfunction at pelvis.
Another thing, radiologist sent me MRI+MRN report attaching that. Not sure if needed

No muscle relaxers tried as of I know.
Pregabalin 75*2, Etoshine 60*1, Duloxetine 30*2, Paracetamol 1 g*4, Ibuprofen 600 mg, MIRBEG-25, Flaboxate - 200.
Other meds - Propranolol 10 mg, Carbimazole 10 mg, Fluonil 20, Lithosun 400 mg, Schizonil 1 mg.
I have a light sleep due to hyperthyroidism & stress. And I feel the Clitoral discomfort n pain which leads me to urinal as to find little relief - though little urine comes out..
Yes, I wake up to go to urine quite a few times with or without Clitoral pain / vaginal pain just sometimes half sleep with consciousness.
Have heard about MPT but haven't tried. Willing to try certainly if you suggest.
Pain killer like Paracetamol or Ibuprofen helps better than Pregabalin.
Pelvic Floor PT was suggested as part of endometriosis journey in rehabilitation, but most of them called psychosomatic, to think positive, or sometimes to meditate. Breathing exercise has been suggested too but sometimes even breathing makes the pain worse.
No botox done.
Can you please tell me if i will ever get fit and well like any other teenager with almost normal bodily function? You used a word permanent
About MPT, should i choose someone with just MPT degree or someone additionally with good success rate of such case? Not getting someone with the latter in XXXXXXX if you have anyone to suggest even out of state, please let me know.

The Dicom File of MRI+MRN has multiple snaps. I am unsure how i can send it over here. I can share the link here- https://drive.google.com/folderview?id=16Ngy-zUl7R8ntn5NN7NFkTcGIh-1-tDZ (Pelvis MRI)
MRN - https://drive.google.com/folderview?id=1urrnKivNEtq8YMLP18L178exHa0d7NXv
The radiologist has said shortly, "it is possible pudendal nerve entrapment due to vascular congestion
The options are pudendal nerve block and if symptoms are relieved ovarian venography and embolisation can be done".

So, if a block doesn't work, could you please sum up what I should try for then? Thank you