Dr. Allyson Shrikhande

Episode 25

Post-Op Pelvic Floor Pain with Dr. Allyson Shrikhande

In Episode 25, Erin Everett, NP-C, interviews Dr. Allyson Shrikhande,  Chief Medical Officer at Pelvic Rehabilitation Medicine about her patient centered approach to treating common post-op pelvic floor pain after gender affirming surgeries. Topics include interstitial cystitis, vaginismus, pain with intercourse, endometriosis and PCOS, and chronic prostatitis.

About This Episode

In episode twenty-five of Exclusively Inclusive, Erin Everett, NP, interviews Dr. Shrikhande, board certified physical medicine and rehabilitation specialist and Chief Medical Officer at Pelvic Rehabilitation Medicine, about the many common pelvic floor issues she encounters and treats at her practice. The interview, originally recorded in late March 2021, covers topics including interstitial cystitis, vaginismus, pain with intercourse, endometriosis and PCOS, and chronic prostatitis. Throughout the episode, Dr. Shrikhande outlines her patient centered, inclusive, and multimodal approach to helping patients find relief from pelvic pain.

Early in the episode, the two discuss Dr. Shrikhande’s recent focus on helping patients prepare for and recover from gender affirming surgery with pelvic floor therapy. Though post-op pelvic floor therapy is common, Dr. Shrikhande encourages patients who might already have issues with their pelvis or pelvic floor to also come in as preparation for surgery, as working on these issues could help make recovery from surgery, at least in the pelvic area, a bit smoother.

Later in the episode, Erin talks to Dr. Shrikhande about her experience and approach to treating interstitial cystitis, by addressing muscle nerve dysfunction, which helps calm the nerves and muscles in the bladder to help patients go to the bathroom less often. Sometimes patients who think they have IC might have bladder pain syndrome, so Dr. Shrikhande emphasizes the importance of getting a diagnosis for IC with a urologist.

Further in the episode, Erin asks Dr. Shrikhande about her experience treating vaginismus among the trans male population. Dr. Shrikhande explains that she has seen this in her practice and approaches vaginismus by treating muscle nerve dysfunction with relaxation techniques and sometimes even a topical muscle relaxer like topical ketamine. The approach is multimodal, to help address the patient’s specific pelvic pain from all angles.

Rounding out the episode, the two discuss one of the most common chief complaints among Dr. Shrikhande’s patients: pain with intercourse. To treat pain with intercourse, Dr. Shrikhande notes that she, once again, treats the nerve dysfunction and muscle spasms to help patients enjoy a better experience during intercourse and relief from pelvic pain.

Related to this topic, Dr. Shrikhande notes that her practice also helps treat pain associated with endometriosis and PCOS. While patients with endometriosis have to deal with plaques attaching to their GI system that add to pelvic pain, patients with PCOS often respond very well to pelvic floor therapy to help with pelvic guarding, as do cis male patients who experience chronic prostatitis symptoms.

Post-Op Pelvic Floor Pain with Dr. Allyson Shrikhande

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