Persistent Abdominal Pain After Hysterectomy: Understanding Nerve Entrapment

Question
Hi there,
Because I have had some continued pain 3 years after a hysterectomy for endometriosis (after other medical/surgical therapies were unsuccessful), I have been doing a lot of reading.  I have read about abdominal wall pain/nerve entrapment syndromes that can be diagnosed using Carnett's Sign and/or a trial of an injection of a local anaesthetic.  
I just moved and saw a new GP last week.  I asked him about this abdominal wall pain.  He was unfamiliar with Carnett's Sign.  He asked me what I thought he should do about it.  I froze, as I am unaccustomed to any doctor asking ME what they should do!  I want to prepare for my appointment with him in 2 weeks.  Is it reasonable to ask him to try to locate the tender spot and then inject it with a local anaesthetic?  
Nevertheless, my new GP has started me on Topamax, which in the past, has effectively managed much of my pain.
Thanks for your time!
Carmen

Answer
I often ask patients what they think they should do, since often they have read and have some ideas... whether right or wrong, it gives us a common starting point on evaluations and testing.......   pelvic pain, along with endometriosis is a complicated problem.... sometimes easy to fix, most of the time complicated with some things helping to make it better.    Topamax is an interesting drug... I am not clear on what you and your doctor are trying to accomplish with it......  talk to your doctor.... it sounds like your doc is honest, which is a good thing, .... he can always look up different signs and symptoms and tests and put them together to help.....