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Pudendal neuralgia

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https://www.readbyqxmd.com/read/29106051/treatment-of-chronic-refractory-neuropathic-pelvic-pain-with-high-frequency-10-kilohertz-spinal-cord-stimulation
#1
Thomas Simopoulos, Jason Yong, Jatinder S Gill
Chronic non-malignant pain perceived in the pelvic region commonly presents as a diagnostic challenge and is often difficult to manage. Treatment options are delayed as well as limited. The prevalence in the United States and the United Kingdom has been estimated to range from 14.7 % to 24% respectively (1, 2). Common chronic pelvic pain syndromes include interstitial cystitis, chronic prostatitis, coccygodynia, vulvodynia, chronic proctalgia, and pudendal neuralgia. This article is protected by copyright. All rights reserved...
November 6, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/29072775/a-new-endoscopic-minimal-invasive-approach-for-pudendal-nerve-and-inferior-cluneal-nerve-neurolysis-an-anatomical-study
#2
Stéphane Ploteau, Roger Robert, Luc Bruyninx, Jérome Rigaud, Katleen Jottard
AIM: To describe a new minimal invasive approach of the gluteal region which will permit to perform neurolysis of the pudendal and cluneal nerves in case of perineal neuralgia due to an entrapment of these nerve trunks. METHOD: Ten transgluteal approaches were performed on five cadavers. Relevant anatomic structures were dissected and further described. Neurolysis of the pudendal nerve or cluneal nerves were performed. Landmarks for secure intraoperative navigation were indicated...
October 26, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28934788/repeated-ganglion-impar-block-in-a-cohort-of-83-patients-with-chronic-pelvic-and-perineal-pain
#3
Quentin-Come Le Clerc, Thibault Riant, Amelie Levesque, Jean-Jacques Labat, Stephane Ploteau, Roger Robert, Marie-Aimee Perrouin-Verbe, Jerome Rigaud
BACKGROUND: The ganglion impar is the first pelvic ganglion of the efferent sympathetic trunk that relays pelvic and perineal nociceptive messages and therefore constitutes a therapeutic target. OBJECTIVE: The objective of this single-center study was to evaluate the effectiveness of 3 repeated ganglion impar blocks in patients with chronic pelvic and perineal pain on intention-to-treat. STUDY DESIGN: Retrospective single-center study. SETTING: We reviewed the medical records of 83 patients with chronic refractory pelvic and perineal pain...
September 2017: Pain Physician
https://www.readbyqxmd.com/read/28676364/neurogenic-pelvic-pain
#4
REVIEW
Nicholas Elkins, Jason Hunt, Kelly M Scott
Pelvic neuralgias frequently cause severe pain and may have associated bladder, bowel, or sexual dysfunctions which also impact quality of life. This article explores the etiology, epidemiology, presentation and treatment of common causes of neurogenic pelvic pain, including neuralgia of the border nerves (ilioinguinal, iliohypogastric, and genitofemoral), pudendal neuralgia, clunealgia, sacral radiculopathies caused by Tarlov cysts, and cauda equina syndrome. Treatment of pelvic neuralgia includes conservative measures such as pelvic physical therapy, lifestyle modification, and medications with escalation to more invasive and novel treatments such as nerve blocks, radiofrequency ablation, cryoablation, neuromodulation and neurectomy/neurolysis if conservative treatments are ineffective...
August 2017: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/28643681/-magnetic-resonance-neurography-for-the-identification-of-pudendal-neuralgia
#5
Claudia P Cejas, Susana Bordegaray, Nadia I Stefanoff, Cecilia Rollán, Inés T Escobar, Pablo Consigliere Rodríguez
The pudendal nerve entrapment is an entity understudied by diagnosis imaging. Various causes are recognized in relation to difficult labors, rectal, perineal, urological and gynecological surgery, pelvic trauma fracture, bones tumors and compression by tumors or pelvic pseudotumors. Pudendal neuropathy should be clinically suspected, and confirmed by different methods such as electrofisiological testing: evoked potentials, terminal motor latency test and electromyogram, neuronal block and magnetic resonance imaging...
2017: Medicina
https://www.readbyqxmd.com/read/28553916/-pudendal-neuralgia-diagnosed-by-electrophysiological-examination
#6
Hatice Isik, Anders Fuglsang-Frederiksen, Kirsten Pugdahl, Hatice Tankisi
A 62-year-old man with suspected pudendal neuralgia was admitted to a department of clinical neurophysiology for examination. The patient had experienced increasingly altered sensations in the groin, particularly in form of pain in a sitting position. The neurophysiological studies substantiated the suspicion. Pudendal neuralgia is a painful neuropathic condition. The most frequent cause is entrapment of the pudendal nerve in the pelvis. The diagnosis is made clinically by using Nantes criteria, and neurophysiological studies of the perineum are important supplements when pudendal nerve entrapment is suspected...
May 22, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28532963/fully-endoscopic-interlaminar-and-transforaminal-lumbar-discectomy-analysis-of-47-complications-encountered-in-a-series-of-835-patients
#7
Ali Güven Yörükoğlu, Burcu Göker, Alican Tahta, Mehmet Osman Akçakaya, Aydın Aydoseli, Pulat Akın Sabancı, Yavuz Aras, Görkem Alkır, Altay Sencer, Murat Imer, Nail Izgi, Ali Tuncay Canbolat
OBJECTIVE: To report perioperative complications in fully endoscopic lumbar discectomy (FELD). METHODS: From September 2010 to November 2016, 835 patients underwent FELD. In total, 865 disc levels were operated on. Of the 835 patients, the transforaminal (TF) approach was used in 174 patients, while 691 patients were operated on using the interlaminar (IL) approach. Surgical complications occurred in 47 patients, which were retrospectively analyzed. RESULTS: Neurological deficits occurred in six patients...
May 19, 2017: Neurocirugía
https://www.readbyqxmd.com/read/28339446/pulsed-radiofrequency-ablation-of-pudendal-nerve-for-treatment-of-a-case-of-refractory-pelvic-pain
#8
Vadim Petrov-Kondratov, Avneesh Chhabra, Stephanie Jones
Pudendal neuralgia (PN) is a result of pudendal nerve entrapment or injury, also called "Alcock syndrome." Pain that develops is often chronic, and at times debilitating. If conservative measures fail, invasive treatment modalities can be considered. The goal of this case report is to add to a small body of literature that a pulsed radiofrequency (PRF) ablation can be effectively used to treat PN and to show that high resolution MR neurography imaging can be used to detect pudendal neuropathy. CASE PRESENTATION: We present a case of a 51-year-old woman with 5 years of worsening right groin and vulva pain...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28236130/entrapment-of-the-posterior-femoral-cutaneous-nerve-and-its-inferior-cluneal-branches-anatomical-basis-of-surgery-for-inferior-cluneal-neuralgia
#9
Stéphane Ploteau, Céline Salaud, Antoine Hamel, Roger Robert
PURPOSE: The apparent failure of pudendal nerve surgery in some patients has led us to suggest the possibility of entrapment of other adjacent nerve structures, leading to the concept of inferior cluneal neuralgia. Via its numerous collateral branches, the posterior femoral cutaneous nerve innervates a very extensive territory including the posterior surface of the thigh, the infragluteal fold, the skin over the ischial tuberosity, but also the lateral anal region, scrotum or labium majus via its perineal branch...
February 24, 2017: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/28072808/use-of-high-concentration-capsaicin-patch-for-the-treatment-of-pelvic-pain-observational-study-of-60-inpatients
#10
Amelie Levesque, Thibault Riant, Jean-Jacques Labat, Stephane Ploteau
BACKGROUND: Chronic pelvic, perineal and gluteal neuralgia is often experienced in a similar way to neuropathic pain, in the territories of four nerves: ilio-inguinal, pudendal, inferior cluneal and posterior gluteal nerves. These pains are often refractory to medical treatment based on the use of systemic molecules with disabling adverse effects and surgical procedure may be necessary. OBJECTIVE: The objective of this study was to evaluate the efficacy and safety of treatment with a high-concentration capsaicin patch in these indications...
January 2017: Pain Physician
https://www.readbyqxmd.com/read/28072805/anatomical-variants-of-the-pudendal-nerve-observed-during-a-transgluteal-surgical-approach-in-a-population-of-patients-with-pudendal-neuralgia
#11
Stephane Ploteau, Marie-Aimee Perrouin-Verbe, Jean-Jacques Labat, Thibault Riant, Amelie Levesque, Roger Robert
BACKGROUND: Several studies have described the course and anatomical relations of the pudendal nerve. Several surgical nerve decompression techniques have been described, but only the transgluteal approach has been validated by a prospective randomized clinical trial. The purpose of this study was to describe the course of the nerve and its variants in a population of patients with pudendal neuralgia in order to guide the surgeon in the choice of surgical approach for pudendal nerve decompression...
January 2017: Pain Physician
https://www.readbyqxmd.com/read/27721781/pudendal-neuralgia-as-the-initial-manifestation-of-infiltrative-sacrococcygeal-chordoma
#12
Sira Carrasco García de León, José Manuel Flores Barragán, Natalia Villasanti Rivas
Sacrococcygeal chordoma is a malignant tumour originating from remnants of the notochord. Chordomas are slow-growing tumours whose symptoms develop insidiously. We present the case of a 72-year-old woman with a 6-month history of genital pain radiating to the perianal area and exacerbating when she was in a sitting position. MRI and PET studies revealed a large mass in the sacrococcygeal region causing bone destruction and invasion of neurovascular structures. The immunohistochemical study of the surgical specimen determined it to be chordoma...
May 2016: Case Reports in Neurology
https://www.readbyqxmd.com/read/27664277/pudendal-nerve-and-branch-neuropathy-magnetic-resonance-neurography-evaluation
#13
REVIEW
Vibhor Wadhwa, Aws S Hamid, Yogesh Kumar, Kelly M Scott, Avneesh Chhabra
Pudendal neuralgia is being increasingly recognized as a cause of chronic pelvic pain, which may be related to nerve injury or entrapment. Due to its complex anatomy and branching patterns, the pudendal nerve abnormalities are challenging to illustrate. High resolution 3 T magnetic resonance neurography is a promising technique for the evaluation of peripheral neuropathies. In this article, the authors discuss the normal pudendal nerve anatomy and its variations, technical considerations of pudendal nerve imaging, and highlight the normal and abnormal appearances of the pudendal nerve and its branches with illustrative case examples...
June 2017: Acta Radiologica
https://www.readbyqxmd.com/read/27626835/nontraumatic-testicular-pain-due-to-sacroiliac-joint-dysfunction-a-case-report
#14
James E Leone, Steve Middleton
OBJECTIVE: To discuss the case of a 49-year-old man who presented to the sports medicine staff with pelvic pain of 10 years' duration consistent with pudendal neuralgia. BACKGROUND: Testicular pain in men is often provoked by direct trauma or may indicate an oncologic process. DIFFERENTIAL DIAGNOSIS: Epididymitis, athletic pubalgia, testicular tumor, sacroiliac joint dysfunction, lumbar radiculopathy. TREATMENT: The patient responded positively to treatment and rehabilitation to restore normal mechanics to the lumbo-pelvic-hip complex...
August 2016: Journal of Athletic Training
https://www.readbyqxmd.com/read/27606282/pudendal-nerve-entrapment-syndrome-due-to-a-ganglion-cyst-a-case-report
#15
Jae Wook Lee, Sung-Moon Lee, Dong Gyu Lee
Pudendal nerve entrapment syndrome is an unusual cause of chronic pelvic pain. We experienced a case of pudendal neuralgia associated with a ganglion cyst. A 60-year-old male patient with a tingling sensation and burning pain in the right buttock and perineal area visited our outpatient rehabilitation center. Pelvis magnetic resonance imaging showed the presence of multiple ganglion cysts around the right ischial spine and sacrospinous ligament, and the pudendal nerve and vessel bundle were located between the ischial spine and ganglion cyst at the entrance of Alcock's canal...
August 2016: Annals of Rehabilitation Medicine
https://www.readbyqxmd.com/read/27465823/adding-corticosteroids-to-the-pudendal-nerve-block-for-pudendal-neuralgia-a-randomised-double-blind-controlled-trial
#16
J J Labat, T Riant, A Lassaux, B Rioult, B Rabischong, M Khalfallah, C Volteau, A-M Leroi, S Ploteau
OBJECTIVE: To compare the effect of corticosteroids combined with local anaesthetic versus local anaesthetic alone during infiltrations of the pudendal nerve for pudendal nerve entrapment. DESIGN: Randomised, double-blind, controlled trial. SETTING: Multicentre study. POPULATION: 201 patients were included in the study, with a subgroup of 122 women. METHODS: CT-guided pudendal nerve infiltrations were performed in the sacrospinous ligament and Alcock's canal...
January 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/27284095/combined-site-specific-sacral-neuromodulation-and-pudendal-nerve-release-surgery-in-a-patient-with-interstitial-cystitis-and-persistent-arousal
#17
Georgina Louise Armstrong, Thierry Georges Vancaillie
A variety of neuromodulation approaches have been described for the management of pelvic neuropathies, including interstitial cystitis, pudendal neuralgia and persistent genital arousal disorder. The benefits of a combined sacral and pudendal nerve neuromodulator has yet to be explored for these patients. In this report, we describe the case of a 35-year-old woman with a complex pelvic neuropathy resulting in urinary, sexual and gastro-intestinal dysfunction. She presented with an established diagnosis of interstitial cystitis; however, she also fulfilled diagnostic criteria for pudendal neuralgia and persistent genital arousal disorder...
June 9, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27250921/pudendal-neuralgia-after-pelvic-surgery-using-mesh-case-reports-and-laparoscopic-pudendal-nerve-decompression
#18
Eyup Burak Sancak, Egemen Avci, Tibet Erdogru
Persistent pain after vaginal mesh surgery is a rare and agonizing entity that has devastating consequences for the patient's quality of life. Many etiologies have been blamed including nerve injuries and entrapments. Pudendal neuralgia is a rare chronic neuropathic pain syndrome in the anatomical territory of the pudendal nerve. Various treatment options, such as medication management, physiotherapy, nerve blocks, decompression surgery and neuromodulation, have been used, but the most appropriate treatment for pudendal neuralgia has not yet been determined...
September 2016: International Journal of Urology: Official Journal of the Japanese Urological Association
https://www.readbyqxmd.com/read/27228517/measuring-the-quality-of-pudendal-nerve-perineural-injections
#19
Stanley Antolak, Christopher Antolak, Lisa Lendway
BACKGROUND: Pudendal neuropathy is a tunnel syndrome characterized by pelvic pain and may include bowel, bladder, or sexual dysfunction or a combination of these. One treatment method, pudendal nerve perineural injections (PNPIs), uses infiltration of bupivacaine and corticosteroid around the nerve to provide symptom relief. Bupivacaine also anesthetizes the skin in the receptive field of the nerve that is injected. Bupivacaine offers rapid pain relief for several hours while corticosteroid provides delayed pain control often lasting 3 to 5 weeks...
May 2016: Pain Physician
https://www.readbyqxmd.com/read/27008300/pudendal-neuralgia-due-to-pudendal-nerve-entrapment-warning-signs-observed-in-two-cases-and-review-of-the-literature
#20
Stephanie Ploteau, Claire Cardaillac, Marie-Aimee Perrouin-Verbe, Thibault Riant, Jean-Jacques Labat
Pudendal neuralgia is a chronic neuropathic pelvic pain that is often misdiagnosed and inappropriately treated. The Nantes criteria provide a basis for the diagnosis of pudendal neuralgia due to pudendal nerve entrapment. The 5 essential diagnostic criteria are pain situated in the anatomical territory of the pudendal nerve, worsened by sitting, the patient is not woken at night by the pain, and no objective sensory loss is detected on clinical examination. The fifth criterion is a positive pudendal nerve block...
March 2016: Pain Physician
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