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Pudendal neuropathy

Roberto Cosimo Melcangi, Daniele Santi, Roberto Spezzano, Maria Grimoldi, Tommaso Tabacchi, Maria Letizia Fusco, Silvia Diviccaro, Silvia Giatti, Giuseppe Carrà, Donatella Caruso, Manuela Simoni, Guido Cavaletti
Recent reports show that, in patients treated with finasteride for male pattern hair loss, persistent side effects including sexual side effects, depression, anxiety and cognitive complaints may occur. We here explored the psychiatric and andrological features of patients affected by post-finasteride syndrome (PFS) and verified whether the cerebrospinal fluid (CSF) and plasma levels of neuroactive steroids (i.e., important regulators of nervous function) are modified. We found that eight out of sixteen PFS male patients considered suffered from a DSM-IV major depressive disorder (MDD)...
April 10, 2017: Journal of Steroid Biochemistry and Molecular Biology
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
Liam A Devane, Eric Lucking, Judith Evers, Maria Buffini, S Mark Scott, Charles H Knowles, P Ronan O'Connell, James F X Jones
AIMS: To develop a behavioural animal model of faecal continence and assess the effect of retrouterine balloon inflation (RBI) injury. RBI in the rat causes pudendal neuropathy, a risk factor for obstetric related faecal incontinence in humans. METHOD: Video-tracking healthy rats (n=12) in a cage containing a latrine box was used to monitor their defaecatory behaviour index (DBI) over 2 weeks. DBI (range 0 - 1) was devised by dividing the defaecation rate (pellets/hour) outside the latrine by that of the whole cage...
March 20, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Alberto Tagliafico, Bianca Bignotti, Carlo Martinoli
This article is a practical review update on ultrasound (US)-guided interventional procedures on peripheral nerves. Technical considerations, biopsy techniques, and some examples of injections are described. US is considered a safe imaging guidance for interventional procedures, due to its high spatial resolution and the possibility to image the needle and inject drugs in real time. US-guided injections could be considered a diagnostic and therapeutic option in the most common neuropathy, before or as an alternative to surgery...
November 2016: Seminars in Musculoskeletal Radiology
Burcu Örmeci, Egemen Avcı, Çigdem Kaspar, Özlem Eranıl Terim, Tibet Erdoğru, A Emre Öge
OBJECTIVE: To examine the diagnostic value of pudendal somatosensory evoked potentials (SEPs) in pudendal nerve entrapment (PNE) neuropathy by stimulating the 2 sides separately after provocation by a standard sitting position. Routine pudendal SEPs performed in the supine position with bilateral simultaneous stimulation may fail to show the abnormality because the complaints of PNE appear or worsen in the sitting position. METHODS: Forty-nine patients with PNE and 16 controls were included...
January 2017: Urology
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...
January 1, 2016: Acta Radiologica
Vibhor Wadhwa, Kelly M Scott, Shai Rozen, Adam J Starr, Avneesh Chhabra
Chronic pelvic pain is a disabling condition that affects a large number of men and women. It may occur after a known inciting event, or it could be idiopathic. A common cause of pelvic pain syndrome is neuropathy of the pelvic nerves, including the femoral and genitofemoral nerves, ilioinguinal and iliohypogastric nerves, pudendal nerve, obturator nerve, lateral and posterior femoral cutaneous nerves, inferior cluneal nerves, inferior rectal nerve, sciatic nerve, superior gluteal nerve, and the spinal nerve roots...
September 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
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
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...
2016: Pain Physician
D Ozkan, T Akkaya, S Yildiz, A Comert
Chronic pelvic pain is a condition that can be caused by pudendal neuralgia, interstitial cystitis, piriformis syndrome and neuropathy of the ilioinguinal, iliohypogastric and genitofemoral nerves. Based on three case reports this article discusses the clinical effectiveness of pulsed high-frequency radiofrequency (PRF) treatment applied to the pudendal nerve under ultrasound guidance in medicinally treated patients with chronic pelvic pain.
February 2016: Der Anaesthesist
Marc Possover, Axel Forman
BACKGROUND: Some patients have pelvic, pudendal, or low lumbar pain radiating into the legs that is worse while sitting but differs from pudendal neuralgia. The purpose of this study was to present a new clinical entity of neuropathic pelvic pain by pelvic neuro-vascular entrapment. OBJECTIVES: To report about the locations of predilection for pelvic neurovascular entrapment. STUDY DESIGN: Prospective cohort pre- and post-intervention. SETTING: University referral unit specializing in advanced gynecological surgery and neuropelveology...
November 2015: Pain Physician
Maxime M van Meegdenburg, Erik Heineman, Paul M A Broens
BACKGROUND: Conscious external anal sphincter contraction is mediated by the pudendal nerve. Pudendal neuropathy is, therefore, believed to result in fecal incontinence. Until urge sensation is experienced, fecal continence is maintained by unconscious external anal sphincter contraction, which is regulated by the anal-external sphincter continence reflex. The innervation of unconscious contraction is yet unknown. OBJECTIVE: We aimed to determine whether unconscious contraction is mediated by the pudendal nerve and whether age influences unconscious contraction...
December 2015: Diseases of the Colon and Rectum
Pedro A Maldonado, Kathleen Chin, Alyson A Garcia, Marlene M Corton
OBJECTIVE: The objective of the study was to examine the anatomic variation of the pudendal nerve in the pelvis, on the dorsal surface of the sacrospinous ligament, and in the pudendal canal. STUDY DESIGN: Detailed dissections of the pudendal nerve were performed in unembalmed female cadavers. Pelvic measurements included the distance from the origin of the pudendal nerve to the tip of ischial spine and the nerve width at its origin. The length of the pudendal canal was measured...
November 2015: American Journal of Obstetrics and Gynecology
Hakan Kocaoğlu, Kerem Başarır, Ramazan Akmeşe, Yasemin Kaya, Muzaffer Sindel, Nurettin Oğuz, Mehmet S Binnet
PURPOSE: To investigate the site of pudendal nerve compression and the relation between traction force and abduction angle regarding pressure levels at setup for hip arthroscopy. METHODS: A total of 17 hips from 9 fresh-frozen cadavers (6 male and 3 female cadavers) were used. The pudendal nerves were dissected, and 3 FlexiForce force sensors (Tekscan, Boston, MA) were implanted on the pudendal nerve where the inferior rectal nerve, perineal nerve, and dorsal nerve of the clitoris/penis emerge...
October 2015: Arthroscopy: the Journal of Arthroscopic & related Surgery
Kumaran Thiruppathy, Adeel Bajwa, Kean Guan Kuan, Charles Murray, Richard Cohen, Anton Emmanuel
OBJECTIVE: Fecal incontinence (FI) occurs in up to 20% of diabetes mellitus (DM) patients. Rectoanal inhibitory reflex (RAIR) is an enteric anorectal reflex that reflects the integrity of mechanisms in the physiology of FI. We aimed to investigate whether diabetic patients with FI, not constipation, had prolongation of RAIR and altered gut-specific autonomic tone. METHODS: In this prospective case-matched study 31 type I DM (19 FI and 12 constipation) and 42 type II DM (26 FI and 16 constipation)...
June 2015: Journal of Digestive Diseases
J N Cohan, A B Chou, M G Varma
AIM: Little is known about men with faecal incontinence. We compared clinical findings and quality of life in a large cohort of men and women with faecal incontinence to guide its evaluation and treatment in men. METHOD: We analysed men and women presenting to a tertiary referral centre with faecal incontinence between 2005 and 2013. Demographics, physical examination, anorectal physiology testing, symptom severity (Fecal Incontinence Severity Index) and quality of life (Fecal Incontinence Quality of Life Scale) were recorded...
September 2015: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Bernardo Ventimiglia, Matilde Sigona, Agata Di Dio, Tiziana Puglisi, Giuseppe Costantino
INTRODUCTION AND OBJECTIVE: The urinary incontinence after radical prostatectomy is secondary to neuropathy with various degrees from neurapraxia to neurotmesis. We propose to apply therapeutic and rehabilitative models appropriate to the diagnosis and to evaluate the results. MATERIALS AND METHODS: We examined 79 homogeneous patients with urinary incontinence after radical prostatectomy. After having defined the diagnosis by a urodynamic examination, the study of pudendal nerve somatosensory-evoked potentials (SEPs) and perineal electromyography (EMG), patients were divided into four groups (A; B; C; D) and submitted to different clinical drug protocols and rehabilitation...
January 2015: Urologia
Dominique Leblanc, Nathalie McFadden, Michel Lebel, Ghislain Devroede
No abstract text is available yet for this article.
April 2015: International Journal of Colorectal Disease
Satish S C Rao, Enrique Coss-Adame, Kasaya Tantiphlachiva, Ashok Attaluri, Jose Remes-Troche
BACKGROUND: Neurologic dysfunction causes fecal incontinence, but current techniques for its assessment are limited and controversial. OBJECTIVE: The purpose of this work was to investigate spino-rectal and spino-anal motor-evoked potentials simultaneously using lumbar and sacral magnetic stimulation in subjects with fecal incontinence and healthy subjects and to compare motor-evoked potentials and pudendal nerve terminal motor latency in subjects with fecal incontinence...
May 2014: Diseases of the Colon and Rectum
Mauro Cervigni, Franca Natale
OBJECTIVES: Bladder pain syndrome/interstitial cystitis, a chronic inflammatory condition of the bladder, is the source of pain in over 30% of female patients with chronic pelvic pain. The aim of the present study was to evaluate the most frequent associations between bladder pain syndrome/interstitial cystitis and gynecological disorders. METHODS: A literature review of the previous 10 years was carried out to evaluate the incidence of gynecological diseases in patients with bladder pain syndrome/interstitial cystitis...
April 2014: International Journal of Urology: Official Journal of the Japanese Urological Association
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