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Pudendal Neuralgia: Two case reports with laparoscopic nerve decompression

Pudendal neuralgia (PN) is a rare and underestimated condition. The reported incidence by the International Pudendal Neuropathy Association is 1/100000. However, the actual rate may be significantly higher, with a propensity for women. It is most frequently caused by an entrapment of the nerve at th...

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Autores principales: Habib, N, Centini, G, Klebanoff, J.S., Fernandes, R, Giorgi, M, Moawad, G.N., Bakar, J
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Universa Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10410660/
https://www.ncbi.nlm.nih.gov/pubmed/37436058
http://dx.doi.org/10.52054/FVVO.15.2.073
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author Habib, N
Centini, G
Klebanoff, J.S.
Fernandes, R
Giorgi, M
Moawad, G.N.
Bakar, J
author_facet Habib, N
Centini, G
Klebanoff, J.S.
Fernandes, R
Giorgi, M
Moawad, G.N.
Bakar, J
author_sort Habib, N
collection PubMed
description Pudendal neuralgia (PN) is a rare and underestimated condition. The reported incidence by the International Pudendal Neuropathy Association is 1/100000. However, the actual rate may be significantly higher, with a propensity for women. It is most frequently caused by an entrapment of the nerve at the level of the sacrospinous and sacrotuberous ligament, also known as pudendal nerve entrapment syndrome. Due to the late diagnosis and inadequate management, pudendal nerve entrapment syndrome often leads to considerable reduction in the quality of life and high health care costs. The diagnosis is made using Nantes Criteria, in conjunction with the patient’s clinical history and physical findings. Clinical examination with an accurate assessment of the territory of the neuropathic pain is mandatory to set the therapeutic strategy. The aim of the treatment is to control the symptoms and it usually starts with conservative approaches which include analgesics, anticonvulsants, and muscle relaxants. Surgical nerve decompression can be proposed after failure of conservative management. The laparoscopic approach is a feasible and appropriate technique to explore and decompress the pudendal nerve, and to rule out other pelvic conditions that can cause similar symptomatology. In this paper, the clinical history of two patients affected by compressive PN is reported. Both patients underwent laparoscopic pudendal neurolysis suggesting that the treatment for PN should be individualised and carried out by a multidisciplinary team. When conservative treatment fails, laparoscopic nerve exploration and decompression is an adequate option to propose and should be performed by a trained surgeon.
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spelling pubmed-104106602023-08-10 Pudendal Neuralgia: Two case reports with laparoscopic nerve decompression Habib, N Centini, G Klebanoff, J.S. Fernandes, R Giorgi, M Moawad, G.N. Bakar, J Facts Views Vis Obgyn Case Report Pudendal neuralgia (PN) is a rare and underestimated condition. The reported incidence by the International Pudendal Neuropathy Association is 1/100000. However, the actual rate may be significantly higher, with a propensity for women. It is most frequently caused by an entrapment of the nerve at the level of the sacrospinous and sacrotuberous ligament, also known as pudendal nerve entrapment syndrome. Due to the late diagnosis and inadequate management, pudendal nerve entrapment syndrome often leads to considerable reduction in the quality of life and high health care costs. The diagnosis is made using Nantes Criteria, in conjunction with the patient’s clinical history and physical findings. Clinical examination with an accurate assessment of the territory of the neuropathic pain is mandatory to set the therapeutic strategy. The aim of the treatment is to control the symptoms and it usually starts with conservative approaches which include analgesics, anticonvulsants, and muscle relaxants. Surgical nerve decompression can be proposed after failure of conservative management. The laparoscopic approach is a feasible and appropriate technique to explore and decompress the pudendal nerve, and to rule out other pelvic conditions that can cause similar symptomatology. In this paper, the clinical history of two patients affected by compressive PN is reported. Both patients underwent laparoscopic pudendal neurolysis suggesting that the treatment for PN should be individualised and carried out by a multidisciplinary team. When conservative treatment fails, laparoscopic nerve exploration and decompression is an adequate option to propose and should be performed by a trained surgeon. Universa Press 2023-06-30 /pmc/articles/PMC10410660/ /pubmed/37436058 http://dx.doi.org/10.52054/FVVO.15.2.073 Text en Copyright © 2023 Facts, Views & Vision https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Habib, N
Centini, G
Klebanoff, J.S.
Fernandes, R
Giorgi, M
Moawad, G.N.
Bakar, J
Pudendal Neuralgia: Two case reports with laparoscopic nerve decompression
title Pudendal Neuralgia: Two case reports with laparoscopic nerve decompression
title_full Pudendal Neuralgia: Two case reports with laparoscopic nerve decompression
title_fullStr Pudendal Neuralgia: Two case reports with laparoscopic nerve decompression
title_full_unstemmed Pudendal Neuralgia: Two case reports with laparoscopic nerve decompression
title_short Pudendal Neuralgia: Two case reports with laparoscopic nerve decompression
title_sort pudendal neuralgia: two case reports with laparoscopic nerve decompression
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10410660/
https://www.ncbi.nlm.nih.gov/pubmed/37436058
http://dx.doi.org/10.52054/FVVO.15.2.073
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