Pudendal neuralgia treatment by injections and surgery : did we help patients ?

الملخص EN

Objectives: In this study, we aim to show our eligible experience in the treatment of patients with chronic pelvic pain attributed to pudendal neuralgia and not responding to conventional drugs or rehabilitation by methods of serial injections and surgery.

Methods: This study was conducted in a private medical centre (Humanitas San Pio X) in Milan/Italy.

Data collected from records of 169 patients treated for pudendal neuralgia from June 2006 till May 2018.

Patients were diagnosed to have pudendal neuralgia by means of clinical diagnosis, pudendal nerve blocks, and neurophysiologic studies.

Treatment by perineural pudendal injections (PNPI) was offered to all patients.

Surgery was considered for patients who met the Nantes criteria with a positive pudendal block but persistent pain after injections.

Type and approach of surgery were trans-gluteal or trans-ischiorectal pudendal neurolysis.

Results: The total number of patients is 169; 118 females and 51 males.

The mean age of patients was 53.2 years.

66.3% of patients responded well to PNPI; 20.5% had a complete recovery, 79.5% had a positive temporary response.

33.7% of patients did not benefit from PNPI.

A total number of 43 patients were considered for surgery.

72% of patients after surgery responded well; 13 had a complete recovery and 18 showed improvements> 80% in a VAS scale.

Twelve patients did not improve after surgery.

Conclusion: Pudendal neuralgia is an infrequent cause of chronic pelvic pain affecting the quality of patient's life.

PNPI and pudendal neurolysis can give hope to most of the patients with good results.