Pudendal Neuralgia – a Case Report

Česká verzia

Authors: Z. Kadaňka Jr
Authors place of work: Neurologická klinika LF MU a FN Brno
Published in the journal: Cesk Slov Neurol N 2010; 73/106(5): 555-558
Category: Case Report

Summary

Pudendal neuralgia, or entrapment syndrome of the pudendal nerve, is a relatively new entity, not commonly encountered in routine neurological practice. The diagnosis is often quite difficult and differential diagnosis of perineal pain is very wide. Nevertheless, great progress in the diagnosis and treatment of this neuralgia has been made in recent years. We address the elucidation of these issues by means of a case report.

Key words:
pudendal neuralgia – perineal pain – pelvic floor

Zdroje

1. Amarenco G, Lanoe Y, Perrigot M, Goudal H. Un noveau syndrom canalaire: la compression du nerf honteaux interne dans le canal d’Alcock ou paralyse perineále du cycliste. Presse Med 1987; 16(8): 399.

2. Thoumas D, Leroi AM, Mauillon J, Muller JM, Benozio M, Denis P et al. Pudendal neuralgia: CT--guided pudendal nerve block technique. Abdom Imaging 1999; 24(3): 309–312.

3. Boisson J, Debbasch L, Bensuade A. Les algies ano-rectales essentiales. Arch Fr Mal Appar Dig 1966; 55: 3–24.

4. Neill ME, Swash M. Chronic perinaeal pain: an unsolved problem. J R Soc Med 1982; 75(2): 96–101.

5. Robert R, Labat JJ, Riant T, Louppe JM, Hamel O. The pudendal nerve: clinical and therapeutic morphogenesis, anatomy, and physiopathology. Neurochirurgie 2009; 55(4–5): 463–469.

6. Sedy J, Nanka O, Belisová M, Walro JM, Jarolím L. Sulcus nervi dorsalis penis/clitoridis: anatomic structure and clinical significance. Eur Urol 2006; 50(5): 1079–1085.

7. Labat JJ, Robert R, Bensignor M, Buzelin JM. Neuralgia of the pudendal nerve. Anatomo-clinical considerations and therapeutical approach. J Urol (Paris) 1990; 96(5): 239–244.

8. Oberpenning F, Roth S, Leusmann DB, van Ahlen H, Hertle L. The Alcock syndrome: temporary penile insensitivity due to compression of the pudendal nerve within the Alcock canal. J Urol 1994; 151(2): 423–425.

9. Robert R, Labat JJ, Riant T, Louppe JM, Lucas O, Hamel O. Somatic perineal pain other than pudendal neuralgia. Neurochirurgie 2009; 55(4–5): 470–474.

10. Rigaud J, Labat JJ, Riant T, Hamel O, Bouchot O, Robert R. Treatment of obturator neuralgia with laparoscopis neurolysis. J Urol 2008; 179(2): 590–594.

11. Amarenco G, Le Cocquen-Amarenco A, Kerdraon J, Lacroix P, Adba MA, Lanoe Y. Perineal neuralgia. Presse Med 1991; 20(2): 71–74.

12. Batta AG, Gundian JC, Myers RP. Neurofibromatosis presenting as perineal pain and urethral burning. Urology 1989; 33(2): 138–140.

13. Kashefi C, Messer K, Barden R, Sexton C, Parsons JK. Incidence and prevention of iatrogenic injuries. J Urol 2008; 179(6): 2254–2257.

14. Takatani J, Takeshima N, Okuda K, Miyajawa H, Noguchi T. A case of perineal pain related to interstitial cystitis which was supposed to be relieved with gabapentin. J Anesth 2009; 23(3): 474–475.

15. Robert R, Labat JJ, Riant T, Louppe JM, Hamel O. The pudendal nerve: clinical and therapeutic morphogenesis, anatomy, and physiopathology. Neurochirurgie 2009; 55(4–5): 463–469.

16. Popeney C, Ansell V, Renney K. Pudendal entrapment as an etiology of chronic perineal pain: Diagnosis and treatment. Neurourol Urodyn 2007; 26(6): 820–827.

17. Labat JJ, Riant T, Robert R, Amarenco G, Lefaucher JP, Rigaud J. Diagnostic criteria for pudendal neuralgia by pudendal nerve entrapment (Nantes criteria). Neurourol Urodyn 2008; 27(4): 306–310.

18. Lefaucheur JP, Labat JJ, Amarenco G, Herbaut AG, Prat-Pradal D, Benaim J et al. What is the place of electroneuromyographic studies in the diagnosis and management of pudendal neuralgia related to entrapment syndrome? Neurophysiol Clin 2007; 37(4): 223–228.

19. Le Tallec de Certaines H, Veillard D, Dugast J, Estébe JP, Kerdraon et al. Comparison between the terminal motor pudendal nerve terminal motor latency, the localization of the perineal neuralgia and the result of infiltrations. Analysis of 53 patients. Ann Redapt Med Phys 2007; 50(2): 65–69.

20. Filler AG, Maravilla KR. MR neurography and muscle MR imaging for image diagnosis of disorder affecting the peripheral nerves and musculature. Neurol Clin 2004; 22(3): 643–682.

21. Amarenco G, Kerdraon J. Pudendal nerve terminal sensitive latency: technique and normal values. J Urol 1999; 161(1): 103–106.

22. Peng PW, Tumber PS. Ultrasound-guided interventional procedures for patients with chronic pelvic pain – a description of techniques and review of literature. Pain Physician 2008; 11(2): 215–224.

23. Reichart R, Kuhn SA, Vogel I, Walter J, Kalff R. Spinal cord stimulation at the level of the conus medullaris: Treatment option for therapy-resistant postoperative neuralgia of the pudendal nerve. Schmerz 2009 23(6): 640–644.

24. Rhame EE, Levey KA, Gharibo CG. Successful treatment of refractory pudendal neuralgia with pulsed radiofrequency. Pain Physician 2009; 12(3): 633–638.

25. Robert R, Bensignor M, Glemain P, Deschamps C, Raoul S, Hamel O. Decompression and transposition of the pudendal nerve in pudendal neuralgia: a randomized controlled trial and long-term evaluation. Eur Urol 2005; 47(3): 403–408.