Materiały źródłowe

• #1 Risk Factors and a Nomogram for Prediction of Refractory Pudendal Neuralgia: A Retrospective Multivariate Analysis Study – PubMed

  https://pubmed.ncbi.nlm.nih.gov/36122264/

  Pudendal neuralgia (PN) is one of the most common forms of genital pain. About 4% or higher of patients suffering from chronic pain. […] The aim of this study was to evaluate the risk factors for prediction of refractory PN (RPN). […] Multivariate analysis of 112 patients with PN demonstrated high self-rating depression scale scores ( 32) (odds ratio [OR], 95% confidence interval [CI]: 0.11, 0.01-0.77), damage to more than 2 terminal branches (OR, 95% CI: 0.22, 0.07-0.71), sensory deficit at S2-S4 on the dermatome map (OR, 95% CI: 0.22, 0.05-0.90), and duration of pain ( 4 years) (OR, 95% CI: 0.10, 0.03-0.42) were significant prognostic factors for nonresponse to the pudendal nerve block. […] A longer duration of pain was correlated with a worse prognosis of the neurological disease. Patients with depression were prone to nonresponse to the pudendal nerve block treatment. Pain involved in more than 2 terminal branches and small fibers, affected at S2-S4 dermatome map, were considered to poor prognosis.

• #2 Pudendal Neuralgia | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/40740

  The sequential treatment of pudendal neuralgia relieves or reduces symptoms in most patients. After successful pudendal nerve blocks, pain reduction usually permits a return to a normal lifestyle. Complete cures over 12 years have been reported, with some extending to 20 years. Overall success for pudendal nerve blocks is about 80%, while surgery provides extended relief in appropriately selected patients in 60% to 80% of those treated. Although there are occasional reports of immediate and total relief following surgery, most clinicians report symptom control gradually improving over 6 to 24 months or longer. Therefore, patients should be given realistic expectations, and a postoperative treatment and monitoring program should be established. […] Alternative treatments, including sacral neuromodulation, cryotherapy, pulse radiofrequency ablation, and lipofilling, should be considered in intractable cases, particularly sacral neuromodulation, which is safe, minimally invasive, widely available, and generally underutilized for PN. Though the medical literature is incomplete on these treatment modalities, reasonable success rates have been reported in small, short-term studies.

• #3 Pudendal Neuralgia | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/40740

  The sequential treatment of pudendal neuralgia relieves or reduces symptoms in most patients. After successful pudendal nerve blocks, pain reduction usually permits a return to a normal lifestyle. Complete cures over 12 years have been reported, with some extending to 20 years. Overall success for pudendal nerve blocks is about 80%, while surgery provides extended relief in appropriately selected patients in 60% to 80% of those treated. Although there are occasional reports of immediate and total relief following surgery, most clinicians report symptom control gradually improving over 6 to 24 months or longer. Therefore, patients should be given realistic expectations, and a postoperative treatment and monitoring program should be established. […] Alternative treatments, including sacral neuromodulation, cryotherapy, pulse radiofrequency ablation, and lipofilling, should be considered in intractable cases, particularly sacral neuromodulation, which is safe, minimally invasive, widely available, and generally underutilized for PN. Though the medical literature is incomplete on these treatment modalities, reasonable success rates have been reported in small, short-term studies.

• #4 Pudendal Neuralgia | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/40740

  The success of the various treatment modalities may be influenced by: The degree of nerve injury and duration of compression present. The skill and experience of the individual treating physicians and their ability to work together as a multidisciplinary team. The availability of therapeutic modalities and clinician use of adjunctive services (eg, pain management, interventional radiology, psychology, and physical therapy) to manage PN. Failure to recognize that the persistence of symptoms is a consistently reported part of the normal healing process, even after definitive therapy. Central sensitization is common in patients with PN and may amplify the persistence or intensity of symptoms. Familiarity with concurrent neuropathies that may occur in pudendal neuropathy patients and may require additional treatment. Recognition that iliohypogastric and ilioinguinal neurectomies may be necessary to eliminate inguinal or lower quadrant pain.

• #5 Pudendal Neuralgia | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/40740

  The success of the various treatment modalities may be influenced by: The degree of nerve injury and duration of compression present. The skill and experience of the individual treating physicians and their ability to work together as a multidisciplinary team. The availability of therapeutic modalities and clinician use of adjunctive services (eg, pain management, interventional radiology, psychology, and physical therapy) to manage PN. Failure to recognize that the persistence of symptoms is a consistently reported part of the normal healing process, even after definitive therapy. Central sensitization is common in patients with PN and may amplify the persistence or intensity of symptoms. Familiarity with concurrent neuropathies that may occur in pudendal neuropathy patients and may require additional treatment. Recognition that iliohypogastric and ilioinguinal neurectomies may be necessary to eliminate inguinal or lower quadrant pain.

• #6 Risk Factors and a Nomogram for Prediction of Refractory Pudendal Neuralgia: A Retrospective Multivariate Analysis Study – PubMed

  https://pubmed.ncbi.nlm.nih.gov/36122264/

  Pudendal neuralgia (PN) is one of the most common forms of genital pain. About 4% or higher of patients suffering from chronic pain. […] The aim of this study was to evaluate the risk factors for prediction of refractory PN (RPN). […] Multivariate analysis of 112 patients with PN demonstrated high self-rating depression scale scores ( 32) (odds ratio [OR], 95% confidence interval [CI]: 0.11, 0.01-0.77), damage to more than 2 terminal branches (OR, 95% CI: 0.22, 0.07-0.71), sensory deficit at S2-S4 on the dermatome map (OR, 95% CI: 0.22, 0.05-0.90), and duration of pain ( 4 years) (OR, 95% CI: 0.10, 0.03-0.42) were significant prognostic factors for nonresponse to the pudendal nerve block. […] A longer duration of pain was correlated with a worse prognosis of the neurological disease. Patients with depression were prone to nonresponse to the pudendal nerve block treatment. Pain involved in more than 2 terminal branches and small fibers, affected at S2-S4 dermatome map, were considered to poor prognosis.

• #7 Risk Factors and a Nomogram for Prediction of Refractory Pudendal Neuralgia: A Retrospective Multivariate Analysis Study – PubMed

  https://pubmed.ncbi.nlm.nih.gov/36122264/

  Pudendal neuralgia (PN) is one of the most common forms of genital pain. About 4% or higher of patients suffering from chronic pain. […] The aim of this study was to evaluate the risk factors for prediction of refractory PN (RPN). […] Multivariate analysis of 112 patients with PN demonstrated high self-rating depression scale scores ( 32) (odds ratio [OR], 95% confidence interval [CI]: 0.11, 0.01-0.77), damage to more than 2 terminal branches (OR, 95% CI: 0.22, 0.07-0.71), sensory deficit at S2-S4 on the dermatome map (OR, 95% CI: 0.22, 0.05-0.90), and duration of pain ( 4 years) (OR, 95% CI: 0.10, 0.03-0.42) were significant prognostic factors for nonresponse to the pudendal nerve block. […] A longer duration of pain was correlated with a worse prognosis of the neurological disease. Patients with depression were prone to nonresponse to the pudendal nerve block treatment. Pain involved in more than 2 terminal branches and small fibers, affected at S2-S4 dermatome map, were considered to poor prognosis.

• #8 Risk Factors and a Nomogram for Prediction of Refractory Pudendal Neuralgia: A Retrospective Multivariate Analysis Study – PubMed

  https://pubmed.ncbi.nlm.nih.gov/36122264/

  Pudendal neuralgia (PN) is one of the most common forms of genital pain. About 4% or higher of patients suffering from chronic pain. […] The aim of this study was to evaluate the risk factors for prediction of refractory PN (RPN). […] Multivariate analysis of 112 patients with PN demonstrated high self-rating depression scale scores ( 32) (odds ratio [OR], 95% confidence interval [CI]: 0.11, 0.01-0.77), damage to more than 2 terminal branches (OR, 95% CI: 0.22, 0.07-0.71), sensory deficit at S2-S4 on the dermatome map (OR, 95% CI: 0.22, 0.05-0.90), and duration of pain ( 4 years) (OR, 95% CI: 0.10, 0.03-0.42) were significant prognostic factors for nonresponse to the pudendal nerve block. […] A longer duration of pain was correlated with a worse prognosis of the neurological disease. Patients with depression were prone to nonresponse to the pudendal nerve block treatment. Pain involved in more than 2 terminal branches and small fibers, affected at S2-S4 dermatome map, were considered to poor prognosis.

• #9 Is Pudendal Neuralgia Permanent

  https://corepelvicfloortherapy.com/is-pudendal-neuralgia-permanent/

  As stated before, treatment timeliness is of the essence and the degree of irritation to the pudendal nerve determines the prognosis of treatment. […] Whether or not this qualifies as a disability depends on the Sedentary Residual Functional Capacity (RFC) score which looks at how much capacity you have and how much is lost with sitting and your job description. Social Security Administration reviews the job description and the medical services reports and procedures to determine if you qualify for disability or not.

• #10 Pudendal Neuralgia | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/40740

  The sequential treatment of pudendal neuralgia relieves or reduces symptoms in most patients. After successful pudendal nerve blocks, pain reduction usually permits a return to a normal lifestyle. Complete cures over 12 years have been reported, with some extending to 20 years. Overall success for pudendal nerve blocks is about 80%, while surgery provides extended relief in appropriately selected patients in 60% to 80% of those treated. Although there are occasional reports of immediate and total relief following surgery, most clinicians report symptom control gradually improving over 6 to 24 months or longer. Therefore, patients should be given realistic expectations, and a postoperative treatment and monitoring program should be established. […] Alternative treatments, including sacral neuromodulation, cryotherapy, pulse radiofrequency ablation, and lipofilling, should be considered in intractable cases, particularly sacral neuromodulation, which is safe, minimally invasive, widely available, and generally underutilized for PN. Though the medical literature is incomplete on these treatment modalities, reasonable success rates have been reported in small, short-term studies.

• #11 Pudendal Neuralgia | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/40740

  The sequential treatment of pudendal neuralgia relieves or reduces symptoms in most patients. After successful pudendal nerve blocks, pain reduction usually permits a return to a normal lifestyle. Complete cures over 12 years have been reported, with some extending to 20 years. Overall success for pudendal nerve blocks is about 80%, while surgery provides extended relief in appropriately selected patients in 60% to 80% of those treated. Although there are occasional reports of immediate and total relief following surgery, most clinicians report symptom control gradually improving over 6 to 24 months or longer. Therefore, patients should be given realistic expectations, and a postoperative treatment and monitoring program should be established. […] Alternative treatments, including sacral neuromodulation, cryotherapy, pulse radiofrequency ablation, and lipofilling, should be considered in intractable cases, particularly sacral neuromodulation, which is safe, minimally invasive, widely available, and generally underutilized for PN. Though the medical literature is incomplete on these treatment modalities, reasonable success rates have been reported in small, short-term studies.

• #12 :: ICU :: Investigative and Clinical Urology

  https://icurology.org/DOIx.php?id=10.4111/icu.20230402

  Both transperitoneal and transgluteal surgeries seem to offer a safe and highly effective therapeutic option for patients experiencing debilitating pain and intractable LUTS that significantly impact their quality of life. […] The present systematic review analyzed the outcomes of surgical neurolysis in patients suffering from PNE. We found that PNN is a viable option for addressing LUTS, ED, AI, SUI, and female sexual arousal related to PNE.

• #13 :: ICU :: Investigative and Clinical Urology

  https://icurology.org/DOIx.php?id=10.4111/icu.20230402

  Pudendal neuropathy is an uncommon condition that exhibits several symptoms depending on the site of nerve entrapment. This study aims to evaluate the efficacy of pudendal nerve neurolysis (PNN) in improving lower urinary tract symptoms, anal and/or urinary incontinence, and sexual dysfunctions. […] PNN improved both urgency and voiding symptoms, and urinary and anal incontinence but is less effective in cases of long-standing entrapment. […] PNN emerges as a viable option for addressing urinary symptoms, fecal incontinence, erectile dysfunction, and female sexual arousal in patients suffering from PNE with minimal postoperative morbidity. […] The relationship between symptoms and the site of entrapment plays a role in choosing the appropriate surgical approach. […] PNE should be considered a potential underlying cause in patients with LUTS refractory to medical therapy.

• #14 :: ICU :: Investigative and Clinical Urology

  https://icurology.org/DOIx.php?id=10.4111/icu.20230402

  Pudendal neuropathy is an uncommon condition that exhibits several symptoms depending on the site of nerve entrapment. This study aims to evaluate the efficacy of pudendal nerve neurolysis (PNN) in improving lower urinary tract symptoms, anal and/or urinary incontinence, and sexual dysfunctions. […] PNN improved both urgency and voiding symptoms, and urinary and anal incontinence but is less effective in cases of long-standing entrapment. […] PNN emerges as a viable option for addressing urinary symptoms, fecal incontinence, erectile dysfunction, and female sexual arousal in patients suffering from PNE with minimal postoperative morbidity. […] The relationship between symptoms and the site of entrapment plays a role in choosing the appropriate surgical approach. […] PNE should be considered a potential underlying cause in patients with LUTS refractory to medical therapy.

• #15

  https://link.springer.com/article/10.1007/BF02237299

  Bilateral normal pudendal nerve terminal motor latencies are the only factors predictive of long-term success after overlapping sphincteroplasty. […] However, 62 percent of 59 patients with bilaterally normal pudendal nerve terminal motor latencies had a successful outcome compared with only 16.7 percent of 12 patients with unilateral or bilateral prolonged pudendal nerve terminal motor latencies.

• #16 Pudendal Neuralgia | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/40740

  The leading cause of recurrent symptoms of PN is the early resumption of the activities that initially aggravated the condition, such as cycling, exercising, jogging, and prolonged sitting. For example, after the sacrospinous ligament has been surgically removed or decompressed and the lobster claw released, the Valsalva maneuver during lifting or squatting may force the pelvic floor to compress the nerve against the sacrotuberous ligament again and reaggravate the injury with a return of symptoms.

• #17 Pudendal Nerve Entrapment/Neuropathy/Damage | Mayo Clinic Connect

  https://connect.mayoclinic.org/discussion/pudendal-nerve-entrapmentneuropathydamage/?pg=3

  My wife has had pudendal nerve pain for 8 years. Initially the pain was due to a bout of shingles. However, during the recovery period I believe that something new kicked in which I believe is PNE (Pudendal Nerve Entrapment) as the symptoms are identical and to me it makes sense. The pain areas in the pelvic region are exactly where the pudendal nerve goes. PNE normally is resolved by relief of any muscle or scar tissue that may be entrapping the pudendal nerve. […] Given that my wife’s pain varies doctors have agreed that the nerve is not damaged. This is good news as apparently there is no treatment for a damaged nerve. […] I questioned doctors at the Mayo Clinic about this and they concluded that the nerve is NOT damaged. This is good news since from what I’ve read there is no cure for damaged nerves. There are cures for entrapped nerves but you just have to find the source of entrapment.

• #18 Pudendal Nerve Entrapment/Neuropathy/Damage | Mayo Clinic Connect

  https://connect.mayoclinic.org/discussion/pudendal-nerve-entrapmentneuropathydamage/?pg=3

  Another neuro doctor is suggesting that the pain is due to inflammation of root of the pudendal nerve which resides at the spinal cord where it connects to the spinal column. Here they want to inject steroids to reduce the inflammation. Results may be nothing, good for two weeks, two months,????? They can’t predict. IF this is the source then my choice would be to determine why it is inflamed at this area and resolve this issue rather than throwing meds at it. […] I can certainly empathize with folks who have said that this condition is a 'lonely’ problem, both because it is more rare in the general population and there apparently is not much data for physicians to access.

• #19 Is Pudendal Neuralgia Permanent

  https://corepelvicfloortherapy.com/is-pudendal-neuralgia-permanent/

  As stated before, treatment timeliness is of the essence and the degree of irritation to the pudendal nerve determines the prognosis of treatment. […] Whether or not this qualifies as a disability depends on the Sedentary Residual Functional Capacity (RFC) score which looks at how much capacity you have and how much is lost with sitting and your job description. Social Security Administration reviews the job description and the medical services reports and procedures to determine if you qualify for disability or not.

• #20 Pudendal Neuralgia | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/40740

  The sequential treatment of pudendal neuralgia relieves or reduces symptoms in most patients. After successful pudendal nerve blocks, pain reduction usually permits a return to a normal lifestyle. Complete cures over 12 years have been reported, with some extending to 20 years. Overall success for pudendal nerve blocks is about 80%, while surgery provides extended relief in appropriately selected patients in 60% to 80% of those treated. Although there are occasional reports of immediate and total relief following surgery, most clinicians report symptom control gradually improving over 6 to 24 months or longer. Therefore, patients should be given realistic expectations, and a postoperative treatment and monitoring program should be established. […] Alternative treatments, including sacral neuromodulation, cryotherapy, pulse radiofrequency ablation, and lipofilling, should be considered in intractable cases, particularly sacral neuromodulation, which is safe, minimally invasive, widely available, and generally underutilized for PN. Though the medical literature is incomplete on these treatment modalities, reasonable success rates have been reported in small, short-term studies.

• #21 Pudendal Neuralgia | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/40740

  The success of the various treatment modalities may be influenced by: The degree of nerve injury and duration of compression present. The skill and experience of the individual treating physicians and their ability to work together as a multidisciplinary team. The availability of therapeutic modalities and clinician use of adjunctive services (eg, pain management, interventional radiology, psychology, and physical therapy) to manage PN. Failure to recognize that the persistence of symptoms is a consistently reported part of the normal healing process, even after definitive therapy. Central sensitization is common in patients with PN and may amplify the persistence or intensity of symptoms. Familiarity with concurrent neuropathies that may occur in pudendal neuropathy patients and may require additional treatment. Recognition that iliohypogastric and ilioinguinal neurectomies may be necessary to eliminate inguinal or lower quadrant pain.

• #22 Pudendal Neuralgia | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/40740

  The success of the various treatment modalities may be influenced by: The degree of nerve injury and duration of compression present. The skill and experience of the individual treating physicians and their ability to work together as a multidisciplinary team. The availability of therapeutic modalities and clinician use of adjunctive services (eg, pain management, interventional radiology, psychology, and physical therapy) to manage PN. Failure to recognize that the persistence of symptoms is a consistently reported part of the normal healing process, even after definitive therapy. Central sensitization is common in patients with PN and may amplify the persistence or intensity of symptoms. Familiarity with concurrent neuropathies that may occur in pudendal neuropathy patients and may require additional treatment. Recognition that iliohypogastric and ilioinguinal neurectomies may be necessary to eliminate inguinal or lower quadrant pain.

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