Pudendal nerve surgery in the management of chronic pelvic and perineal pain

摘要

OBJECTIVE: To define the place of pudendal nerve surgery in pudendal nerve entrapment syndromes. MATERIALS AND METHODS: Description of the various surgical techniques and published results. RESULTS: The original surgical technique, which remains the reference technique, consists of performing surgical release of the pudendal nerve from the infrapiriformis foramen to Alcock's canal via a transgluteal approach. This surgical procedure is safe and gives encouraging results validated by a prospective, randomized protocol: 66 to 80% of patients are improved. Other transvaginal or transperineal approaches have also been proposed. CONCLUSION: Pudendal nerve surgery is a reasonable treatment option when all other treatments have failed. However, the various techniques proposed and their respective criticisms must be carefully evaluated.