Benson Jesse Thomas, Griffis Kenneth
Department of Obstetrics and Gynecology, Indiana University/Methodist Hospital, Indianapolis, USA.
Am J Obstet Gynecol. 2005 May;192(5):1663-8. doi: 10.1016/j.ajog.2005.01.051.
To describe the clinical and electrodiagnostic findings, therapies, and outcomes of patients with pudendal neuralgia.
A retrospective, descriptive study of 64 patients from March 19 to December 22, 2003.
Clinical findings included pain along nerve distribution (64, 100%), pain aggravated by sitting (62, 97%), pain relieved by standing or lying (57, 89%), and misdiagnosis (53, 83%). Neurophysiologic findings were normal (23, 35%), demyelination (17, 26%), axonal loss (5, 7.5%), and demyelination with axonal loss (21, 32%). Therapies were conservative (64, 100%), nerve injection (38, 59%), neuromodulation (2, 3%), and decompression surgery (10, 15%). Slight or moderate pain improvement with therapies included conservative (64, 100%), nerve injection (12, 31%), neuromodulation (2, 100%), and decompression (6, 60%).
Pudendal neuralgia is poorly recognized and poorly treated. Improvement is gained with conservative therapy. Injections and decompression benefit one half and one third of patients, respectively. Neuromodulation needs further evaluation.
描述阴部神经痛患者的临床及电诊断结果、治疗方法和预后。
对2003年3月19日至12月22日期间的64例患者进行回顾性描述性研究。
临床症状包括沿神经分布区域疼痛（64例，100%）、坐位时疼痛加剧（62例，97%）、站立或卧位时疼痛缓解（57例，89%）以及误诊（53例，83%）。神经生理学检查结果正常（23例，35%）、脱髓鞘（17例，26%）、轴突丧失（5例，7.5%）以及脱髓鞘伴轴突丧失（21例，32%）。治疗方法包括保守治疗（64例患者，100%）、神经注射（38例，59%）、神经调节（2例，3%）以及减压手术（10例，15%）。经治疗后疼痛有轻度或中度改善的情况包括保守治疗（64例，100%）、神经注射（12例，31%）、神经调节（2例，100%）以及减压手术（6例，60%）。
阴部神经痛的认知和治疗情况均较差。保守治疗可使病情得到改善。注射治疗和减压手术分别使一半和三分之一的患者受益。神经调节疗法有待进一步评估。
