Labat Jean-Jacques, Riant Thibault, Robert Roger, Amarenco Gérard, Lefaucheur Jean-Pascal, Rigaud Jérôme
Service d'Urologie, CHU Hôtel-Dieu, Nantes, France.
Neurourol Urodyn. 2008;27(4):306-10. doi: 10.1002/nau.20505.
The diagnosis of pudendal neuralgia by pudendal nerve entrapment syndrome is essentially clinical. There are no pathognomonic criteria, but various clinical features can be suggestive of the diagnosis. We defined criteria that can help to the diagnosis.
A working party has validated a set of simple diagnostic criteria (Nantes criteria).
The five essentials diagnostic criteria are: (1) Pain in the anatomical territory of the pudendal nerve. (2) Worsened by sitting. (3) The patient is not woken at night by the pain. (4) No objective sensory loss on clinical examination. (5) Positive anesthetic pudendal nerve block. Other clinical criteria can provide additional arguments in favor of the diagnosis of pudendal neuralgia. Exclusion criteria are also proposed: purely coccygeal, gluteal, or hypogastric pain, exclusively paroxysmal pain, exclusive pruritus, presence of imaging abnormalities able to explain the symptoms.
The diagnosis of pudendal neuralgia by pudendal nerve entrapment syndrome is essentially clinical. There are no specific clinical signs or complementary test results of this disease. However, a combination of criteria can be suggestive of the diagnosis.
由阴部神经卡压综合征导致的阴部神经痛本质上是临床诊断。不存在具有诊断特异性的标准,但多种临床特征可提示该诊断。我们定义了有助于诊断的标准。
一个工作小组验证了一套简单的诊断标准(南特标准)。
五项基本诊断标准为:(1)阴部神经解剖区域疼痛。(2)坐位时加重。(3)患者夜间不因疼痛醒来。(4)临床检查无客观感觉丧失。(5)阴部神经阻滞麻醉阳性。其他临床标准可为阴部神经痛的诊断提供更多依据。还提出了排除标准:单纯尾骨、臀部或下腹疼痛,仅阵发性疼痛,仅瘙痒,存在能够解释症状的影像学异常。
由阴部神经卡压综合征导致的阴部神经痛本质上是临床诊断。该疾病不存在特定的临床体征或辅助检查结果。然而,一系列标准的综合可提示诊断。