Labat J-J, Delavierre D, Sibert L, Rigaud J
Centre fédératif de pelvipérinéologie, clinique urologique, CHU de Nantes, 44093 Nantes, France.
Prog Urol. 2010 Nov;20(12):922-9. doi: 10.1016/j.purol.2010.08.055. Epub 2010 Oct 13.
Pudendal neuralgia is a recently identified and now clearly recognized clinical entity. This chronic disabling pain is due to a pelviperineal tunnel syndrome.
Review of the literature based on a Medline search of articles devoted to this subject.
The diagnosis is purely clinical, based on simple consensual criteria (Nantes Criteria): pain situated in the anatomical territory of the pudendal nerve, worse on sitting, not usually waking the patient at night, not accompanied by any objective perineal sensory loss with a positive anaesthetic block of the pudendal nerve at the ischial spine.
The diagnosis of pudendal neuralgia is straightforward when the patient's symptoms remain confined to these diagnostic criteria, which are all essential for the diagnosis. However, the patient often presents associated urinary, anorectal, sexual, neuromuscular and hypersensitization signs, which can complicate the diagnostic approach and therapeutic management.
阴部神经痛是一种最近才被确认且现已得到明确认识的临床病症。这种慢性致残性疼痛是由骨盆会阴管综合征引起的。
基于对致力于该主题的文章进行的医学文献数据库(Medline)检索对文献进行综述。
诊断完全基于临床,依据简单的共识标准(南特标准):疼痛位于阴部神经的解剖区域,坐位时加重,通常不会在夜间唤醒患者,不伴有任何客观的会阴感觉丧失,且在坐骨棘处阴部神经麻醉阻滞阳性。
当患者症状符合这些对诊断至关重要的诊断标准时,阴部神经痛的诊断很简单。然而,患者常伴有泌尿、肛肠、性、神经肌肉和感觉过敏等体征,这可能会使诊断方法和治疗管理变得复杂。