Robert R, Labat J-J, Khalfallah M, Louppe J-M, Riant T, Hamel O
Service de neurotraumatologie et laboratoire d'anatomie, CHU de Nantes, 44100 Nantes, France.
Prog Urol. 2010 Nov;20(12):1084-8. doi: 10.1016/j.purol.2010.09.016. Epub 2010 Oct 14.
To define the place of pudendal nerve surgery in pudendal nerve entrapment syndromes.
Description of the various surgical techniques and published 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.
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.
明确阴部神经手术在阴部神经卡压综合征中的地位。
描述各种手术技术及已发表的结果。
最初的手术技术仍是参考技术，包括经臀入路从梨状肌下孔至阿尔科克管对阴部神经进行手术松解。该手术操作安全，前瞻性随机试验方案证实其效果令人鼓舞：66%至80%的患者病情得到改善。也有人提出了其他经阴道或经会阴入路。
当所有其他治疗方法均失败时，阴部神经手术是一种合理的治疗选择。然而，必须仔细评估所提出的各种技术及其各自的不足之处。
