Rigaud J, Delavierre D, Sibert L, Labat J-J
Clinique urologique, centre fédératif de pelvipérinéologie, hôpital Hôtel-Dieu, CHU de Nantes, 1, place Alexis-Ricordeau, 44000 Nantes, France.
Prog Urol. 2010 Nov;20(12):1139-44. doi: 10.1016/j.purol.2010.08.050. Epub 2010 Oct 20.
Chronic postoperative pain has been defined as pain arising after a surgical operation, present for at least 2 months, with no organic (active cancer or chronic infection) or pre-existing cause. The purpose of this article is to review the aetiological and diagnostic assessment of chronic postoperative pelvic and perineal pain.
A review of the literature was performed by searching PUBMED for articles on the diagnostic approach to chronic postoperative pelvic and perineal pain.
The chronology of the symptoms, i.e., rapid onset of pain following a surgical procedure that does not subsequently resolve, is a leading argument to incriminate the surgical procedure in the pathogenesis of the pain. Clinical examination of the scars and detailed analysis of the topography and type of pain are essential elements in the analysis of this pain. The primary objective of complementary investigations (imaging, EMG, etc.) is to eliminate a differential diagnosis, as they are normal in the case of chronic postoperative pain. A test block of a nerve or trigger point is the main test performed to determine the level of the lesion responsible for pain.
The aetiological and diagnostic assessment of chronic postoperative pelvic and perineal pain requires a detailed clinical analysis based on examination of the scars and analysis of the clinical signs of muscle and nerve lesions. A local test block confirms the level of the lesion.
慢性术后疼痛被定义为手术后出现的疼痛，持续至少2个月，且无器质性病因（活动性癌症或慢性感染）或既往病因。本文旨在综述慢性术后盆腔和会阴疼痛的病因及诊断评估。
通过在PUBMED上搜索关于慢性术后盆腔和会阴疼痛诊断方法的文章，对文献进行综述。
症状的时间顺序，即手术后疼痛迅速发作且随后未缓解，是将手术过程归咎于疼痛发病机制的主要依据。对瘢痕的临床检查以及对疼痛的部位和类型进行详细分析是分析这种疼痛的关键要素。补充检查（影像学、肌电图等）的主要目的是排除鉴别诊断，因为在慢性术后疼痛的情况下这些检查结果通常是正常的。神经或触发点的试验性阻滞是确定疼痛相关病变部位的主要检查。
慢性术后盆腔和会阴疼痛的病因及诊断评估需要基于对瘢痕的检查以及对肌肉和神经病变临床体征的分析进行详细的临床分析。局部试验性阻滞可确定病变部位。
