de Bisschop E, Nundlall R
Clinique chirurgicale de Martigues, Martigues, France.
J Gynecol Obstet Biol Reprod (Paris). 2011 May;40(3):225-30. doi: 10.1016/j.jgyn.2010.12.002. Epub 2011 Apr 8.
Describe and analyze the surgical decompression of pudendal nerve by transperineal approach using a probe with a small balloon.
Since 2009 may, 43 patients (31 females, 12 males) underwent for a pudendal nerve decompression. These patients had clinical symptoms of pudendal neuralgia. Neurophysiological tests based on differential staged sacral reflexes and on somesthesic evoked potentials and ultrasound investigations of pudendal vessels evoked a zone of compressive hyperpressure at the level of the axis infrapiriformis area-ischiorectal fossea. In all of these 43 patients, injection block at the level of the infrapiriformis area appeared positive between one to nine months. Patients were known for this pathology since many years. Among these 43 patients, six had already pudendal nerve decompression, four by transgluteal approach and two by transvaginal (♀)/transischiorectal (♂) approach but without clinical efficiency. In all of these 43 patients, surgical decompression was done by transperineal approach using a probe with a small balloon.
Surgical methodology, post-operation follow-up and results are reported hereby, which appear quite successful: after two days 77%, after one month 84% and after three months 89% of the subjects are symptom-free or with a significant reduction of pain.
描述并分析使用带小气囊探头经会阴途径对阴部神经进行手术减压。
自2009年5月起，43例患者（31例女性，12例男性）接受了阴部神经减压手术。这些患者有阴部神经痛的临床症状。基于不同阶段骶反射和躯体感觉诱发电位的神经生理学测试以及阴部血管的超声检查在梨状肌下区域 - 坐骨直肠窝水平诱发了一个压迫性高压区。在这43例患者中，梨状肌下区域的注射阻滞在1至9个月内均呈阳性。这些患者患有该病症已有多年。在这43例患者中，6例曾接受过阴部神经减压手术，4例经臀部途径，2例经阴道（♀）/经坐骨直肠（♂）途径，但均无临床疗效。在这43例患者中，均采用带小气囊探头经会阴途径进行手术减压。
特此报告手术方法、术后随访及结果，结果颇为成功：术后两天77%的受试者无症状或疼痛显著减轻，术后一个月为84%，术后三个月为89%。
