Malec-Milewska Małgorzata, Horosz Bartosz, Kolęda Iwona, Sękowska Agnieszka, Kucia Hanna, Kosson Dariusz, Jakiel Grzegorz
Department of Anesthesiology and Intensive Care, Medical Center for Postgraduate Education, Warsaw, Poland.
Pain Clinic, Department of Anesthesiology and Intensive Care, Medical Center for Postgraduate Education, Warsaw, Poland.
Wideochir Inne Tech Maloinwazyjne. 2014 Sep;9(3):458-62. doi: 10.5114/wiitm.2014.43079. Epub 2014 May 29.
Here we report on the use of neurolytic block of ganglion impar (ganglion of Walther) for the management of intractable chronic pelvic pain, which is common enough to be recognized as a problem by gynecologists, likely to be difficult to diagnose and even more challenging to manage. Following failure in controlling the symptoms with pharmacological management, nine women underwent neurolysis of the ganglion impar in our Pain Clinic from 2009 to March 2013. The indication for the procedure was chronic pelvic pain (CPP) of either malignancy-related (4) or other origin (5). The Numeric Rating Scale (NRS) and duration of pain relief were employed to assess effectiveness of the procedure. Neurolysis was efficacious in patients with both malignancy-related CPP and CPP of non-malignant origin. Reported relief time varied from 4 weeks to 3 years, while in 4 cases complete and permanent cessation of pain was achieved. No complications were noted.
在此，我们报告使用奇神经节（瓦尔特神经节）神经溶解阻滞术治疗顽固性慢性盆腔疼痛。这种疼痛很常见，妇科医生已将其视为一个问题，可能难以诊断，更具挑战性的是进行治疗。在药物治疗无法控制症状后，2009年至2013年3月期间，9名女性在我们的疼痛诊所接受了奇神经节神经溶解术。手术指征为恶性肿瘤相关的慢性盆腔疼痛（CPP）（4例）或其他原因引起的慢性盆腔疼痛（5例）。采用数字评分量表（NRS）和疼痛缓解持续时间来评估手术效果。神经溶解术对恶性肿瘤相关CPP和非恶性肿瘤源性CPP患者均有效。报告的缓解时间从4周至3年不等，4例患者实现了疼痛完全且永久缓解。未观察到并发症。
