Armstrong Georgina Louise, Vancaillie Thierry Georges
Department of Obstetrics and Gynaecology, Royal Hospital for Women, Sydney, New South Wales, Australia School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia.
Women's Health and Research Institute Australia, Sydney, New South Wales, Australia.
BMJ Case Rep. 2016 Jun 9;2016:bcr2015213513. doi: 10.1136/bcr-2015-213513.
A variety of neuromodulation approaches have been described for the management of pelvic neuropathies, including interstitial cystitis, pudendal neuralgia and persistent genital arousal disorder. The benefits of a combined sacral and pudendal nerve neuromodulator has yet to be explored for these patients. In this report, we describe the case of a 35-year-old woman with a complex pelvic neuropathy resulting in urinary, sexual and gastro-intestinal dysfunction. She presented with an established diagnosis of interstitial cystitis; however, she also fulfilled diagnostic criteria for pudendal neuralgia and persistent genital arousal disorder. The patient underwent implantation of a combined sacral and pudendal nerve neuoromodulation device at the time of surgical decompression of the pudendal nerves. An impressive clinical response followed. This case demonstrates a unique clinical presentation and highlights the value of a combined surgical and neuromodulatory approach in the management of patients with complex pelvic neuropathies.
已描述了多种用于治疗盆腔神经病变的神经调节方法，包括间质性膀胱炎、阴部神经痛和持续性性唤起障碍。对于这些患者，骶神经和阴部神经联合神经调节器的益处尚未得到探索。在本报告中，我们描述了一名35岁女性的病例，该患者患有复杂的盆腔神经病变，导致泌尿、性功能和胃肠功能障碍。她已确诊为间质性膀胱炎；然而，她也符合阴部神经痛和持续性性唤起障碍的诊断标准。该患者在阴部神经手术减压时植入了骶神经和阴部神经联合神经调节装置。随后出现了令人印象深刻的临床反应。该病例展示了一种独特的临床表现，并突出了手术和神经调节联合方法在治疗复杂盆腔神经病变患者中的价值。
