Elkins Nicholas, Hunt Jason, Scott Kelly M
Department of Physical Medicine and Rehabilitation, UT Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-9055, USA.
Department of Physical Medicine and Rehabilitation, UT Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-9055, USA.
Phys Med Rehabil Clin N Am. 2017 Aug;28(3):551-569. doi: 10.1016/j.pmr.2017.03.007. Epub 2017 May 12.
Pelvic neuralgias frequently cause severe pain and may have associated bladder, bowel, or sexual dysfunctions which also impact quality of life. This article explores the etiology, epidemiology, presentation and treatment of common causes of neurogenic pelvic pain, including neuralgia of the border nerves (ilioinguinal, iliohypogastric, and genitofemoral), pudendal neuralgia, clunealgia, sacral radiculopathies caused by Tarlov cysts, and cauda equina syndrome. Treatment of pelvic neuralgia includes conservative measures such as pelvic physical therapy, lifestyle modification, and medications with escalation to more invasive and novel treatments such as nerve blocks, radiofrequency ablation, cryoablation, neuromodulation and neurectomy/neurolysis if conservative treatments are ineffective.
盆腔神经痛常导致剧痛，可能伴有膀胱、肠道或性功能障碍，这些也会影响生活质量。本文探讨神经源性盆腔疼痛常见病因的病因学、流行病学、临床表现及治疗方法，包括边缘神经（髂腹股沟神经、髂腹下神经和生殖股神经）神经痛、阴部神经痛、臀上皮神经痛、由塔尔洛夫囊肿引起的骶神经根病以及马尾综合征。盆腔神经痛的治疗包括保守措施，如盆腔物理治疗、生活方式改变和药物治疗，若保守治疗无效，则升级为更具侵入性的新型治疗方法，如神经阻滞、射频消融、冷冻消融、神经调节以及神经切除术/神经松解术。
