Pereira Augusto, Pérez-Medina Tirso, Rodríguez-Tapia Ana, Chiverto Yoana, Lizarraga Santiago
Department of Gynecologic Surgery, Gregorio Marañón University General Hospital in Madrid, Madrid,
Department of Gynecologic Surgery, Puerta de Hierro University Hospital Majadahonda, Madrid, Spain.
Gynecol Obstet Invest. 2018;83(6):593-599. doi: 10.1159/000489497. Epub 2018 Jul 13.
The objective was to describe clinical findings and outcomes of patients with pudendal neuralgia in relation with the anatomical segment affected.
Fifty-one consecutive patients with chronic perineal pain (CPP) located in the areas supplied by the pudendal nerve (PN), from January 2011 to June 2012, were analyzed.
The distribution of pain at perineal, dorsal clitoris and inferior anal nerves was 92.2, 31.4 and 25.5% respectively. The duration of pain was longer when the dorsal clitoris nerve (DCN) was affected (p < 0,003). The pain in the pudendal canal was frequently associated with the radiation of pain to the inferior members (p < 0.043).
CPP and radiation of pain to lower limbs suggest a disorder at the second segment of PN. A positive Tinel sign in the third segment indicates a nerve entrapment. In terminal branches, pain was more frequent at the perineal nerve and more persistent at the DCN.
目的是描述阴部神经痛患者的临床发现及与受影响解剖节段相关的结果。
对2011年1月至2012年6月期间连续收治的51例慢性会阴痛（CPP）患者进行分析，这些患者的疼痛部位位于阴部神经（PN）所支配的区域。
会阴、阴蒂背侧和肛门下神经的疼痛分布分别为92.2%、31.4%和25.5%。当阴蒂背侧神经（DCN）受影响时，疼痛持续时间更长（p < 0.003）。阴部管内的疼痛常伴有疼痛向下肢放射（p < 0.043）。
CPP及疼痛向下肢放射提示PN第二段存在病变。第三段Tinel征阳性表明神经受压。在终末分支中，会阴神经疼痛更常见，而DCN处疼痛更持久。
