Bonham Luke W, Herati Amin S, McCarthy Edward F, Dellon A Lee, Fritz Jan
Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Transl Androl Urol. 2020 Jun;9(3):1442-1447. doi: 10.21037/tau.2020.03.22.
Injury to the pudendal nerve in men presents with pain, paresthesia, or numbness of the perineum, and/or scrotum, and/or penis. There is evidence implicating the brachytherapy seeds used to treat prostate cancer as source of pudendal nerve injury. Compared to surgical prostatectomy, brachytherapy has the advantage of being less invasive, but seeds may not only lead to well-established complications such as urinary, bowel, and erectile dysfunction, but also injury to the sensory branches of the pudendal nerve. We report and document a case of pudendal nerve injury secondary to brachytherapy seeds diagnosed with magnetic resonance (MR) neurography, nerve blocks, and histopathological examination; and successful treatment via sensory branch neurectomy.
男性阴部神经损伤表现为会阴、阴囊和/或阴茎疼痛、感觉异常或麻木。有证据表明，用于治疗前列腺癌的近距离放射治疗种子源是阴部神经损伤的原因。与手术前列腺切除术相比，近距离放射治疗具有侵入性较小的优点，但种子源不仅可能导致如泌尿、肠道和勃起功能障碍等公认的并发症，还可能损伤阴部神经的感觉分支。我们报告并记录了一例因近距离放射治疗种子源导致的阴部神经损伤病例，该病例通过磁共振（MR）神经成像、神经阻滞和组织病理学检查得以确诊；并通过感觉支神经切除术成功治愈。
