Urology Department, Institut Jules Bordet, Brussels, Belgium.
Urology Department, Hotel-Dieu de France, University of Saint Joseph, Beirut, Lebanon.
Low Urin Tract Symptoms. 2021 Apr;13(2):286-290. doi: 10.1111/luts.12368. Epub 2020 Nov 29.
The aim of this study was to assess the efficacy of laparoscopic transperitoneal pudendal decompression in the improvement of refractory lower urinary tract symptoms (LUTS) in young males presenting with clinical features of pudendal nerve entrapment with no known comorbidities that could explain their LUTS.
This is a prospective pilot study involving patients suffering from LUTS refractory to standard treatment and clinical features of pudendal nerve entrapment on physical examination. They underwent laparoscopic transperitoneal pudendal decompression. International Prostate Symptom Score (IPSS) and maximal flow (Qmax) on uroflowmetry were evaluated before and 3 months after the procedure.
Five male patients aged 34 ± 4 years were recruited. The median IPSS differed significantly before and 3 months after the procedure (18 vs 8, P = .042); likewise, median Qmax differed significantly before and 3 months after the procedure (12 vs 18 mL/s, P = .042).
Pudendal nerve entrapment syndrome should be considered as a main differential diagnosis for refractory LUTS in young males with no other comorbidities. When clinical features of pudendal nerve entrapment are present, laparoscopic transperitoneal pudendal decompression relieves LUTS in these young males.
本研究旨在评估腹腔镜经腹腔阴部神经减压术治疗无其他已知合并症但存在阴部神经卡压临床特征的年轻男性难治性下尿路症状（LUTS）的疗效。
这是一项前瞻性试点研究，纳入了对标准治疗和体格检查阴部神经卡压的临床特征均无反应的 LUTS 患者。他们接受了腹腔镜经腹腔阴部神经减压术。在术前和术后 3 个月，通过国际前列腺症状评分（IPSS）和尿流率的最大流量（Qmax）进行评估。
共纳入 5 名年龄 34±4 岁的男性患者。术前和术后 3 个月的 IPSS 中位数差异有统计学意义（18 与 8，P=0.042）；同样，术前和术后 3 个月的 Qmax 中位数差异有统计学意义（12 与 18mL/s，P=0.042）。
对于无其他合并症的年轻男性难治性 LUTS，阴部神经卡压综合征应作为主要鉴别诊断。当存在阴部神经卡压的临床特征时，腹腔镜经腹腔阴部神经减压术可缓解这些年轻男性的 LUTS。
