Beerten Simon Gabriël, Calabrò Rocco Salvatore
Dr. Beerten is with the Department of Public Health and Primary Care at KU Leuven in Leuven, Belgium.
Dr. Calabrò is with IRCCS Centro Neurolesi Bonino Pulejo in Messina, Italy.
Innov Clin Neurosci. 2021 Apr-Jun;18(4-6):8-10.
Pudendal neuralgia is a form of chronic pelvic pain, although the validity of this diagnosis has not been firmly established. It is characterized by unilateral pain in the pudendal nerve dermatome, mostly while sitting. In this case report, a 76-year-old female patient presented to her general practitioner with a 10-year history of unilateral buttock pain, which had been diagnosed as pudendal neuralgia. She tried various treatments and visited numerous specialists, but there was little improvement overall. Some medications seemed to have a positive effect, but pain ultimately persisted until psychological factors were appropriately addressed. Management of pudendal neuralgia follows general chronic neuralgia principles, from medication over nerve block to definitive surgery. However, this case serves as a prime example of how the psychosocial approach is equally important. Given that psychological factors can make pain persist, it is imperative to properly address them. As pudendal neuralgia is uncommonly encountered in primary care, specific attention must be paid to psychological factors, which become significantly more important in long-standing chronic pelvic pain.
阴部神经痛是一种慢性盆腔疼痛，尽管这一诊断的有效性尚未得到确切证实。其特征是阴部神经皮节出现单侧疼痛，主要在坐位时发作。在本病例报告中，一名76岁女性患者因单侧臀部疼痛10年就诊于她的全科医生，该疼痛此前被诊断为阴部神经痛。她尝试了各种治疗方法并咨询了众多专家，但总体改善甚微。一些药物似乎有积极效果，但疼痛最终仍持续，直到心理因素得到妥善处理。阴部神经痛的治疗遵循一般慢性神经痛原则，从药物治疗到神经阻滞，再到确定性手术。然而，本病例是一个典型例子，说明社会心理方法同样重要。鉴于心理因素会使疼痛持续，妥善处理这些因素至关重要。由于阴部神经痛在初级保健中并不常见，必须特别关注心理因素，而在长期慢性盆腔疼痛中，心理因素变得尤为重要。
