Department of Surgery, Complejo Hospitalario Universitario de Vigo, Vigo, Spain.
Instituto de Investigaciones Sanitarias Galicia Sur, Vigo, Spain.
Colorectal Dis. 2022 Oct;24(10):1243-1244. doi: 10.1111/codi.16190. Epub 2022 Jun 27.
Pudendal neuralgia is a highly disabling entity with complex diagnostic and controversial treatment results. Surgical neurolysis has been shown to be the most effective treatment. Sacral root neurostimulation or posterior tibial nerve stimulation are used to rescue patients who either have not responded to surgery or have worsened after an initial improvement.
Given the excellent visualization of the pudendal nerve during laparoscopic pudendal release, we propose to combine this procedure with neurostimulation, taking advantage of the possibility of in situ placement of the electrode. The abdominal cavity is accessed laparoscopically through four ports, and after identifying and releasing the pudendal nerve a neurostimulation electrode is placed next to the nerve and is connected to a generator located in a subcutaneous pocket.
This procedure has been performed in one patient with a satisfactory result.
Laparoscopic pudendal release with neurostimulator prosthesis is an experimental technique that can be promising for the treatment of pudendal neuralgia.
阴部神经痛是一种高度致残的疾病，其诊断复杂，治疗结果存在争议。阴部神经松解术已被证明是最有效的治疗方法。骶神经根刺激或胫后神经刺激用于治疗那些对手术无反应或在最初改善后恶化的患者。
鉴于腹腔镜阴部松解术可极好地显示阴部神经，我们建议将该手术与神经刺激相结合，利用电极原位放置的可能性。通过四个端口进行腹腔镜进入腹腔，在识别和释放阴部神经后，将神经刺激电极放置在神经旁边，并连接到位于皮下囊袋中的发生器。
该手术已在 1 例患者中进行，效果满意。
带神经刺激器假体的腹腔镜阴部松解术是一种有前途的治疗阴部神经痛的实验技术。
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