Amarenco G, Kerdraon J, Bouju P, Le Budet C, Cocquen A L, Bosc S, Goldet R
Service de Rééducation Neurologique, Hôpital Robert Ballanger, Aulnay-sous-Bois.
Rev Neurol (Paris). 1997 Jun;153(5):331-4.
We report 170 cases of perineal neuralgia due to pudendal nerve compression within Alcock canal or by ischiatic spine. 117 women and 53 men were investigated. Mean age was 60.3 years and the follow-up one year. Infiltrations of the pudendal nerve in the ischio-rectal fossa (pudendal canal or Alcock canal) with corticoids under CT-scan guidance, were successful immediately in only 1/3 of the cases. Infiltrations of the nerve near by ischiatic spine (radioscopic guidance) were successful in 57 p. 100, but only in 15 p. 100 of the cas after one year. Surgical treatment (performed in 27 cases) was good (8 or excellent (9). For all treatments, the results are good in 65 p. 100 of the cases. Perineal neurophysiologic examinations are useful to confirm pudendal nerve lesion and propose specific medical and/or surgical treatment.
我们报告了170例因阴部神经在阿尔科克管内或坐骨棘处受压引起的会阴神经痛病例。共调查了117名女性和53名男性。平均年龄为60.3岁，随访时间为一年。在CT扫描引导下，向坐骨直肠窝（阴部管或阿尔科克管）内注射皮质类固醇进行阴部神经浸润，仅1/3的病例立即成功。在X线透视引导下，向坐骨棘附近的神经进行浸润，成功率为57%，但一年后仅15%的病例仍有效果。手术治疗（27例）效果良好（8例）或极佳（9例）。所有治疗方法中，65%的病例效果良好。会阴神经生理检查有助于确认阴部神经损伤，并提出具体的药物和/或手术治疗方案。
