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Transvaginal Pudendal Nerve Blocks in Patients With Pudendal Neuralgia: Two-year Follow-up Results

Article scientifique 2022 Anglais

Résumé

Abstract Purpose: Pudendal neuralgia (PN) is an extremely painful neuropathy of the pudendal nerve resulting in a negative impact on a patient's quality of life. The aim of this study is to evaluate the 2-years outcomes of repetitive doses of the transvaginal pudendal nerve injections (PNI) and to compare the success of the PNI concerning anatomical levels (endopelvic and extrapelvic portion) of the pudendal nerve pathology.Methods: This retrospective longitudinal cohort study consists of patients with PN diagnosed with the first four essential Nantes criteria. Diagnostic PNI was performed on 67 patients to fulfill the fifth criteria of Nantes. After the drop-outs, further analyses were carried out with a total of 56 patients.Results: The efficacy of the PNIs significantly declined over time. Pudendal nerve blocks provided a significant decrease in pain scores; however, this decrease lost its strength significantly in the 24th month. The intervention was more effective in entrapments of the pudendal nerve between sacrospinous and sacrotuberous ligaments or below (Level-2) when compared to the injuries in the endopelvic part (Level-1). More than 50% pain reduction continued in five patients with pathology at Level-1 and 24 patients with pathology at Level-2. Conclusion: Repeated PNIs could provide a significant decrease in pain scores for both short and long-term periods. However, the efficacy of the PNIs declined over two years. The success of PNIs may be affected by the anatomical level of the nerve injury; therefore, interligamentous pudendal nerve entrapment cases have more benefits than the cases of pudendal nerve entrapment in the endopelvic part. However, it is recommended to perform therapeutic nerve blocks even in patients with suspected endopelvic pudendal nerve pathology before the referral to surgery.

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Başol, G., Kale, A., Gürbüz, H., Gündoğdu, E., Baydilli, K., Usta, T. (2022). Transvaginal Pudendal Nerve Blocks in Patients With Pudendal Neuralgia: Two-year Follow-up Results. https://doi.org/10.21203/rs.3.rs-1310220/v1

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Auteur(s)

Gülfem Başol Ahmet Kale Hande Gürbüz Elif Cansu Gündoğdu Kursad Nuri Baydilli Taner Usta

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