Anorectal and perineal pain: new pathophysiological hypothesis

Mazza, Louise; Formento, E; Fonda, G

doi:10.1007/s10151-004-0060-x

Cited by 45 publications

(27 citation statements)

References 22 publications

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“…Radiological investigations in the form of CT or MRI would assist in the diagnosis of protruding lower lumbar discs, spinal infection, spinal degeneration and tumours [37]. Similarly, colorectal doctors could exclude the presence of rectal pathologies (rectal tumours or teratomas, proctalgia fugax, levator ani syndrome, Alcock's canal syndrome and descending perineum syndrome) [38][39][40] by performing rectal examination accompanied by sigmoidoscopy.…”

Section: Discussionmentioning

confidence: 99%

Surgical treatment of coccygodynia: an analytic review of the literature

2010

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Coccygodynia is a pathological condition associated with pain-discomfort all around the bottom end of the spine. The aetiology and the intensity of the symptoms may defer significantly. The effectiveness of the surgical treatment remains obscure. Our purpose, through this systematic review is to evaluate the results of surgical treatment of coccygectomy. Literature retrieval was performed by the use of the PubMed searching engine utilising the terms 'coccygodynia-coccygectomy' in the English language from January 1980 to January 2010. Case reports and tumour related case series were excluded as well as articles published in other languages. In total 24 manuscripts were analyzed. Only 2 of them were prospective studies whereas 22 were retrospective case series; five were classified as Level III studies and the remaining as Level IV studies. In total, 671 patients with coccygodynia underwent coccygectomy following failed conservative management. The sex ratio, male/female was 1:4.4. The most popular aetiology for coccygodynia was direct trauma in 270 patients. 504 of the patients reported an excellent/ good outcome following the procedure. There were 9 deep and 47 superficial infections. Other complications included two haematomas, six delayed wound healings and nine wound dehiscence. The overall complication rate was 11%. Patients with history of spinal or rectal disorders, as well as idiopathic or with compensation issues, had less predictable outcome than those with history of trauma or childbirth. Coccygectomy can provide pain relief to as high as 85% of the cases. The most common reported complication was wound infection.

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Section: Discussionmentioning

confidence: 99%

Surgical treatment of coccygodynia: an analytic review of the literature

2010

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“…Although some authors have proposed a neurological aetiology, the great majority of cases are strictly idiopathic with a controversial pathophysiology (smooth muscle spasm?). 12,13 This type of paroxysmal pain also comprises pain experienced exclusively during defecation (suggesting a proctological disease), or micturition (suggesting a urological disease), or related to sexual intercourse (vaginismus, vestibulitis).…”

Section: Exclusively Paroxysmal Painmentioning

confidence: 99%

Diagnostic criteria for pudendal neuralgia by pudendal nerve entrapment (Nantes criteria)

Labat

Riant

Robert

et al. 2007

Neurourology and Urodynamics

387

190

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“…[3][4][5][6][7] Psychologic and psychosomatic disorders, such as stress, anxiety, and tension, seem to influence the severity of the condition. 2,3 Current treatments concentrate on relieving spasm and include pharmacologic agents, such as benzodiazepines, baclofen, cyclobenzeprine, and botulinum toxin injections, 2,3 and behavioral therapies, such as weight loss, sitz bath, digital massage, 5 anal dilation, and biofeedback. [7][8][9] Rectal electrogalvanic stimulation also has been used with 43 to 90 percent of patients reportedly achieving good results.…”

Section: Discussionmentioning

confidence: 99%