First case-series of robot-assisted pudendal nerve release: technique and outcomes

Giulioni, Carlo; Asimakopoulos, Anastasios D.; Annino, Filippo; Garelli, Giulia; Riviere, Julien; Piechaud-Kressmann, Julie; Vuong, Nam‐Son; Lopez, Laurent; Roche, Jean-Baptiste; Rouffilange, J.; Hoepffner, Jean-Luc; Galosi, Andrea Benedetto; Gaston, R.; Piéchaud, Thierry; Pierquet, G.

doi:10.1007/s00464-023-10096-9

Cited by 5 publications

(4 citation statements)

References 17 publications

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“…Regarding the robotic approach, after a few initial cases of PNN, initially performed and described by Rey and Oderda [ 36 ], a significant paper detailing more substantial outcomes was reported by Giulioni et al [ 37 ]. The steps of this surgical technique closely mirrored those presented by Bollens et al [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

“…Efficacy data on pain relief of the robotic surgical approach were provided by the study by Giulioni et al [ 37 ], and explored at 3 and 6 months postoperatively, according to numeric pain rating scale (NPRS), which significantly improved. Specifically, NPRS score progressively reduced (8 vs. 6 and 6 vs. 4 after three and 6 months from surgery, respectively).…”

Section: Discussionmentioning

confidence: 99%

“…Among the included studies, 11 were retrospective [12-17, 22, 26, 29, 36, 38], 11 were prospective [10,18,19,21,23,28,[31][32][33][34][35], 7 were case reports [11,20,25,27,30,37,39], and one was a randomized trial [24]. The surgical techniques utilized exhibited variation, encompassing transperineal open surgery in 8 studies [10][11][12][13][14][15][16][17], transgluteal in 8 studies [18][19][20][21][22][23][24][25], and the remainder adopting minimally invasive approaches, which comprised 12 laparoscopic [26][27][28][29][30][31][32][33][34][35][36][3...…”

Section: Study Characteristicsmentioning

confidence: 99%

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Pudendal Nerve Neurolysis in Patients Afflicted With Pudendal Nerve Entrapment: A Systematic Review of Surgical Techniques and Their Efficacy

Giulioni,

Pirola,

Maggi

et al. 2024

Int Neurourol J

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To assess the effectiveness and safety of various techniques of pudendal nerve neurolysis (PNN) in patients with pudendal nerve entrapment (PNE). A comprehensive literature search was conducted on May 20th, 2023, using Scopus, PubMed, and Embase databases. Only studies in English involving adults were accepted, while meeting abstracts and preclinical studies were excluded. A total of 34 papers were included. Transperineal PNN emerged as a promising technique, demonstrating significant potential in alleviating pain, restoring erectile function in males, and improving the resolution of urinary stress incontinence in females. Furthermore, the bilateral approach consistently yielded positive outcomes in addressing urinary symptoms. The transgluteal technique appeared particularly suitable for cases of posterior PNE, situated between the sacrospinous ligament and the lesser sciatic foramen. A progressive amelioration of painful symptoms was observed during follow-up. Minimally invasive PNN is evolving and enables decompression along the entire proximal tract up to the Alcock canal, minimizing the risk of comorbidities. In addition to reducing pudendal neuralgia, robot-assisted and laparoscopic approaches determined a reduction in lower urinary tract symptoms and an improvement in erectile function, though further studies are required to corroborate these findings. PNN emerges as an effective treatment for PNE with minimal morbidity. Therefore, PNN should be tailored according to the site of PNE to enhance functional outcomes and improve patient quality of life.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

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Pudendal Nerve Neurolysis in Patients Afflicted With Pudendal Nerve Entrapment: A Systematic Review of Surgical Techniques and Their Efficacy

Giulioni,

Pirola,

Maggi

et al. 2024

Int Neurourol J

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“…Minimally invasive surgery has been introduced for pudendal nerve surgery, offering reduced operative time and a lower risk of postoperative complications. By using the robot-assisted technique, the Numeric Pain Rating Scale showed a reduction from 8 to 4 after 6 months, accompanied by a general “much improved” Patient Global Impression of Change [ 8 ]. These benefits also extend to symptoms related to the genitourinary sphere.…”

Section: Introductionmentioning

confidence: 99%

Pudendal nerve neurolysis outcomes for urogenital and rectal disorders in patients suffering from pudendal nerve entrapment: A systematic review

Giulioni,

Pitoni,

Fuligni

et al. 2024

Investig Clin Urol

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Purpose Pudendal neuropathy is an uncommon condition that exhibits several symptoms depending on the site of nerve entrapment. This study aims to evaluate the efficacy of pudendal nerve neurolysis (PNN) in improving lower urinary tract symptoms, anal and/or urinary incontinence, and sexual dysfunctions. Materials and Methods A systematic literature search was performed on 20 May 2023 using Scopus, PubMed, and Embase. Only English and adult papers were included. Meeting abstracts and preclinical studies were excluded. Results Twenty-one papers were accepted, revealing significant findings in the field. The study identified four primary sites of pudendal nerve entrapment (PNE), with the most prevalent location likely being at the level of the Alcock canal. Voiding symptoms are commonly exhibited in patients with PNE. PNN improved both urgency and voiding symptoms, and urinary and anal incontinence but is less effective in cases of long-standing entrapment. Regarding sexual function, the recovery of the somatic afferent pathway results in an improvement in erectile function early after neurolysis. Complete relief of persistent genital arousal disorder occurs in women, although bilateral PNN is necessary to achieve the efficacy. PNN is associated with low-grade complications. Conclusions PNN emerges as a viable option for addressing urinary symptoms, fecal incontinence, erectile dysfunction, and female sexual arousal in patients suffering from PNE with minimal postoperative morbidity.

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Impact of Treatment of Pudendal Neuralgia on Pain: A Systematic Review and Meta-Analysis

Andiman,

Maron,

Dandolu

et al. 2024

Int Urogynecol J

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First case-series of robot-assisted pudendal nerve release: technique and outcomes

Cited by 5 publications

References 17 publications

Pudendal Nerve Neurolysis in Patients Afflicted With Pudendal Nerve Entrapment: A Systematic Review of Surgical Techniques and Their Efficacy

Pudendal Nerve Neurolysis in Patients Afflicted With Pudendal Nerve Entrapment: A Systematic Review of Surgical Techniques and Their Efficacy

Pudendal nerve neurolysis outcomes for urogenital and rectal disorders in patients suffering from pudendal nerve entrapment: A systematic review

Impact of Treatment of Pudendal Neuralgia on Pain: A Systematic Review and Meta-Analysis

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