Neuropelveological assessment of neuropathic pelvic pain

Possover, Marc; Forman, Axel

doi:10.1007/s10397-014-0838-4

Cited by 17 publications

(7 citation statements)

References 9 publications

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“…Somatic pelvic nerve damage due to endometriosis is responsible for pain that precedes functional impairment. Systematized neuropelveological evaluation, including anamnesis and gynecological examination, anamnesis on neurological symptoms and exploration of plexus and pelvic nerves adapted to the gynecological pathology, including imaging and functional techniques, is necessary in these cases of chronic pain (16, 17).…”

Section: Discussionmentioning

confidence: 99%

Sciatic Nerve Involvement as an Unusual Presentation of Deep Endometriosis

Carrasco

Gutiérrez

et al. 2017

Journal of Endometriosis and Pelvic Pain Disorders

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ORIGINAL RESEARCH ARTICLE to 40% (5). Thus, sciatica and endometriosis are frequent pathologies and it is not uncommon for them to occur simultaneously. Endometriosis as the cause of sciatica by direct involvement of the sciatic nerve is extremely rare. This condition was first described by Denton and Sherrill (6). In relation to this issue, the most important thing is that neuropathy can occur over time, and because diagnosis is usually delayed for years, serious and often irreversible consequences that affect the quality of life of patients happen. We report our experience in the diagnosis, management and treatment of two cases of endometriosis with histologic confirmation affecting the sciatic nerve. Methods After patients' specific consent, we retrospectively reviewed the medical charts of all sciatic nerve endometriosis cases followed up at the Endometriosis Unit of La Paz University Hospital since 2006 to the present. We searched in our Unit of Endometriosis database and the inclusion criteria were: recurrent catamenial sciatica, in the absence of spinal pathology, MRI pointing to endometriosis as the cause of symptoms and

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Section: Discussionmentioning

confidence: 99%

Sciatic Nerve Involvement as an Unusual Presentation of Deep Endometriosis

Carrasco

Gutiérrez

et al. 2017

Journal of Endometriosis and Pelvic Pain Disorders

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“…After then, Pereira et al [9] studied PN according to the segmental anatomy of the pudendal nerve. Recently, Neuropelveology has been introduced as a new discipline focused on determining the level of the lesion (below, in, or above the pelvis) [10]. Entrapment of the endopelvic part of the pudendal nerve may cause similar perineal or perianal pain with the extrapelvic pudendal nerve entrapment.…”

Section: Introductionmentioning

confidence: 99%

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

Başol

Kale

Gürbüz

et al. 2022

Preprint

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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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“…The diagnostic stage uses its own instruments and an anamnesis covering many aspects from gynecology, urology, orthopedics, pelvic vessel pathology and psychology of the chronic patient and parapleology. The clinical examination combines the examination of the pelvic organs and their functions, the neurological examination of the musculoskeletal system with a neuropelveological examination and the palpation of the pelvic nerves by the vaginal or rectal route [ 8 ]. As somatic, neuropathic pain is more specific, a neuropelveological workup typically allows for specific diagnosis of the lesion site in the pelvic nerves.…”

Section: Introductionmentioning

confidence: 99%

Neuropelveology: An Emerging Discipline for the Management of Pelvic Neuropathies and Bladder Dysfunctions through to Spinal Cord Injury, Anti-Ageing and the Mars Mission

Possover

2020

JCM

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Neuropelveology is a new specialty in medicine that has yet to prove itself but the need for it is obvious. This specialty includes the diagnosis and treatment of pathologies and dysfunctions of the pelvic nerves. It encompasses knowledge that is for the most part already known but scattered throughout various other specialties; neuropelveology gathers all this knowledge together. Since the establishment of the International Society of Neuropelveology, this discipline is experiencing an ever-growing interest. In this manuscript, the author gives an overview of the different aspects of neuropelveology from the management of pelvic neuropathic pain to pelvic nerves stimulation for the control of pelvic organ dysfunctions and loss of functions in people with spinal cord injuries. The latter therapeutic option opens up new treatments but also widens preventive horizons not only in the field of curative medicine (osteoporosis and cardio-vascular diseases) but also in preventive medicine and anti-ageing, all the way to future applications in the “Mars mission” project.

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Neuropelveological assessment of neuropathic pelvic pain

Cited by 17 publications

References 9 publications

Sciatic Nerve Involvement as an Unusual Presentation of Deep Endometriosis

Sciatic Nerve Involvement as an Unusual Presentation of Deep Endometriosis

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

Neuropelveology: An Emerging Discipline for the Management of Pelvic Neuropathies and Bladder Dysfunctions through to Spinal Cord Injury, Anti-Ageing and the Mars Mission

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