Pudendal nerve decompression in perineology : a case series

Beco, Jacques; Climov, Daniela; Bex, Michèle

doi:10.1186/1471-2482-4-15

Cited by 89 publications

(75 citation statements)

References 32 publications

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“…The inferior rectal nerve is then traced to the entrance of Alcock's canal. 6 In a large series of 212 patients, Bautrant and colleagues described a transischiorectal approach to the pudendal nerve, 5 mostly for pudendal decompression (104 cases). The use of a transvaginal approach in a female patient has also been reported.…”

Section: Discussionmentioning

confidence: 99%

“…To date the most commonly described surgical approach for pelvic schwannomas has been open median laparotomy with transperitoneal dissection. 2 Only 2 cases of laparoscopy have been reported; 3,4 other approaches, such as transischiorectal, 5 transperineal, 6 transgluteal 7 and transvaginal, 8 are just as rare. We report a case of a pudendal schwannoma removed laparoscopically.…”

Section: Introductionmentioning

confidence: 99%

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Pudendal schwannoma: A case report and literature review

Mazzola

Power

Bilsky

et al. 2014

CUAJ

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Schwannomas are benign nerve sheath tumours most often associated with the cranial nerves and the peripheral nerve system of the neck and extremities. Pelvic schwannomas are rare, with only about 25 cases reported. We report the case of a 34-year-old man referred for worsening pain of 10 years duration involving the right testicle and right penile shaft. Magnetic resonance imaging discovered a well-circumscribed pelvic tumour of 3.2 × 2.8 × 3.2 cm. Considering the possible complications involved in exposing the pudendal nerve during surgical resection, we performed an extensive literature search to aid preoperative planning. The most commonly described surgical approach for pelvic schwannomas has been open median laparotomy with transperitoneal dissection. To our knowledge, pudendal schwannomas have never been described in the literature. However, after considering the location and characteristics of the tumour, we chose laparoscopy because it offers the advantages of better visualization of anatomical structures with minimal invasiveness and faster recovery. At the 3-week follow-up, the patient described a significant decrease in pain and normal neurological and urological examinations.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Pudendal schwannoma: A case report and literature review

Mazzola

Power

Bilsky

et al. 2014

CUAJ

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“…Perner 29 described lower urinary tract symptoms in a prospective observational study of 108 male patients admitted for surgery for lumbar disc herniation or spinal stenosis. The distal pudendal nerve is susceptible to compression at the passage from Alcock's canal, often resulting in urinary incontinence and other symptoms 30,31 ; surgical treatment for pudendal nerve compression has been described. 31 There have been some case reports of symphysis pubis diastasis which resulted in urinary symptoms including urinary incontinence.…”

Section: Clinical Evidence For a Spinal Origin Of Urinary Bladder Dysmentioning

confidence: 99%

“…The distal pudendal nerve is susceptible to compression at the passage from Alcock's canal, often resulting in urinary incontinence and other symptoms 30,31 ; surgical treatment for pudendal nerve compression has been described. 31 There have been some case reports of symphysis pubis diastasis which resulted in urinary symptoms including urinary incontinence. 32,33 Clinical Evidence Suggesting Manual Therapy Alleviates Lower Urinary Tract Dysfunction Dangaria 34 reports a case of a 27-year-old female with urinary frequency and urgency that resolved with sacroiliac manipulation, perhaps due to shared innervation.…”

Section: Clinical Evidence For a Spinal Origin Of Urinary Bladder Dysmentioning

confidence: 99%

Chiropractic Management of Pubic Symphysis Shear Dysfunction in a Patient With Overactive Bladder

Cooperstein

Lisi

Burd

2014

Journal of Chiropractic Medicine

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Objective: The purpose of this case report is to describe chiropractic management of a patient with overactive bladder (OAB) and to describe an hypothetical anatomical basis for a somatovesical reflex and possible clinical link between pelvic and symphysis pubis dysfunction to OAB. Clinical features: A 24-year-old nulliparous female with idiopathic OAB, with a primary complaint of nocturia presented for chiropractic care. Her sleep was limited to 2 consecutive hours due to bladder urgency. Pubic symphysis shear dysfunction was observed on physical examination. Intervention and outcomes: The primary treatment modality used was chiropractic side-posture drop-table manipulation designed to reduce pubic shear dysfunction. After 8 treatments in 1 month, the pubic shear gradually reduced while nocturia diminished and consecutive sleep hours increased from 2 to 7. At 1-year follow-up, the nocturia remained resolved. Conclusion: The patient reported in this case responded favorably to chiropractic care, which resulted in reduced nocturia and increased sleep continuity.

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“…[18,19] Also, other explanations for pelvic pain need to be considered. [20][21][22][23][24][25][26] Teaching clinical anatomy of the female pelvic floor to undergraduate students: a critical review of neuralgic points * Beat M. Riederer 1 At the University of Lausanne, Switzerland, pelvis and pelvic floor anatomy of men and women is taught in the second year of medical studies; this includes also students from dentistry and psychiatric curricula. Teaching is done in form of four periods of ex cathedra lectures, three hours of pelvic dissection to realize the complexity of the region, and two hours of self-directed learning on prosected and plastinated specimens of the pelvic floor to understand the three-dimensional organization.…”

Section: Introductionmentioning

confidence: 99%

Teaching clinical anatomy of the female pelvic floor to undergraduate students: a critical review of neuralgic points

Riederer¹,

Spinosa²

2011

Anatomy

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Pelvic floor anatomy is complex and its three-dimensional organization is often difficult to understand for both undergraduate and postgraduate students. Here, we focused on several critical points that need to be considered when teaching the perineum. We have to deal with a mixed population of students and with a variety of interest. Yet, a perfect knowledge of the pelvic floor is the basis for any gynecologist and for any surgical intervention. Our objectives are several-fold; i) to establish the objectives and the best way of teaching, ii) to identify and localize areas in the female pelvic floor that are susceptible to generate problems in understanding the three-dimensional organization, iii) to create novel approaches by respecting the anatomical surroundings, and iv) prospectively, to identify elements that may create problems during surgery i.e. to have a closer look at nerve trajectories and on compression sites that may cause neuralgia or postoperative pain. A feedback from students concludes that they have difficulties to assimilate this much information, especially the different imaging techniques. Eventually, this will lead to a severe selection of what has to be taught and included in lectures or practicals. Another consequence is that more time to study prosected pelves needs to be given.

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Pudendal nerve decompression in perineology : a case series

Cited by 89 publications

References 32 publications

Pudendal schwannoma: A case report and literature review

Pudendal schwannoma: A case report and literature review

Chiropractic Management of Pubic Symphysis Shear Dysfunction in a Patient With Overactive Bladder

Teaching clinical anatomy of the female pelvic floor to undergraduate students: a critical review of neuralgic points

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