Selection criteria for surgical treatment of pudendal neuralgia

Waxweiler, Charlotte; Dobos, Sebastian; Thill, V.; Bruyninx, Luc

doi:10.1002/nau.22988

Cited by 15 publications

(8 citation statements)

References 7 publications

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“…As suggested by Amarenco et al (1997), taking into account their short duration of effectiveness (only 15% effectiveness at 1 year), intracanal injections were more a method of selecting surgical indications than a therapeutic weapon. The positive block test as a selection criterion for patients eligible for pudendal nerve release surgery will also be resumed and validated in a retrospective study (Waxweiler et al, 2017).…”

Section: Resultsmentioning

confidence: 99%

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Recommendations on the management of pudendal nerve entrapment syndrome: A formalised expert consensus

Levesque

Bautrant²,

Quistrebert

et al. 2021

European Journal of Pain

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Background Since the development and publication of diagnostic criteria for pudendal nerve entrapment (PNE) syndrome in 2008, no comprehensive work has been published on the clinical knowledge in the management of this condition. The aim of this work was to develop recommendations on the diagnosis and the management of PNE. Methods The methodology of this study was based on French High Authority for Health Method for the development of good practice and the literature review was based on the PRISMA method. The selected articles have all been evaluated according to the American Society of Interventional Pain Physicians assessment grid. Results The results of the literature review and expert consensus are incorporated into 10 sections to describe diagnosis and management of PNE: (1) diagnosis of PNE, (2) patients advice and precautions, (3) drugs treatments, (4) physiotherapy, (5) transcutaneous electrostimulations (TENS), (6) psychotherapy, (7) injections, (8) surgery, (9) pulsed radiofrequency, and (10) Neuromodulation. The following major points should be noted: (i) the relevance of 4+1 Nantes criteria for diagnosis; (ii) the preference for initial monotherapy with tri‐tetracyclics or gabapentinoids; (iii) the lack of effect of opiates, (iv) the likely relevance (pending more controlled studies) of physiotherapy, TENS and cognitive behavioural therapy; (v) the incertitudes (lack of data) regarding corticoid injections, (vi) surgery is a long term effective treatment and (vii) radiofrequency needs a longer follow‐up to be currently proposed in this indication. Conclusion These recommendations should allow rational and homogeneous management of patients suffering from PNE. They should also allow to shorten the delays of management by directing the primary care. Significance Pudendal nerve entrapment (PNE) has only been known for about 20 years and its management is heterogeneous from one practitioner to another. This work offers a synthesis of the literature and international experts' opinions on the diagnosis and management of PNE.

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Section: Resultsmentioning

confidence: 99%

“…According to the authors, surgery is effective in 60–80% of cases. As described by Waxweiler et al (2017), a rigorous selection of patients is necessary in order to exclude the effectiveness of surgery. Only patients presenting the five Nantes criteria were, in this study, responders to surgery.…”

Section: Resultsmentioning

confidence: 99%

Recommendations on the management of pudendal nerve entrapment syndrome: A formalised expert consensus

Levesque

Bautrant²,

Quistrebert

et al. 2021

European Journal of Pain

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“…4 Repetitive, sequential PNPI (n = 3 at 4-week intervals) gradually reduce symptoms. 5 Subjectively, patients often note an increase in pain after week three. Validated symptom scores, used weekly, demonstrate the effectiveness of such a treatment series.…”

Section: Sirmentioning

confidence: 99%

Re: Adding corticosteroids to the pudendal nerve block for pudendal neuralgia: a randomised, double‐blind, controlled trial

Antolak¹,

Chung

2017

BJOG

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“…We performed a diagnostic pudendal nerve block in several patients and subsequent surgery in the case of a positive test response, as this fifth Nantes criteria is an effective predictor of surgical success. 4 Although the diagnosis of pudendal nerve entrapment was indeed subjective, we only performed suture removal in patients who were severely limited in performing their daily activities because of pain, and when conservative treatment had failed.…”

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confidence: 99%

Authors’ reply: Surgical management of pudendal nerve entrapment after sacrospinous ligament fixation

Vodegel

Delft

Nuboer

et al. 2022

BJOG

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Selection criteria for surgical treatment of pudendal neuralgia

Abstract: The selection of candidates for surgery should always include a single diagnostic anesthetic injection of the pudendal nerve, as the fifth of the Nantes criteria is an effective predictor of the success of surgery. Neurourol. Urodynam. 36:663-666, 2017. © 2016 Wiley Periodicals, Inc.

Cited by 15 publications

References 7 publications

Recommendations on the management of pudendal nerve entrapment syndrome: A formalised expert consensus

Recommendations on the management of pudendal nerve entrapment syndrome: A formalised expert consensus

Re: Adding corticosteroids to the pudendal nerve block for pudendal neuralgia: a randomised, double‐blind, controlled trial

Authors’ reply: Surgical management of pudendal nerve entrapment after sacrospinous ligament fixation

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