[Dyschezia, pudendal neuropathy, and functional pelvico-perineal disorders]

A critical literature review allows an analysis on chronic constipation evaluation and on the association with anatomical or functional pelvic perineal disorders, the link with a pudendal neuropathy being frequent. The dyschezia clinical diagnosis must be completed by X-ray and manometric examinations to well determine the respective part of anatomical and/or functional disturbances. Stretch pudendal neuropathy was first described in association with descending perineum and chronic constipation. This kind of neuropathy is frequently obvious in other pelvic defects, genital prolapses, urinary incontinence, micturition disturbances. The diagnosis must be made with a complete electrophysiological assessment and not only with the pudendal nerve latency terminal motor latency measurement. These pelvic-perineal disorders have plurifactorial aetiologies, they are linked together without univoqual chronology, each one may be the cause or the consequence of the other, and self-worsening evolution may occur.