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Updated: Aug 8, 2026
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Microvascular Decompression: Salient Surgical Principles and Technical Nuances
Published on: July 5, 2011
[Modern algorithm for treating pudendal neuralgia: 212 cases and 104 decompressions]
E Bautrant1, E de Bisschop, V Vaini-Elies
1Centre Libéral Aixois de Réhabilitation Pelvi-périnéale, Le Grand Angle, 4, place Barthélémy Niollon, 13100 Aix-en-Provence.
Summary
Pudendal neuralgia diagnosis is challenging, but electrophysiological tests aid confirmation. Surgical decompression offers significant pain relief for many women with peripheral pudendal nerve injury.
Area of Science:
- Neurology
- Surgical Anatomy
Context:
- Pudendal neuralgia presents with diverse and variable symptoms, complicating clinical diagnosis.
- Electrophysiological tests are crucial for confirming or refuting pudendal neuralgia.
- A diagnosis score facilitated patient selection for this study.
Purpose:
- To evaluate the diagnostic methods and treatment outcomes for pudendal neuralgia in women.
- To identify the most common sites of pudendal nerve entrapment.
- To assess the efficacy of surgical decompression for intractable pudendal neuralgia.
Summary:
- Over a four-year period, 200 women with peripheral pudendal nerve injury were studied.
- The sacro-spino-tuberal ligament grip was the most frequent site of entrapment (68%), followed by Alcock canal (20%).
- Surgical decompression via a trans-ischio-rectal approach was performed on 104 patients, with 86% achieving symptom relief after one year.
Impact:
- This study highlights the effectiveness of surgical decompression for pudendal neuralgia.
- It provides valuable insights into the anatomical locations of pudendal nerve entrapment.
- The findings support the use of a structured diagnostic approach and surgical intervention for improved patient outcomes.
