Pudendal nerve decompression in perineology: a case series

Area of Science:

• Neurology
• Pelvic Health
• Surgical Innovation

Background:

• Pudendal Canal Syndrome (PCS) involves perineodynia, anal, and urinary incontinence due to pudendal nerve entrapment.
• Key symptoms include abnormal sensibility, painful Alcock's canal, and a positive
• skin rolling test.

Purpose of the Study:

• Evaluate the efficacy of bilateral pudendal nerve decompression (PND) on PCS symptoms.
• Assess the impact of PND on clinical and neurophysiological markers.
• Determine the diagnostic value of clinical signs in PCS.

Main Methods:

• Retrospective analysis of 74 female patients undergoing bilateral PND (1995-2002).
• Comparison of patient symptoms and clinical signs before and after surgery.
• Statistical comparison with a control group of 82 women without relevant pelvic conditions.

Main Results:

• Bilateral PND achieved cure rates of 8/14 for perineodynia, 4/5 for anal incontinence, and 3/5 for urinary incontinence.
• Significant reduction in the frequency of clinical signs, PNTML values, and increased anal EMG richness observed.
• The three clinical signs demonstrated a high Odd Ratio (16.97) for PCS diagnosis.

Conclusions:

• Bilateral PND is a viable treatment for perineodynia, anal, and urinary incontinence in PCS.
• Clinical signs are effective in suspecting a PCS diagnosis.
• Further research is recommended to validate these findings.