[Surgical decompression of pudendal nerve by transperineal approach using a probe with a small balloon]

Describe and analyze the surgical decompression of pudendal nerve by transperineal approach using a probe with a small balloon.

Since 2009 may, 43 patients (31 females, 12 males) underwent for a pudendal nerve decompression. These patients had clinical symptoms of pudendal neuralgia. Neurophysiological tests based on differential staged sacral reflexes and on somesthesic evoked potentials and ultrasound investigations of pudendal vessels evoked a zone of compressive hyperpressure at the level of the axis infrapiriformis area-ischiorectal fossea. In all of these 43 patients, injection block at the level of the infrapiriformis area appeared positive between one to nine months. Patients were known for this pathology since many years. Among these 43 patients, six had already pudendal nerve decompression, four by transgluteal approach and two by transvaginal (♀)/transischiorectal (♂) approach but without clinical efficiency. In all of these 43 patients, surgical decompression was done by transperineal approach using a probe with a small balloon.

Surgical methodology, post-operation follow-up and results are reported hereby, which appear quite successful: after two days 77%, after one month 84% and after three months 89% of the subjects are symptom-free or with a significant reduction of pain.