Artikel
Quality of life QoL after decompression of the pudendal nerve – is surgery a viable therapeutical option?
Lebensqualität nach Dekompression des Nervus pudendus – macht die chirurgische Behandlung Sinn?
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Veröffentlicht: | 4. Juni 2021 |
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Objective: Pudendal neuralgia can be caused by a rare compression neuropathy. Affected patients suffer from severe impairment of their social and personal life. Surgical decompression of the nerve is a treatment option. We evaluated outcomes of our operated patients in terms of patient’s satisfaction.
Methods: From 2015-2020 n=29 patients were operated for pudendal neuropathy, n=25 (n= 31 procedures) could be included in this retrospective study. Patient data and patient’s satisfaction were assessed using an adapted questionnaire.
Results: Mean age was 54 years, n=15 were female, n= 10 male. Pain was present in all patients, n= 5 presented with sensory, n=6 with motor deficits. All patients received preoperative nerve block. In n= 29 surgeries, we performed dorsal transgluteal decompression (n=13 unilateral/ n=12 bilateral) and in n=2 transperineal ventral. The identified compression site was in n=15 a hypertrophic sacrotuberal ligament. Additionally, n n=16 cases we found scarring and fibrous tissue, varicosis, and a sacrospinal ligament compression. No perioperative complications occurred. Overall postoperative pain intensity dropped significantly from 7.96 on Visual Analogue Scale VAS to 5.96 (p<0.0002). Pain medication could be reduced in n=10, n=11 improved their free time life activity and n=17 patients overall well-being.
Conclusion: In our experience, surgical pudendal nerve decompression led to a significant improvement if patient’s life quality. Careful patient selection and meticulous workup are mandatory for a successful treatment. Further studies with larger patient groups and longer follow-up are required.