Long-term outcomes of applying pulsed radiofrequency ablation in patients with pudendal neuropathy
https://doi.org/10.34680/2076-8052.2024.2(136).311-321
Abstract
The study includes medical records of patients with pudendal neuropathy (PN) who underwent the pulsed radiofrequency ablation (PRA) procedure. Clinical parameters and adverse events were studied during the entire perioperative period. The follow-up period for the respondents was at least 24 months. The study includes medical records of 25 patients (17 (68%) female respondents, 8 (32%) male respondents, the age of patients ranged from 28 to 80 years, the average age was 54.5±13.7 years) with a confirmed PN diagnosis, who underwent the PRA procedure of the pudendal nerves. Analysis of the severity of pain syndrome according to visual analogue scale (VAS) at 3, 6, 9, 12 and 24 months after the PRA procedure showed a significant decrease in this indicator (p < 0.001). In the early postoperative period (the first 7 days after the operation), there was a statistically significant improvement in the level of patients’ capacity according to Oswestry Disability Index (ODI) by 10–15% in 72% (p=0.042). In the late period of the respondents’ postoperative observation, we also noted a significant improvement in the level of capacity by ODI (p<0.001). The study of the time spent in the respondents’ sitting position showed a statistically significant increase in this indicator from 29±13 minutes to 83±37 minutes 3 months after the PRA procedure of the pudendal nerves and up to 86±41 minutes after 12 months (p<0.001). There were no significant adverse clinical events in the study group of patients. PRA procedure of pudendal nerves is an effective and safe method of minimally invasive surgical treatment of patients with PN. The clinical efficacy of PRA of the pudendal nerves in the long-term period of patients’ postoperative follow-up was 92%.
About the Authors
I. A. Stepanov
Irkutsk State Medical University; Kharlampiev Clinic
Russian Federation
Russian Federation
Irkutsk
V. A. Beloborodov
Irkutsk State Medical University
Russian Federation
Russian Federation
Irkutsk
References
1. Khoder W., Hale D. Pudendal neuralgia // Obstetrics and Gynecology Clinics of North America. 2014. 41(3). 443-452. DOI: 10.1016/j.ogc.2014.04.002
2. Hibner M., Desai N., Robertson L. J., Nour M. Pudendal neuralgia // Journal of Minimally Invasive Gynecology. 2010. 17(2). 148-153. DOI: 10.1016/j.jmig.2009.11.003
3. Spinosa J.-P., de Bisschop E., Laurençon J., Kuhn G., Dubuisson J. B., Riederer B. M. Les réflexes sacrés etagés dans l'etude de la névralgie pudendalte: validation anatomique [Sacral staged reflexes to localize the pudendal compression: an anatomical validation of the concept] // Revue Medicale Suisse. 2006. 2(84). 2416-2421.
4. Izvozchikov S. B. Tazovaya bol' v praktike vracha-nevrologa [Pelvic pain in neurological practice] // S. S. Korsakov Journal of Neurology and Psychiatry. 2018. 118(4). 94-99. DOI: 10.17116/jnevro20181184194-99
5. Izvozchikov S. B. Mekhanizmy formirovaniya i diagnostika tunnel'nykh pudendoneyropatiy [Mechanisms of formation and diagnosis of tunnel pudendal neuropathy] // S. S. Korsakov Journal of Neurology and Psychiatry. 2019. 119(11). 98-102. DOI: 10.17116/jnevro201911911198
6. Pérez-López F. R., Hita-Contreras F. Management of pudendal neuralgia // Climacteric. 2014. 17(6). 654-656. DOI: 10.3109/13697137.2014.912263
7. Luesma M. J., Galé I., Fernando J. Diagnostic and therapeutic algorithm for pudendal nerve entrapment syndrome // Medicina Clínica (English Edition). 2021. 157(2). 71-78. DOI: 10.1016/j.medcli.2021.02.002
8. Chang M. C. Efficacy of Pulsed Radiofrequency Stimulation in Patients with Peripheral Neuropathic Pain: A Narrative Review // Pain Physician. 2018. 21(3). E225-E234. DOI: 10.36076/ppj.2018.3.E225
9. Krijnen E. A., Schweitzer K. J., van Wijck A. J. M., Withagen M. I. J. Pulsed Radiofrequency of Pudendal Nerve for Treatment in Patients with Pudendal Neuralgia. A Case Series with Long-Term Follow-Up // Pain Practice. 2021. 21(6). 703-707. DOI: 10.1111/papr.12999
10. Petrov-Kondratov V., Chhabra A., Jones S. Pulsed Radiofrequency Ablation of Pudendal Nerve for Treatment of a Case of Refractory Pelvic Pain // Pain Physician. 2017. 20(3). E451-E454.
11. Vandenbroucke J. P., von Elm E., Altman D. G., Gøtzsche P. C., Mulrow C. D Pocock S. J., Poole C., Schlesselman J. J., Egger M. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): explanation and elaboration // PLoS Medicine. 2007. 4(10). e297. DOI: 10.1371/journal.pmed.0040297
12. Labat J. J., Riant T., Robert R., Amarenco G., Lefaucheur J. P., Rigaud J. Diagnostic criteria for pudendal neuralgia by pudendal nerve entrapment (Nantes criteria) // Neurourology and Urodynamics. 2008. 27(4). 306-310. DOI: 10.1002/nau.20505
13. World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects // Journal of the American Medical Association (JAMA). 2013. 310(20). 2191-2194. DOI: 10.1001/jama.2013.281053
14. Robert R., Labat J. J., Bensignor M., Glemain P., Deschamps C., Raoul S., Hamel O. Decompression and transposition of the pudendal nerve in pudendal neuralgia: a randomized controlled trial and long-term evaluation // European Urology. 2005. 47(3). 403-408. DOI: 10.1016/j.eururo.2004.09.003
15. Ploteau S., Perrouin-Verbe M. A., Labat J. J., Riant T., Levesque A., Robert R. Anatomical Variants of the Pudendal Nerve Observed during a Transgluteal Surgical Approach in a Population of Patients with Pudendal Neuralgia // Pain Physician. 2017. 20(1). E137-E143. DOI: 10.36076/2017.1.E137
16. Pélissié M., Fischbach E., Lecointre L., Faller E., Akladios C. Pudendal Neurolysis by Laparoscopy // Journal of Minimally Invasive Gynecology. 2021. 28(5). 938. DOI: 10.1016/j.jmig.2020.11.003
17. Waxweiler C., Dobos S., Thill V., Bruyninx L. Selection criteria for surgical treatment of pudendal neuralgia // Neurourology and Urodynamics. 2017. 36(3). 663-666. DOI: 10.1002/nau.22988
18. Rhame E. E., Levey K. A., Gharibo C. G. Successful treatment of refractory pudendal neuralgia with pulsed radiofrequency // Pain Physician. 2009. 12(3). 633-638. DOI: 10.36076/ppj.2009/12/633
19. Chang M. C. Efficacy of Pulsed Radiofrequency Stimulation in Patients with Peripheral Neuropathic Pain: A Narrative Review // Pain Physician. 2018. 21(3). E225-E234. DOI: 10.36076/ppj.2018.3.E225
20. Teixeira A., Sluijter M. E. Intradiscal high-voltage, long-duration pulsed radiofrequency for discogenic pain: a preliminary report // Pain Medicine. 2006. 7(5). 424-428. DOI: 10.1111/j.1526-4637.2006.00148.x
21. Cahana A., Van Zundert J., Macrea L., van Kleef M., Sluijter M. Pulsed radiofrequency: current clinical and biological literature available // Pain Medicane. 2006. 7(5). 411-423. DOI: 10.1111/j.1526-4637.2006.00148.x
22. Fang H., Zhang J., Yang Y., Ye L., Wang X. Clinical effect and safety of pulsed radiofrequency treatment for pudendal neuralgia: a prospective, randomized controlled clinical trial // Journal of Pain Research. 2018. 11. 2367-2374. DOI: 10.2147/JPR.S167866
23. Ozkan D., Akkaya T., Yildiz S., Comert A. Ultrasound-guided pulsed radiofrequency treatment of the pudendal nerve in chronic pelvic pain // Der Anaesthesist. 2016. 65(2). 134-136. DOI: 10.1007/s00101-015-0133-4
Review
For citations:
Stepanov I.A., Beloborodov V.A. Long-term outcomes of applying pulsed radiofrequency ablation in patients with pudendal neuropathy. Title in english. 2024;(2(136)):311-321. (In Russ.) https://doi.org/10.34680/2076-8052.2024.2(136).311-321
Views:
32
Email this article 