• Pain Med · Aug 2015

    Pudendal Neuralgia: A New Option for Treatment? Preliminary Results on Feasibility and Efficacy.

    • Marco Venturi, Paolo Boccasanta, Bruno Lombardi, Max Brambilla, Contessini AvesaniEttoreEDepartment of Pathophysiology and Transplantation, Section of Surgery, Università degli Studi di Milano.Department of General and Emergency Surgery, Fondazione I.R.C.C.S Ca' Granda, Ospedale Maggiore Policlinico, Via F. Sforza 35,, and Contardo Vergani.
    • Department of Pathophysiology and Transplantation, Section of Surgery, Università degli Studi di Milano.
    • Pain Med. 2015 Aug 1; 16 (8): 1475-81.

    ObjectiveThe aim of this prospective study was to investigate the feasibility and report the short-term results of a new procedure for treatment of pudendal neuralgia, consisting of transperineal injections of autologous adipose tissue with stem cells along the Alcock's canal.MethodsFifteen women with pudendal neuralgia not responsive to 3-months medical therapy were examined clinically, with VAS score, validated SF-36 questionnaire, and pudendal nerve motor terminal latency (PNMTL). These patients were submitted to pudendal nerve lipofilling. Clinical examinations with VAS, SF36, and PNTML were scheduled during 12 months follow-up, with the incidence of pain recurrence (VAS > 5) as primary outcome measure. Appropriate tests were used for statistics.ResultsAll patients had preoperative increase of pudendal nerve latencies. Twelve patients completed the follow-up protocol. There was no mortality, and no complications. Two patients had no pain improvement and continued to use analgesic drugs. At 12 months VAS significantly improved (3.2 ± 0.6 vs 8.1 ± 0.9, P < 0.001), as well SF36 (75.5 ± 4.1 vs 85.0 ± 4.5 preoperative, P < 0.01), while PNTML showed a nonsignificant trend to a better nerve conduction (2.64 ± 0.04 vs 2.75 ± 0.03 preoperative, P = 0.06).ConclusionsThe new technique seems to be easy, with low risk of complications, and with significant improvement of symptoms in the short period. A larger study with appropriate controls and longer follow-up is now needed to assess its real effectiveness.Wiley Periodicals, Inc.

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