Surgical Decompression of Pudendal Nerve by Transperineal Approach Using a Balloon Probe

Abstract

Since 2009 may to 31 january 2012, 512 patients (371 females, 141 males) have benefited fro m a pudendal nerve (PN) deco mpression by transperineal approach using a ballon probe. These patients had clinical sympto ms of pudendal neuralgia. Neurophysiological tests based on the staged sacral reflexes, on ultrasound investigations of pudendal vessels and on a pelvic floor u ltrasounds evoked a zone of compressive hyperpressure at the level of the axis infrapirifo rmis area-ischiorectal fossa. All of these 512 patients, in jection block at the level of the infrapirifo rmis area appeared positive between 1 to 9 months. Patients were known for this pathology since many years. Among these 512 patients, 66 had already PN decomp ression, 27 by t ransgluteal approach, 36 by transvaginal (♀)/transischiorectal (♂) approach and 3 by transperineal approach (Shakik extended) but without clinical efficiency. All of these 512 patients, surgical decompression was done by transperineal approach using a balloon probe. Surgical methodology, post-op follow up and results are reported hereby, which appear quite successful with few risks to make worse the pathology and no risk on pelvic static.