O. Fomenko, A. A. Mudrov, S. V. Belousova, M. A. Nekrasov, S. Achkasov
{"title":"会阴下降综合征会阴神经病变的复杂神经电生理算法","authors":"O. Fomenko, A. A. Mudrov, S. V. Belousova, M. A. Nekrasov, S. Achkasov","doi":"10.33878/2073-7556-2023-22-4-80-88","DOIUrl":null,"url":null,"abstract":"Aim: to improve diagnostics for descending perineum syndrome.Patients and Methods: the prospective cohort study included 127 patients (85 (66.9%) — females), aged 49.9 ± 14.4 years with descending perineum syndrome. All patients had proctogenic constipation, anal incontinence and/or chronic neurogenic pelvic pain. All patients underwent a neurophysiological examination according to the original complex pudendal nerve terminal motor latency (PNTML) method — neurophysiological protocol for detection of the pelvic floor muscles innervation disorders.Results: the latency of the M-response of the pudendal nerve increased on at least one side in 85 (66.9%) patients (50 women and 35 men). The use of a new complex neurophysiological diagnostic protocol made it possible to identify signs of pudendal neuropathy in 29.9% of patients. The incidence of neuropathy in patients with clinically significant perineal prolapse syndrome was 96.5% in females and 97.6% in males.Conclusion: the new complex neurophysiological diagnostic algorithm made it possible to identify disorders of innervation along the efferent pathway in the Alcock’s canal and distally in 85 (66.9%) cases, along the efferent pathway proximal to the Alcock’s canal — in 23 (18.1%); a combination of efferent and afferent disturbances occurred in 15 (11.8%).","PeriodicalId":17840,"journal":{"name":"Koloproktologia","volume":"82 7","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Complex neurophysiological algorithm for pudendal nerve neuropathy for descending perineum syndrome\",\"authors\":\"O. Fomenko, A. A. Mudrov, S. V. Belousova, M. A. Nekrasov, S. Achkasov\",\"doi\":\"10.33878/2073-7556-2023-22-4-80-88\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Aim: to improve diagnostics for descending perineum syndrome.Patients and Methods: the prospective cohort study included 127 patients (85 (66.9%) — females), aged 49.9 ± 14.4 years with descending perineum syndrome. All patients had proctogenic constipation, anal incontinence and/or chronic neurogenic pelvic pain. All patients underwent a neurophysiological examination according to the original complex pudendal nerve terminal motor latency (PNTML) method — neurophysiological protocol for detection of the pelvic floor muscles innervation disorders.Results: the latency of the M-response of the pudendal nerve increased on at least one side in 85 (66.9%) patients (50 women and 35 men). The use of a new complex neurophysiological diagnostic protocol made it possible to identify signs of pudendal neuropathy in 29.9% of patients. The incidence of neuropathy in patients with clinically significant perineal prolapse syndrome was 96.5% in females and 97.6% in males.Conclusion: the new complex neurophysiological diagnostic algorithm made it possible to identify disorders of innervation along the efferent pathway in the Alcock’s canal and distally in 85 (66.9%) cases, along the efferent pathway proximal to the Alcock’s canal — in 23 (18.1%); a combination of efferent and afferent disturbances occurred in 15 (11.8%).\",\"PeriodicalId\":17840,\"journal\":{\"name\":\"Koloproktologia\",\"volume\":\"82 7\",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-12-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Koloproktologia\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.33878/2073-7556-2023-22-4-80-88\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Koloproktologia","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.33878/2073-7556-2023-22-4-80-88","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Complex neurophysiological algorithm for pudendal nerve neuropathy for descending perineum syndrome
Aim: to improve diagnostics for descending perineum syndrome.Patients and Methods: the prospective cohort study included 127 patients (85 (66.9%) — females), aged 49.9 ± 14.4 years with descending perineum syndrome. All patients had proctogenic constipation, anal incontinence and/or chronic neurogenic pelvic pain. All patients underwent a neurophysiological examination according to the original complex pudendal nerve terminal motor latency (PNTML) method — neurophysiological protocol for detection of the pelvic floor muscles innervation disorders.Results: the latency of the M-response of the pudendal nerve increased on at least one side in 85 (66.9%) patients (50 women and 35 men). The use of a new complex neurophysiological diagnostic protocol made it possible to identify signs of pudendal neuropathy in 29.9% of patients. The incidence of neuropathy in patients with clinically significant perineal prolapse syndrome was 96.5% in females and 97.6% in males.Conclusion: the new complex neurophysiological diagnostic algorithm made it possible to identify disorders of innervation along the efferent pathway in the Alcock’s canal and distally in 85 (66.9%) cases, along the efferent pathway proximal to the Alcock’s canal — in 23 (18.1%); a combination of efferent and afferent disturbances occurred in 15 (11.8%).