[Pudendal nerve surgery in the management of chronic pelvic and perineal pain].

OBJECTIVE

To define the place of pudendal nerve surgery in pudendal nerve entrapment syndromes.

MATERIALS AND

METHODS

Description of the various surgical techniques and published results.

RESULTS

The original surgical technique, which remains the reference technique, consists of performing surgical release of the pudendal nerve from the infrapiriformis foramen to Alcock's canal via a transgluteal approach. This surgical procedure is safe and gives encouraging results validated by a prospective, randomized protocol: 66 to 80% of patients are improved. Other transvaginal or transperineal approaches have also been proposed.

CONCLUSION

Pudendal nerve surgery is a reasonable treatment option when all other treatments have failed. However, the various techniques proposed and their respective criticisms must be carefully evaluated.