Premium
The drug‐resistant pudendal neuralgia management: A systematic review
Author(s) -
Tricard Thibault,
Munier Pierre,
Story Fleur,
Lang Hervé,
Saussine Christian
Publication year - 2019
Publication title -
neurourology and urodynamics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 90
eISSN - 1520-6777
pISSN - 0733-2467
DOI - 10.1002/nau.23824
Subject(s) - medicine , medline , prospective cohort study , homogeneous , meta analysis , systematic review , pudendal nerve , neuralgia , surgery , neuropathic pain , anesthesia , physics , political science , law , thermodynamics
Aims Pudendal neuralgia (PN) due to pudendal nerve entrapment is a well‐known disease in medical community but both diagnostic and treatment may be delayed for patients. The goal of this study was to achieve a systematic review of the published treatments of PN in order to help physician to take their decision to treat PN. Methods A Systematic review based on MEDLINE, Embase, and Cochrane databases was performed to identify articles related to PN. Studies involving ≥ 10 patients presenting PN according to Nantes's criteria who were managed with an intervention for their pain were reviewed. Data were extracted manually for qualitative analysis. Results Fifteen studies involving 672 patients (mean age 53.2 +/−5.1, SD 95%) were included. Nine different types of treatments were evaluated. Effectiveness of the treatments was heterogeneously assessed. Pain improvement was achieved in 41% to 100%, 13.4% to 100%, 60% to 100%, 12.2% to 100% in immediate, 3‐month, 6‐month, and 1‐year post procedure, respectively. Complications reported were all grade ≤ II of Dindo‐Clavien classification's. Given the heterogeneity of the outcomes measures and the lack of homogeneous prospective studies, no recommendation could be established to choose in between treatments. Methodological quality of the studies was heterogeneous. Conclusion Many treatments seems available for drug‐resistant PN. Given the heterogeneity of the outcomes measures and the lack of homogeneous prospective studies, no recommendation could be established to determine the best management strategy. Further studies about PN management are needed and should have common endpoint and follow‐up.