Clinical usefulness of quantitative thermal sensory testing in the diagnosis and surgical treatment of women with pudendal neuropathy.

Background: The aim of this study, conducted on women with pudendal neuropathy, was to evaluate the usefulness of quantitative thermal sensory testing (QTST) in the diagnosis, surgical management, and prognosis of the disease.

Methods: The study was conducted on 90 women with pudendal neuropathy. QTST in pudendal nerve sensory innervation territory was realized before and more than 24 months after operative pudendoscopy on most patients.

Perineural dextrose injections in the treatment of lower urinary tract symptoms and dyspareunia induced by obturator neuralgia.

Obturator neuralgia is commonly diagnosed and treated in orthopedics. It produces groin pain, sensory alteration in the medial thigh (dysesthesia, sensory loss, or pain), adductor muscle weakness and pain/restriction of hip movements. Basically, the clinical diagnosis of obturator neuralgia is made by producing pain during internal rotation of the hip against resistance ("obturator sign") or by extension and lateral leg movements.

Endoscopic transperineal pudendal nerve decompression: operative pudendoscopy.

Background: Pudendal nerve entrapment can produce a pudendal syndrome comprising perineodynia together with urinary, sexual, and anorectal symptoms. This syndrome can be treated surgically by the transperineal approach. By using an endoscope during the procedure ("operative pudendoscopy"), the surgeon has close-up visual control of each decompression steps, demonstrates the different levels of entrapment, and cuts the sacrospinous ligament under visual control.

Normative values of skin temperature and thermal sensory thresholds in the pudendal nerve territory.

Aims: The aim of this study was to define normative values of skin temperature and thermal sensory threshold in the pudendal nerve territory.

Methods: Warm and cold detection thresholds (using the method of limits) and skin temperature were measured in a group of 41 presumably healthy female volunteers aged 41 years (range: 23-66 years) at left thenar eminence and in the pudendal nerve territory. Outlying data were discarded and 95% normative values were derived assuming Normal distributions.