[Urological consequences of pudendal nerve trauma during orthopedic surgery: review and practical advice].
Pudendal nerve trauma is a rare complication of orthopaedic and traumatological surgery, which occurs after traction of the pelvis on an orthopaedic table fitted with a pelvic support. This trauma is generally due to crushing of the nerve against the central part of the table or stretching of the pudendal nerve due to excessive traction during fractures of the femur. the urological consequences of this neurological trauma present in the form of disorders of perineal sensitivity, which usually rapidly resolve spontaneously, or vesicosphincteric and/or erectile disorders, which have a more pejorative course and which can sometimes persist. The prognosis depends on the severity of the symptoms and the results of electrophysiological studies, which are reserved for serious lesions. This investigation identifies the level of the neurological lesion. Surgical decompression, rarely indicated, can be necessary in the case of serious and persistent sensory or motor lesions. Patients must be clearly informed about this possible neurological complication before an operation on the orthopaedic table as part of good surgical practice.
Service de Chirurgie Urologique, CHU Rangueil-Larrey, 31043 Toulouse. soulie.m@chu-toulouse.fr
Michel
M
Soulié
Nicolas
N
Vazzoler
Philippe
P
Seguin
Philippe
P
Chiron
Pierre
P
Plante
D007172:Erectile Dysfunction / Q000209:etiology; D005260:Female; D005264:Femoral Fractures / Q000150:complications* / Q000601:surgery; D006801:Humans; D008297:Male; D009437:Neuralgia / Q000209:etiology; D017773:Pelvic Floor / Q000294:innervation*; D010523:Peripheral Nervous System Diseases / Q000209:etiology*; D011379:Prognosis; D014555:Urination Disorders / Q000209:etiology