Role of interventional radiology in pudendal neuralgia: a description of techniques and review of the literature.
OBJECTIVE
The authors sought to evaluate indications, technical feasibility and clinical efficacy of computed tomography (CT)-guided pudendal nerve infiltration in patients with chronic anoperineal pain by reviewing the role of the CT technique in their personal experience and in the recent interventional literature.


METHODS
Twenty-eight women, mean age 50 years, and with a diagnosis of pudendal neuralgia on the basis of clinical and electromyographic criteria were enrolled in the study. CT-guided pudendal nerve injections were performed during three consecutive sessions held 2 weeks apart. In each session, patients received two percutaneous injections: one in the ischial spine, and the other in the pudendal (Alcock's) canal.


RESULTS
One patient dropped out of the study after the first session. At clinical assessment, 24h h after treatment, 21/27 patients reported significant pain relief. At follow-up at 3, 6, 9 and 12 months, 24/27 patients reported a>or=20% improvement in the Quality of Life (QOL) index.


CONCLUSIONS
In pudendal nerve entrapment, CT-guided perineural injection in the anatomical sites of nerve impingement is a safe and reproducible treatment with a clinical efficacy of 92% at 12 months.
Fanucci
E
E
Department of Imaging Diagnostics, Molecular Imaging, Interventional Radiology and Radiotherapy, Policlinico Universitario Tor Vergata, 00133, Rome, Italy. ezio.fanucci@libero.it
Manenti
G
G
Ursone
A
A
Fusco
N
N
Mylonakou
I
I
D'Urso
S
S
Simonetti
G
G
D000082:Acetaminophen / Q000008:administration & dosage; D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D000927:Anticonvulsants / Q000008:administration & dosage; D000928:Antidepressive Agents / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007052:Ibuprofen / Q000008:administration & dosage; D007267:Injections / Q000379:methods; D008875:Middle Aged; D009408:Nerve Compression Syndromes / Q000000981:diagnostic imaging / Q000188:drug therapy; D009437:Neuralgia / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D015641:Radiography, Interventional / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D000927:Anticonvulsants; D000928:Antidepressive Agents; D000082:Acetaminophen; D007052:Ibuprofen