title: [Evidence of pudendal neuropathy in Proctalgia Fugax: perineal neurophysiological assessment in 55 patients].
abstract: OBJECTIVE
  Proctalgia fugax (PF) is a very common condition especially in women. Causes and pathophysiological mechanisms of PF are unknown. Recently, a pudendal neuropathy was clinically suspected in women with PF. The goal of our study was to demonstrate, or not, such abnormalities by means electrophysiological testing.
  
  
  METHODS
  Fifty-five patients with PF (45 female and 10 male, mean age 50.2 years) were evaluated. EMG testing with motor unit potential analysis of pelvic floor muscles (bulbocavernosus muscle and striated external anal sphincter), study of bulbocavernosus reflex and pudendal nerve terminal motor latencies (PNTML) were performed.
  
  
  RESULTS
  EMG testing was altered in two males out of 10 (20%) and 29/45 females (64%). In women, denervation was found bilateral in 25/29 (86%). Sacral latency was delayed in eight out of 29 (bilateral in five cases, unilateral in three cases) and PNTML altered in 17 cases (13 bilateral alteration, four unilateral). A significant difference (P<0.002 Chi(2) test) was demonstrated between male and female concerning pelvic floor muscles denervation.
  
  
  CONCLUSIONS
  Pelvic floor muscles denervation was a common feature in women suffering from PF, due to a stretch bilateral pudendal neuropathy. Distal lesions of the pudendal nerves, principally due to a stretch perineal neuropathy, can be imagined as a factor or co-factor of PF.
authors.affiliation: Service de médecine physique et de réadaptation, CHU de Rennes, 2, rue Henri-Le-Guilloux, 35033 Rennes cedex 9, France.
authors.forename: M
authors.initials: M
authors.lastname: Damphousse
authors.forename: M
authors.initials: M
authors.lastname: Jousse
authors.forename: D
authors.initials: D
authors.lastname: Verollet
authors.forename: A
authors.initials: A
authors.lastname: Guinet
authors.forename: F
authors.initials: F
authors.lastname: Le Breton
authors.forename: P
authors.initials: P
authors.lastname: Lacroix
authors.forename: S
authors.initials: S
authors.lastname: Sheik Ismael
authors.forename: G
authors.initials: G
authors.lastname: Amarenco
mesh_terms: D004576:Electromyography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology* / Q000503:physiopathology; D010502:Perineum / Q000503:physiopathology; D060545:Pudendal Neuralgia / Q000150:complications*; D012007:Rectum; D012189:Retrospective Studies