title: CT-guided percutaneous pulse-dose radiofrequency for pudendal neuralgia.
abstract: OBJECTIVE
  The purpose of our study was to evaluate the efficacy of computed tomography (CT)-guided percutaneous pulse-dose radiofrequency (PDRF) for the treatment of chronic pain in patients with pudendal neuralgia (PN) unresponsive to conservative approaches.
  
  
  METHODS
  From March 2010 to January 2012, 30 patients with a diagnosis of PN were prospectively enrolled in the study, 18 women and 12 men (mean age 47 years). A 20-gauge cannula with a 10-cm length was placed under CT guide in the pudendal (Alcock's) canal. After the spindle was removed, a radiofrequency needle with a 5-mm active tip was introduced. The appropriate needle placement near the pudendal nerve, without an involvement of the vessels, was confirmed with an injection of 1-2 ml of contrast agent. PDRF was performed with 1,200 pulses at high voltage (45 V) with 20 ms duration followed by 480 ms silent phases.
  
  
  RESULTS
  Twenty-six patients completed the study. Procedural success was achieved in all patients. Mean VAS scores before PDRF was 9 ± 0.7. Patients had a great improvement in pain intensity after 1 week by PDRF (mean VAS scores 3.8 ± 1.7, p < 0.05), with a stabilization of the symptomatology in the following months (mean VAS scores 1.5 ± 1.1 at 6 months by PDRF, p < 0.05) and excellent results after 1 year by the procedure (mean VAS scores 1.9 ± 0.7, p < 0.05).
  
  
  CONCLUSIONS
  In our preliminary experience, CT-guided percutaneous PDRF should be recommended for treatment of PN because we evaluated the tolerability of this procedure with satisfactory and encouraging results.
authors: Department of Diagnostic and Molecular Imaging, Interventional Radiology and Radiation Therapy, University of Rome - Tor Vergata, Viale Oxford 81, 00133, Rome, Italy, salva.masala@tiscali.it.
authors: Salvatore
authors: S
authors: Masala
authors: Eros
authors: E
authors: Calabria
authors: Alessandro
authors: A
authors: Cuzzolino
authors: Mario
authors: M
authors: Raguso
authors: Marco
authors: M
authors: Morini
authors: Giovanni
authors: G
authors: Simonetti
mesh_terms: D000328:Adult; D000368:Aged; D003287:Contrast Media; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010148:Intractable Pain / Q000000981:diagnostic imaging / Q000628:therapy*; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011446:Prospective Studies; D060545:Pudendal Neuralgia / Q000000981:diagnostic imaging / Q000628:therapy*; D061208:Pulsed Radiofrequency Treatment / Q000379:methods*; D011856:Radiographic Image Enhancement; D015641:Radiography, Interventional; D018570:Risk Assessment; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media