title: Pudendal neuralgia after pelvic surgery using mesh: Case reports and laparoscopic pudendal nerve decompression.
abstract: Persistent pain after vaginal mesh surgery is a rare and agonizing entity that has devastating consequences for the patient's quality of life. Many etiologies have been blamed including nerve injuries and entrapments. Pudendal neuralgia is a rare chronic neuropathic pain syndrome in the anatomical territory of the pudendal nerve. Various treatment options, such as medication management, physiotherapy, nerve blocks, decompression surgery and neuromodulation, have been used, but the most appropriate treatment for pudendal neuralgia has not yet been determined. In this article, we present two cases of postoperative pelvic pain thought to be secondary to injury or mechanical distortion of the pudendal nerve after rectocele repair using mesh and tension-free vaginal tape sling. In cases of failed conservative treatment and of mesh removal surgery, laparoscopic pudendal nerve decompression and omental flap wrapping operation can be a treatment option for pudendal neuralgia.
authors.affiliation: Department of Urology, Faculty of Medicine, Canakkale Onsekiz Mart University, Canakkale, Turkey.
authors.forename: Eyup Burak
authors.initials: EB
authors.lastname: Sancak
authors.affiliation: Department of Urology, Memorial Atasehir Hospital, Istanbul, Turkey.
authors.forename: Egemen
authors.initials: E
authors.lastname: Avci
authors.affiliation: Department of Urology, Memorial Atasehir Hospital, Istanbul, Turkey.
authors.forename: Tibet
authors.initials: T
authors.lastname: Erdogru
mesh_terms: D019299:Decompression, Surgical; D005260:Female; D006801:Humans; D010535:Laparoscopy; D017699:Pelvic Pain; D060525:Pudendal Nerve; D060545:Pudendal Neuralgia / Q000209:etiology / Q000628:therapy*; D011788:Quality of Life; D013526:Surgical Mesh
keywords: laparoscopic pudendal nerve decompression; omental flap wrapping; pudendal neuralgia; rectocele repair; tension-free vaginal tape