阴部神经痛的解剖学基础及治疗进展

阴部神经痛是发生于会阴部阴部神经支配区域的烧灼样,电击样,针刺样疼痛,是典型的神经病理性疼痛,其目前的患病率尚未准确统计、诊断和治疗均比较困难,患者长期遭受精神和身体上的双重折磨、生活质量低下。阴部神经常与阴部血管伴行共同走行于阴部神经管内,可分为三个主要的分支,即直肠下神经,会阴神经和阴茎/阴蒂背神经。不同分支病变将会导致不同部位的疼痛。其治疗方法目前主要包括保守治疗、阴部神经阻滞、阴部神经外科减压以及神经调控。本文就阴部神经解剖结构,阴部神经痛病因和临床表现,诊断及其治疗进展做一简要综述。

Pudendal Neuralgia: fromAnatomy to Treatment

Pudendal neuralgia (PN) is a debilitating neuropathic pain involving the innervation area of the pudendal nerve, with buring, electric, shock or pinking-like pain. Due to various reasons, the prevalence of this disease has not been statistically analyzed. Both diagnose and treatment of PN are difficult, so that the patients usually suffer from physical and mental torment for years, and terrifically affect the quality of life. The pudendal nerve along with its vessels often passes through the pudendal canal, and it can be divided into three branches: the inferior anal nerve, the perineal nerve, and the dorsal nerve of the penis or clitoris. Different branch lesions will lead to corresponding pains, where the branches innervated. At present the therapeutic method mainly contains conservative treatment, pudendal nerve injection, pudendal nerve decompression, and neuromodulation. This article briefly reviewed the anatomy of pudendal nerve, the cause of pudendal neuralgia and clinical manifestations, as well as currently available diagnostic and therapeutic methods.