Published in:
01-02-2020 | Neuropathic Pain | Short Communication
A minimally invasive, endoscopic transgluteal procedure for pudendal nerve and inferior cluneal nerve neurolysis in case of entrapment: 3- and 6-month results. The ENTRAMI technique for neurolysis
Published in: International Journal of Colorectal Disease | Issue 2/2020
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Background
Pudendal and cluneal nerve entrapment can cause a neuropathic pain syndrome in the sensitive areas innervated by these nerves. Recently, a new endoscopic minimal invasive approach for pudendal and inferior cluneal nerve neurolysis has been published in a cadaver study. The aim of our study was to describe the feasibility of this new approach and to evaluate the clinical outcome.
Methods
Fifteen patients underwent the ENTRAMI technique. The Numeric Pain Rating Scale (NPRS) and Patient Global Impression of Change (PGIC) were recorded at baseline and at 3 and 6 months after surgery.
Result
The average duration of intervention (skin to skin) was 139 min (range 50–270 min) for bilateral pudendal neurolysis and/or cluneal neurolysis and 113 min (range 100–130 min) for unilateral pudendal and/or cluneal neurolysis. No perioperative blood loss occurred. At 3 months, 50% of patients declared a more than 30% improvement of their PGIC, increasing to 57% at 6 months; 31% reported more than 90% improvement of PGIC at 6 months. Overall reduction of the average maximal NPRS score was from 9 (range 7–10) to 6 at 3 months (range 0–10; p value < 0.05) and to 5 at 6 months (range 0–10; p value < 0.05). There were no postoperative complications.
Conclusions
The ENTRAMI technique is feasibly in patients suffering from pudendal and/or cluneal neuralgia and preliminary results are promising.
Clinical trial number:
NCT03883178