The Experts below are selected from a list of 30 Experts worldwide ranked by ideXlab platform
Adelin Albert - One of the best experts on this subject based on the ideXlab platform.
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endoscopic transperineal pudendal nerve decompression operative pudendoscopy
Surgical Endoscopy and Other Interventional Techniques, 2018Co-Authors: Jacques Beco, Laurence Seidel, Adelin AlbertAbstract:Pudendal nerve entrapment can produce a pudendal syndrome comprising perineodynia together with urinary, sexual, and anorectal symptoms. This syndrome can be treated surgically by the transperineal approach. By using an endoscope during the procedure (“operative pudendoscopy”), the surgeon has close-up visual control of each decompression steps, demonstrates the different levels of entrapment, and cuts the sacrospinous ligament under visual control. The aim of this study was to describe the technical details of this new technique and its outcome in the treatment of the pudendal syndrome. A series of 113 patients with severe pudendal syndrome underwent operative pudendoscopy. A complete history, pain visual analog scale (VAS) for perineodynia, and four scores evaluating the main symptoms (ICIQ-SF, NHI-CPSI, St Mark’s, and Wexner) were obtained before and at least 24 months after surgery. The three clinical signs of pudendal syndrome (abnormal pinprick sensitivity, painful skin rolling test, and painful pudendal nerve) and perineal descent were analyzed before and after surgery in 91 patients. The mean operating time per side was 50.3 ± 15.2 min and the average hospital stay was 2.1 ± 0.4 days. Perineodynia VAS dropped from 7.2 ± 1.4 to 4.5 ± 2.9 after surgery (p < 0.0001) and the symptoms scores significantly improved. Frequency of sexual arousal syndrome, dyspareunia, and Cystalgia was also significantly reduced. Pathological perineal descent (≥ 1.5 cm measured with a Perineocaliper®) observed in 13 patients was reduced from 1.81 to 0.77 cm after surgery (p < 0.0001). The only significant complication was severe hemorrhage in one patient induced by an inferior gluteal vessel laceration and successfully treated by arterial embolization. A complete pudendal nerve decompression, from the distal branches to the sacral foramina, safely performed under visual control by using operative pudendoscopy markedly improves clinical signs and symptoms of the pudendal syndrome.
Jacques Beco - One of the best experts on this subject based on the ideXlab platform.
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endoscopic transperineal pudendal nerve decompression operative pudendoscopy
Surgical Endoscopy and Other Interventional Techniques, 2018Co-Authors: Jacques Beco, Laurence Seidel, Adelin AlbertAbstract:Pudendal nerve entrapment can produce a pudendal syndrome comprising perineodynia together with urinary, sexual, and anorectal symptoms. This syndrome can be treated surgically by the transperineal approach. By using an endoscope during the procedure (“operative pudendoscopy”), the surgeon has close-up visual control of each decompression steps, demonstrates the different levels of entrapment, and cuts the sacrospinous ligament under visual control. The aim of this study was to describe the technical details of this new technique and its outcome in the treatment of the pudendal syndrome. A series of 113 patients with severe pudendal syndrome underwent operative pudendoscopy. A complete history, pain visual analog scale (VAS) for perineodynia, and four scores evaluating the main symptoms (ICIQ-SF, NHI-CPSI, St Mark’s, and Wexner) were obtained before and at least 24 months after surgery. The three clinical signs of pudendal syndrome (abnormal pinprick sensitivity, painful skin rolling test, and painful pudendal nerve) and perineal descent were analyzed before and after surgery in 91 patients. The mean operating time per side was 50.3 ± 15.2 min and the average hospital stay was 2.1 ± 0.4 days. Perineodynia VAS dropped from 7.2 ± 1.4 to 4.5 ± 2.9 after surgery (p < 0.0001) and the symptoms scores significantly improved. Frequency of sexual arousal syndrome, dyspareunia, and Cystalgia was also significantly reduced. Pathological perineal descent (≥ 1.5 cm measured with a Perineocaliper®) observed in 13 patients was reduced from 1.81 to 0.77 cm after surgery (p < 0.0001). The only significant complication was severe hemorrhage in one patient induced by an inferior gluteal vessel laceration and successfully treated by arterial embolization. A complete pudendal nerve decompression, from the distal branches to the sacral foramina, safely performed under visual control by using operative pudendoscopy markedly improves clinical signs and symptoms of the pudendal syndrome.
Laurence Seidel - One of the best experts on this subject based on the ideXlab platform.
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endoscopic transperineal pudendal nerve decompression operative pudendoscopy
Surgical Endoscopy and Other Interventional Techniques, 2018Co-Authors: Jacques Beco, Laurence Seidel, Adelin AlbertAbstract:Pudendal nerve entrapment can produce a pudendal syndrome comprising perineodynia together with urinary, sexual, and anorectal symptoms. This syndrome can be treated surgically by the transperineal approach. By using an endoscope during the procedure (“operative pudendoscopy”), the surgeon has close-up visual control of each decompression steps, demonstrates the different levels of entrapment, and cuts the sacrospinous ligament under visual control. The aim of this study was to describe the technical details of this new technique and its outcome in the treatment of the pudendal syndrome. A series of 113 patients with severe pudendal syndrome underwent operative pudendoscopy. A complete history, pain visual analog scale (VAS) for perineodynia, and four scores evaluating the main symptoms (ICIQ-SF, NHI-CPSI, St Mark’s, and Wexner) were obtained before and at least 24 months after surgery. The three clinical signs of pudendal syndrome (abnormal pinprick sensitivity, painful skin rolling test, and painful pudendal nerve) and perineal descent were analyzed before and after surgery in 91 patients. The mean operating time per side was 50.3 ± 15.2 min and the average hospital stay was 2.1 ± 0.4 days. Perineodynia VAS dropped from 7.2 ± 1.4 to 4.5 ± 2.9 after surgery (p < 0.0001) and the symptoms scores significantly improved. Frequency of sexual arousal syndrome, dyspareunia, and Cystalgia was also significantly reduced. Pathological perineal descent (≥ 1.5 cm measured with a Perineocaliper®) observed in 13 patients was reduced from 1.81 to 0.77 cm after surgery (p < 0.0001). The only significant complication was severe hemorrhage in one patient induced by an inferior gluteal vessel laceration and successfully treated by arterial embolization. A complete pudendal nerve decompression, from the distal branches to the sacral foramina, safely performed under visual control by using operative pudendoscopy markedly improves clinical signs and symptoms of the pudendal syndrome.
A Vladimir M D Krasnov - One of the best experts on this subject based on the ideXlab platform.
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laser heat puncturing as highly effective method of post tuberculous Cystalgia treatment
Selected Papers from Seventh Internation Conference on Advanced Laser Technologies (ALT'98): Laser Methods in Medicine and Biology, 1999Co-Authors: V Ekaterina M D Koultchavenia, A Vladimir M D KrasnovAbstract:The tuberculosis of an urine bladder in men develops is authentic less often, and recovery is authentic more often, than in the women. In 39,1 percent of the women with nephrotuberculosis and urocystis and urocystis tuberculosis a specific cystitides is finished in development of post- tuberculous Cystalgia. One of starting mechanism of dysuria after the transferred urocystis tuberculosis in the women in menopause is hormonal insufficiency. The method of laser heat puncturing, developed by us, for the treatment this complication is highly effective, does not require additional introduction of medicines, can be executed as in hospitals, and in our-patient.
Albert Adelin - One of the best experts on this subject based on the ideXlab platform.
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Pelvic trauma and pudendal syndrome (post-traumatic pudendal syndrome)
2018Co-Authors: Beco Jacques, Antolak Stanley, Seidel Laurence, Albert AdelinAbstract:The pudendal syndrome can result from pelvic trauma but the link is difficult to prove. The study was intended to disentangle potentially linking elements of the post-traumatic pudendal syndrome, in particular perineodynia (perineal pain), one of the salient symptoms of the pudendal syndrome. Two case reports were used to illustrate the point. The study was based on 394 female patients of whom 216 (54.8%) had a history of pelvic trauma. Patients were further classified into mutually exclusive groups according to presence/absence of perineodynia and, for those with pelvic trauma, according to latency of pain appearance (pain before trauma, early onset, or late onset). Urge urinary incontinence, Cystalgia, anal incontinence and proctalgia fugax were found statistically more frequent in the pelvic trauma group. Perineodynia visual analog score, NHI-CPSI score and Wexner’s score were also significantly greater in traumatic patients. The three pudendal syndrome clinical signs were significantly more present in pelvic trauma patients than in non-trauma subjects. In the three post-traumatic perineodynia groups with different latency, only minor significant symptoms frequency differences were observed but importantly urge incontinence, Cystalgia, anal incontinence and proctalgia fugax remained more frequent than in the non-trauma perineodynia group for similar pain scores. Post-traumatic pudendal syndrome is a reality. Perineodynia, urge incontinence, anal incontinence, proctalgia fugax and Cystalgia are the most frequently symptoms encountered. These findings recommend performing a detailed history search for any symptom of the pudendal syndrome and a comprehensive clinical examination including its three clinical signs after any significant pelvic trauma.Peer reviewe
