Chronic pelvic pain after laser prostatectomy: Treatment by resection of the perineal branches of the pudendal nerve

Research output: Contribution to journalArticle

Abstract

Abstract Development of chronic pelvic pain after laser resection for benign prostatic hypertrophy has not been described previously (Clavien IIIb complication). The etiology of this chronic pain, which persisted despite medical chronic pain and urologic management for 5 years, was proven to be of pudendal nerve origin by local anesthetic blockade of the pudendal nerves bilaterally at the ischial spines. Surgical treatment was based upon the anatomic proximity of the perineal and dorsal branches of the pudendal nerve to the site of laser therapy on the pelvic side of the urogenital diaphragm. Treatment required resection of the perineal branches of the pudendal nerve bilaterally and neurolysis of the dorsal nerve to the penis bilaterally through incisions overlying the inferior pubic ramus. Relief of perineal pain and pain with micturition occurred in the immediate postoperative period. Pain relief and resumption of all normal activity occurred by 3 months postoperatively and continues 13 months following the surgery.

Original languageEnglish (US)
Pages (from-to)547-550
Number of pages4
JournalJournal of Reconstructive Microsurgery
Volume30
Issue number8
DOIs
StatePublished - Oct 1 2014

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Pudendal Nerve
Pelvic Pain
Prostatectomy
Chronic Pain
Lasers
Pain
Therapeutics
Urination
Prostatic Hyperplasia
Laser Therapy
Pain Management
Local Anesthetics
Diaphragm
Postoperative Period
Spine

Keywords

  • laser
  • prostatectomy
  • pudendal nerve

ASJC Scopus subject areas

  • Surgery
  • Medicine(all)

Cite this

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title = "Chronic pelvic pain after laser prostatectomy: Treatment by resection of the perineal branches of the pudendal nerve",
abstract = "Abstract Development of chronic pelvic pain after laser resection for benign prostatic hypertrophy has not been described previously (Clavien IIIb complication). The etiology of this chronic pain, which persisted despite medical chronic pain and urologic management for 5 years, was proven to be of pudendal nerve origin by local anesthetic blockade of the pudendal nerves bilaterally at the ischial spines. Surgical treatment was based upon the anatomic proximity of the perineal and dorsal branches of the pudendal nerve to the site of laser therapy on the pelvic side of the urogenital diaphragm. Treatment required resection of the perineal branches of the pudendal nerve bilaterally and neurolysis of the dorsal nerve to the penis bilaterally through incisions overlying the inferior pubic ramus. Relief of perineal pain and pain with micturition occurred in the immediate postoperative period. Pain relief and resumption of all normal activity occurred by 3 months postoperatively and continues 13 months following the surgery.",
keywords = "laser, prostatectomy, pudendal nerve",
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TY - JOUR

T1 - Chronic pelvic pain after laser prostatectomy

T2 - Treatment by resection of the perineal branches of the pudendal nerve

AU - Dellon, A. Lee

AU - Wright, Edward James

AU - Manson, Paul

PY - 2014/10/1

Y1 - 2014/10/1

N2 - Abstract Development of chronic pelvic pain after laser resection for benign prostatic hypertrophy has not been described previously (Clavien IIIb complication). The etiology of this chronic pain, which persisted despite medical chronic pain and urologic management for 5 years, was proven to be of pudendal nerve origin by local anesthetic blockade of the pudendal nerves bilaterally at the ischial spines. Surgical treatment was based upon the anatomic proximity of the perineal and dorsal branches of the pudendal nerve to the site of laser therapy on the pelvic side of the urogenital diaphragm. Treatment required resection of the perineal branches of the pudendal nerve bilaterally and neurolysis of the dorsal nerve to the penis bilaterally through incisions overlying the inferior pubic ramus. Relief of perineal pain and pain with micturition occurred in the immediate postoperative period. Pain relief and resumption of all normal activity occurred by 3 months postoperatively and continues 13 months following the surgery.

AB - Abstract Development of chronic pelvic pain after laser resection for benign prostatic hypertrophy has not been described previously (Clavien IIIb complication). The etiology of this chronic pain, which persisted despite medical chronic pain and urologic management for 5 years, was proven to be of pudendal nerve origin by local anesthetic blockade of the pudendal nerves bilaterally at the ischial spines. Surgical treatment was based upon the anatomic proximity of the perineal and dorsal branches of the pudendal nerve to the site of laser therapy on the pelvic side of the urogenital diaphragm. Treatment required resection of the perineal branches of the pudendal nerve bilaterally and neurolysis of the dorsal nerve to the penis bilaterally through incisions overlying the inferior pubic ramus. Relief of perineal pain and pain with micturition occurred in the immediate postoperative period. Pain relief and resumption of all normal activity occurred by 3 months postoperatively and continues 13 months following the surgery.

KW - laser

KW - prostatectomy

KW - pudendal nerve

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