Pudendal nerve block by transgluteal way guided by computed tomography in a woman with refractory pudendal neuralgia expressed like chronic perineal and pelvic pain.
Keywords
Abstract
OBJECTIVE
To demonstrate that the deep infiltration of the pudendal nerve guided by tomography is a good treatment option for patients with refractory neuralgia.
METHODS
Two cases of pudendal neuralgia are presented, both expressed mainly with pain in the perineal and gluteal areas. Both cases had changes in the skin and one with urinary symptoms. A deep trans-gluteal infiltration guided by CT scan was performed, administering bupivacaine 0.25% with 80 mg methylprednisolone.
RESULTS
In women, after infiltration, there was a decrease in pain from 6 to 3. In man infiltrations were performed monthly, completing 4. He reported pain reduction from 8 to 2.
CONCLUSIONS
Pudendal Neuralgia diagnosis is unknown. The most common cause is inflammation of adjacent structures to the nerve frequently caused by falling. Diagnosis is mainly clinical. Trans-gluteal infiltration guided by CT scan is an effective option in treatment.
