P Moscatiello1, D Carracedo Calvo2, L Yupanqui Guerra3, M E Rivera Martínez4, A Mendiola de la Hoza5, M Sánchez Encinas1. 1. Servicio de Urología, Hospital Universitario Rey Juan Carlos, Universidad Rey Juan Carlos, Móstoles, Madrid, España. 2. Servicio de Urología, Hospital Universitario Rey Juan Carlos, Universidad Rey Juan Carlos, Móstoles, Madrid, España. Electronic address: davidcarracedocalvo@gmail.com. 3. Servicio de Neurofisiología, Hospital Universitario Rey Juan Carlos, Universidad Rey Juan Carlos, Móstoles, Madrid, España. 4. Servicio de Rehabilitación, Hospital Universitario Rey Juan Carlos, Universidad Rey Juan Carlos, Móstoles, Madrid, España. 5. Servicio de Anestesiología y Reanimación, Hospital Universitario Rey Juan Carlos, Universidad Rey Juan Carlos, Móstoles, Madrid, España.
Abstract
INTRODUCTION: Pudendal nerve entrapment syndrome (PNE) is characterised by the presence of neuropathic pain in the pudendal nerve (PN) territory, associated or not with urinary, defecatory and sexual disorders. Surgical PN decompression is an effective and safe alternative for cases when conservative treatment fails. The aim of this study is to describe the first robot-assisted pudendal neurolysis procedure performed in our country. MATERIAL AND METHODS: We describe step by step the technique of robot-assisted laparoscopic neurolysis of the left PN performed with intraoperative neurophysiological monitoring on a 60-year-old patient diagnosed with left PNE. RESULTS: The procedure was performed satisfactorily without complications. After 24h, the patient was discharged from the hospital. We observed a 50% reduction in pain measured using the visual analogue scale 2 weeks after the procedure, which remained after 10 weeks of the neurolysis. CONCLUSIONS: Robot-assisted neurolysis of the PN constitutes a feasible and safe approach, enabling better visualisation and accuracy in the dissection of the PN. Intraoperative neurophysiological monitoring is useful for locating the PN and for detecting intraoperative changes after the release of the nerve.
INTRODUCTION:Pudendal nerve entrapment syndrome (PNE) is characterised by the presence of neuropathic pain in the pudendal nerve (PN) territory, associated or not with urinary, defecatory and sexual disorders. Surgical PN decompression is an effective and safe alternative for cases when conservative treatment fails. The aim of this study is to describe the first robot-assisted pudendal neurolysis procedure performed in our country. MATERIAL AND METHODS: We describe step by step the technique of robot-assisted laparoscopic neurolysis of the left PN performed with intraoperative neurophysiological monitoring on a 60-year-old patient diagnosed with left PNE. RESULTS: The procedure was performed satisfactorily without complications. After 24h, the patient was discharged from the hospital. We observed a 50% reduction in pain measured using the visual analogue scale 2 weeks after the procedure, which remained after 10 weeks of the neurolysis. CONCLUSIONS: Robot-assisted neurolysis of the PN constitutes a feasible and safe approach, enabling better visualisation and accuracy in the dissection of the PN. Intraoperative neurophysiological monitoring is useful for locating the PN and for detecting intraoperative changes after the release of the nerve.