Neuromuscular DiseasesNeuromuscular DiseasesНервно-мышечные болезни2222-87212413-0443Publishing House ABV Press57610.17650/2222-8721-2023-13-4-83-96LECTURES AND REVIEWSЛЕКЦИИ И ОБЗОРЫPudendal neuralgiaПудендальная невралгияhttps://orcid.org/0000-0001-7526-1553BorodulinaI. V.БородулинаИ. В.
Russian Federation

Build. 1, 2/1 Barrikadnaya St., Moscow 125993

125993 Москва, ул. Баррикадная, 2/1, стр. 1

https://orcid.org/0000-0003-4884-6884KovalevG. V.КовалевГ. В.
Russian Federation

154 Naberezhnaya reki Fontanki, Saint Petersburg 190103

190103 Санкт-Петербург, набережная реки Фонтанки, 154

Russian Medical Academy of Continuing Postgraduate Education, Ministry of Health of RussiaФГБОУ ДПО «Российская медицинская академия непрерывного последипломного образования» Минздрава РоссииClinic of High Medical Technologies, Saint Petersburg State UniversityКлиника высоких медицинских технологий ФГБОУ ВО «Санкт-Петербургский государственный университет»050120241340501202405012024Copyright ©; 2024, Borodulina I.V., Kovalev G.V.Copyright ©; 2024, Бородулина И.В., Ковалев Г.В.2024Borodulina I.V., Kovalev G.V.Бородулина И.В., Ковалев Г.В.https://creativecommons.org/licenses/by/4.0https://nmb.abvpress.ru/jour/article/view/576

Pudendal neuralgia is the most common type of neurogenic chronic pelvic pain and is defined as a chronic neuropathic pain syndrome caused by compression and/or neuropathy of the genital nerve and localized in the area of its sensory innervation. Pudendal neuralgia negatively affects daily activity and reduces the quality of life. The diagnosis of pudendal neuralgia is established on the basis of clinical manifestations and examination data in accordance with the Nantes criteria, while instrumental methods (ultrasound, magnetic resonance and computed tomography, electrodiagnostic methods) do not allow verifying the diagnosis due to significant limitations. Currently, there are no unambiguous recommendations and standards for the treatment of pudendal neuralgia, however, a combination of different methods and a personalized approach allows in some cases to achieve significant success and long-term pain control. The article highlights in detail the anatomical features of the pudendal nerve, examines the possibilities and stages of diagnosis of pudendal neuralgia, and provides an overview of therapeutic methods from the standpoint of evidence-based medicine.

Пудендальная невралгия является наиболее часто встречающимся типом нейрогенной хронической тазовой боли и определяется как хронический нейропатический болевой синдром, обусловленный компрессией и/или нейропатией полового нерва и локализующийся в зоне его сенсорной иннервации. Пудендальная невралгия негативно влияет на повседневную активность и снижает качество жизни. Диагноз пудендальной невралгии устанавливается на основании клинических проявлений и данных осмотра в соответствии с Нантскими критериями, при этом инструментальные методы (ультразвуковое исследование, магнитно-резонансная и компьютерная томография, методы электродиагностики) не позволяют верифицировать диагноз в связи со значительными ограничениями. В настоящее время не существует однозначных рекомендаций и стандартов по лечению пудендальной невралгии, однако комбинация разных методов и персонализированный подход позволяют в ряде случаев достичь значительного успеха и продолжительного контроля болевого синдрома. В статье подробно освещены анатомические особенности пудендального нерва, рассмотрены возможности и этапы диагностики пудендальной невралгии, представлен обзор лечебных методов с позиций доказательной медицины.

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